Bookend

Can’t talk now

A student reflects upon life on the wards and looks for ways to improve communication.

I met him in the emergency room. As a third-year student, I now performed many basic procedures on a daily basis but this case was a first for me. The physical examination was unremarkable until I discovered a large, bleeding, irregular mass where his prostate should have been. From that moment, I knew the man had cancer.Subsequent work-up confirmed diagnosis, metastatic rectal carcinoma, but what disturbed me most was that, as far as I could tell, nobody informed the patient for over 36 hours. Yet in that time he was subjected to a series of rectal exams by grave-faced physicians. A biopsy and CT scan were performed to confirm suspicions. Within 10 minutes of my discovery, we were already detailing his poor...

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