Published Fall 2024
As the ink on my medical degree was still drying, I covered a hospital’s oncology service at night, taking care of cancer patients admitted for chemotherapy. The prognoses of the patients were variable: Some underwent aggressive treatment with anticipated remission; others received brief palliative treatment to improve their quality of life before the end. The experience taught me how medicine deals not only with disease itself, but with the dis-ease that both illness and life circumstances create.
I recall in powerful detail a woman in her 60s with stage IV lung cancer in her liver and bones. The oncology team measured her remaining time in weeks and months rather than years. In the evenings, I would give the woman morphine for her pain. She often requested extra doses to mitigate the ravages of disease.
It wasn’t always pain that preoccupied her, though. Her children and ex-husband could not or did not come to see her. No visitors sat by her bedside. Her frustrations emerged in unseemly ways. She lashed out at the nurses caring for her: cursing at them, screaming at them, making awful accusations about their competency or concern. Every night a different nurse took care of her so others wouldn’t get burned out. They often called me to help deal with the patient’s anger — outbursts amplified by solitude and abandonment.
During a singularly challenging evening, the patient asked to see me. I found myself at her bedside, standing uncomfortably as she railed against my incompetence as a physician, accusing me and the nurses of abandoning her and ignoring her suffering. She told me how horrible her life was, how she needed it to end. Finally, she begged: “Please, just kill me. Give me enough morphine to end it. I’ve suffered enough!”
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Aaron Rothstein, M.D., is an EPPC fellow in the Bioethics and American Democracy Program and an attending neurovascular physician and neuroepidemiologist. He completed his neurovascular fellowship at the University of Pennsylvania and his residency in neurology at the NYU School of Medicine. He received a B.A. in History from Yale University and his M.D. from the Wake Forest School of Medicine.
