Storm Warning

Sometimes oncologists spend the day performing strictly as oncologists - asking questions, listening, poking, inspecting, talking on the phone, giving orders, looking at x-rays or arcane columns of numbers. The casual observer might characterize this routine as akin to watching a cat in the middle of its siesta. I believe the term is soporific.

Ahem...no offense taken; in fact, we call this "Having a good day at the office."

Despite the urge to get down on bended knee and ask for every day to be like this, all docs worth their salt know that such prayers will fall on deaf ears. The rigmarole of office hours may be mundane, but the smart ones know it can be interrupted at any time with a crisis. They know that it takes more than adherence to the strict rules of efficiency to earn a reputation they can be proud of. Great doctors must wield talents that appear as mysteriously as watching a friend pick up three apples and juggle them - who would have guessed he could do it?

One of the talents doctors must have is the ability to predict a change in the status of their patients, not unlike meteorologists conjuring up a forecast from the jumble of data sent in from our orbiting skywatchers. Oncologists must learn the skill of anticipating problems from the clues their patients give them, just as the weatherperson on T.V. tells us whether or not to bring our umbrella to the ball game.

It's hard to be correct all the time. Recently I felt my radar go off when a patient of mine came in for her last chemotherapy treatment. I warned her that the last cycle is traditionally the hardest to recover from. She laughed at my nagging, but listened carefully.

Ten days later she ended up in the intensive care unit. While admitting her I could hear the distant thunder and tried to prepare her as best I could, but the fury of her pneumonia still shocked us both when it hit. May every doctor have the foresight and wisdom to know when to give out a storm warning, even if the tempest passes by. As the saying goes, "Keep a eye on the skies," and if turmoil hits, keep up hope for a change in the weather.

The slope of the sides of the vast funnel became momently less and less steep. The gyrations of the whirl grew, gradually, less and less violent. By degrees, the froth and the rainbow disappeared, and the bottom of the gulf seemed slowly to uprise. The sky was clear, the winds had gone down, and the full moon was setting radiantly in the west, when I found myself on the surface of the ocean...

A Descent into the Maelstrom, Edgar Allan Poe