Day: 4

Time: 08h00

Place: Surgical Ward

“Dr. Baker, can we speak?”

Dr. Baker turns to see the social worker for the Surgical Department standing behind him with her arms crossed. “Ok, Nancy. You look serious.”

“I am. I believe we need to meet with Fred Johnson and discuss the next steps for his treatment and how best to support everyone. His partner, Eric, says they haven’t had an update from you since surgery.”

“That is correct. I’m waiting for the specimen results. Let’s check together for the results, and if they’re back, plan to meet with them both later today.”

Dr. Baker signs into one of the nursing station computers and quickly navigates to Fred Johnson’s results, “Ok, they’re back. Now, let’s see…”

Dr. Baker looks through the results and sees that Fred has a terminal diagnosis with the spread of his cancer.

“Ok, Nancy. This is not good. I knew it would be pretty bad, but not terminal.”

“Oh. That makes it very important for us to talk with him today. What are his options?”

“I’m thinking that we could offer radiation to a couple of the areas, along with chemo. All this would be palliative and could extend his life another six months to even a year. No treatment, he probably has less than a year. So the pain of chemo may be worth it, but it’s up to them to decide.”

“I agree that it’s their choice, and I’ll support them to make this decision. Is there a rush on this decision?” asks Nancy.

“No, I don’t believe so. A few days here or there is not going to make a big difference. I do need to consult with the Cancer Agency to make sure that I’m correct. I’ll call them now. Can you set up a meeting for later today with the Johnsons and the nursing staff caring for him?”

“Yes, I’ll talk to the charge nurse now and get things set up. Say 3pm?”

“Good. I will have more answers then. Thank you.”

Time: 15h00

Fred and Eric meet with Dr. Baker and the nursing staff, along with Nancy, to discuss goals of care and the next steps in treatment. Fred’s children attend by speaker phone so that everyone can hear firsthand the results of the tests and the suggested treatments and outcome.