<p>Watching a child lose the battle with cancer isn’t easy. Dr Saro Jacob shares the story of a young mother who did it with rare fortitude.<br /><br /></p>.<p>The Wednesday morning OPD was busy, and I had my hands full with patients in the outpatient area as well as those who were on treatment in the Linear Accelerator room. The reception nurse informed me that little Karen (name changed to protect identity) had come with her mother to see me.<br /><br />Karen was a six-year old girl, very thinly built, as she had been battling cancer since she was two. The little one was diagnosed with Rhabdomyosarcoma, a muscle tumour in the right cheek. She underwent surgery, radiation therapy, and multiple lines of chemotherapy at various centres. Her last chemotherapy was two months ago at our centre. Sadly, the disease was too stubborn; the tumour kept recurring. The disease being resistant to all known modalities of treatment, the paediatric oncologist had quietly suggested that the only option was best supportive care.<br /><br />As a rule, I never allow oncology paediatric patients to wait for long for my consultation. I decided to see Karen in the hallway for a quick consultation, as she was lying down on the waiting hall bench. Her mother had partially covered the girl’s face with a mask. I could get a stench so pungent and characteristic of dead and decaying tumour cells. Growing from her mouth was an ugly mass of malignant tissue so voluminous that she seemed attached to it. Her mouth was open completely wide with the tumour and there was a thready space through which the child could take in fluids. Her right eye was nearly shut by the mass pushing it. There were maggots coming and going out from a small opening at the side of the tumour. I almost gasped aloud! As doctors, we have an unwritten rule in our conduct to patients, that we must remain inert in times of deep grief and shock. But in all my practice of Medicine, I had never seen anything so cruel. I was not prepared for this sight. I think the child’s mother would not have missed the disbelief and tears in my eyes.<br /><br />I excused myself for another urgent work and headed to the restroom to gather my thoughts. What is the meaning of all this? Why does this tender, harmless little one have to endure this? What will her thoughts be when she watches other children? Does she crave to have chocolates? Does she itch to be in the playground? Does she have questions? Will they be answered? Will mine be answered?<br /><br />Over a coffee break, I discussed with my colleagues the option of reirradiation of little Karen’s tumour, for whatever benefit it may have. As I called her mother, a young lady, barely in her mid-twenties, for the treatment plan for palliation, I was struck by her composure and calmness to discuss an issue that she knew would be over in a few weeks. As the lady walked away from my room and cradled the child in her arms, I almost stood to salute this mother who was living a warrior’s life. History records men and women who have climbed Mount Everest, swam the English Channel and brought independence to nations. It will not record this strong woman who is learning to say good bye to the most precious thing in her life. As she left, she quietly thanked me and I looked into the eyes of one of the bravest women I will ever know.<br /><br />(The writer is head of radiation oncology at Bangalore Baptist Hospital)</p>
<p>Watching a child lose the battle with cancer isn’t easy. Dr Saro Jacob shares the story of a young mother who did it with rare fortitude.<br /><br /></p>.<p>The Wednesday morning OPD was busy, and I had my hands full with patients in the outpatient area as well as those who were on treatment in the Linear Accelerator room. The reception nurse informed me that little Karen (name changed to protect identity) had come with her mother to see me.<br /><br />Karen was a six-year old girl, very thinly built, as she had been battling cancer since she was two. The little one was diagnosed with Rhabdomyosarcoma, a muscle tumour in the right cheek. She underwent surgery, radiation therapy, and multiple lines of chemotherapy at various centres. Her last chemotherapy was two months ago at our centre. Sadly, the disease was too stubborn; the tumour kept recurring. The disease being resistant to all known modalities of treatment, the paediatric oncologist had quietly suggested that the only option was best supportive care.<br /><br />As a rule, I never allow oncology paediatric patients to wait for long for my consultation. I decided to see Karen in the hallway for a quick consultation, as she was lying down on the waiting hall bench. Her mother had partially covered the girl’s face with a mask. I could get a stench so pungent and characteristic of dead and decaying tumour cells. Growing from her mouth was an ugly mass of malignant tissue so voluminous that she seemed attached to it. Her mouth was open completely wide with the tumour and there was a thready space through which the child could take in fluids. Her right eye was nearly shut by the mass pushing it. There were maggots coming and going out from a small opening at the side of the tumour. I almost gasped aloud! As doctors, we have an unwritten rule in our conduct to patients, that we must remain inert in times of deep grief and shock. But in all my practice of Medicine, I had never seen anything so cruel. I was not prepared for this sight. I think the child’s mother would not have missed the disbelief and tears in my eyes.<br /><br />I excused myself for another urgent work and headed to the restroom to gather my thoughts. What is the meaning of all this? Why does this tender, harmless little one have to endure this? What will her thoughts be when she watches other children? Does she crave to have chocolates? Does she itch to be in the playground? Does she have questions? Will they be answered? Will mine be answered?<br /><br />Over a coffee break, I discussed with my colleagues the option of reirradiation of little Karen’s tumour, for whatever benefit it may have. As I called her mother, a young lady, barely in her mid-twenties, for the treatment plan for palliation, I was struck by her composure and calmness to discuss an issue that she knew would be over in a few weeks. As the lady walked away from my room and cradled the child in her arms, I almost stood to salute this mother who was living a warrior’s life. History records men and women who have climbed Mount Everest, swam the English Channel and brought independence to nations. It will not record this strong woman who is learning to say good bye to the most precious thing in her life. As she left, she quietly thanked me and I looked into the eyes of one of the bravest women I will ever know.<br /><br />(The writer is head of radiation oncology at Bangalore Baptist Hospital)</p>
