“It is stage 4” is too difficult to say.
His blue eyes look yearningly into those of his patient.
“I can’t really help you”, he is trying to say.
But not; his words speak of probability, outcomes, options.
Indirect, vague. Struggle.
The pelvic MRI: mashed potatoes.
The cancer in our patient’s rectum reaching into bladder,
Squeezing amongst hepatocytes.
Tunneling to allow urine with stool-ish swirl;
“It is likely advanced.”
But what does that really mean?
The language of metastases lost.
Or rather, the significance of which, never explained.
Pain = primary concern.
Morphine, 4 hrs clockwork. Insufficient.
His ribs reaching from disease, cachexia.
My inexperience: no guise, no screen to cloud severity.
The questions: surgery? Radiation? Hovers in air.
Curative intent non-existant, like butter in mashed potatoes.
Palliation a word not uttered today.
Next visit? I can only guess.
Wincing to stand. Pursed lips, slowly.
Hand shake, pleasantries postured.
Out again into the world,
Where cancer creeps, metastases distant.
“I just hope it’s not stage 4”, he mutters.