Theyweresuchsimplewords,butitwasn’thardtosense
howmuchtheycommunicated.Ihadgivenherthefacts.
ButbyincludingthefactthatIwasworried,I’dnotonly
toldherabouttheseriousnessofthesituation,I’dtoldher
thatIwasonherside—Iwaspullingforher.Thewords
also toldher that,althoughI fearedsomethingserious,
there remained uncertainties—possibilities for hope
within the parameters nature had imposed.
Ilet her andher family take inwhat I’d said.I don’t
rememberDouglass’sprecisewordswhenshespoke,but
Irememberthattheweatherintheroom hadchanged.
Cloudsrolledin.Shewantedmoreinformation.Iasked
her what she wanted to know.
Thiswasanotherpracticedanddeliberatequestiononmy
part.Ifeltfoolishtostillbelearninghowtotalktopeople
at this stage of my career. But Arnold had also
recommended a strategy palliativecare physicians use
whentheyhavetotalkaboutbadnewswithpeople—they
“ask, tell,ask.” Theyaskwhat youwant tohear,then
theytellyou,andthentheyaskwhatyouunderstood.SoI
asked.
Douglasssaidshewantedtoknowwhatcouldhappento
her. I said that it was possible that nothing like this
episode would ever happen again. I was concerned,
however, that the tumor would likely cause another
blockage.She’dhavetoreturntothehospitalinthatcase.
We’dhavetoputthetubebackin.OrImightneedtodo
surgerytorelievetheblockage.Thatcouldrequiregiving
heranileostomy,a reroutingofhersmallboweltothe
surfaceofherskinwherewewouldattachtheopeningto