ofvarious kindstheyweretolerable.Afollow-up scan
showedthetreatmenthadn’tworked,though.Thetumors
grew. They began giving her shooting pains in her pelvis.
Sheswitchedtoathirdkindofchemotherapy.Thisone
was more effective—the tumors shrank, the shooting
painswentaway—butthesideeffectsweremuchworse.
Herrecords reportedher havingterriblenauseadespite
trying multiple medications to stop it. Limb-sapping
fatigue put her in bed for hours a day. An allergic
reactiongaveherhivesandintenseitchingthatrequired
steroidpills to control. One day, she becameseverely
shortofbreathandhadtobebroughttothehospitalby
ambulance.Testsshowedshehaddevelopedpulmonary
emboli,justasSaraMonopolihad.Shewasputondaily
injectionsofabloodthinnerandonlygraduallyregained
her ability to breathe normally.
Thenshedevelopedclenching,gas-likepainsinherbelly.
She began vomiting. She found she could not hold
anythingdown,liquidorsolid.Shecalledheroncologist,
whoorderedaCTscan.Itshowedablockageinaloopof
herbowelcausedbyhermetastases.Shewassentfrom
theradiologydepartmenttotheemergencyroom.Asthe
generalsurgeononduty,IwascalledtoseewhatIcould
do.
Ireviewedtheimagesfromherscanwitharadiologist,
butwecouldnotpreciselymakeouthowthecancerwas
causingherintestinalblockage.Itwaspossible thatthe
bowelloophadgottencaughtonaknuckleoftumorand
thentwisted—aproblemthatcouldpotentiallyresolveon
its own,if giventime. Or elsethebowel had become
physically compressed by a tumor growth—a problem