Pretty Little Butcher: Memoirs of a Female Thoracic Surgeon

a special kind of friendship

Recently, two of my patients came back to my outpatient department for a checkup after being previously discharged from the hospital. The operation I performed was successful and they both seemed to have recovered well. They also both needed treatment with chemotherapy, however, so I told them that I would refer them to a medical oncologist for further care.

Before they left, they said the same thing to me.

"Will I ever see you again?"

As we all know, cancer surveillance is of great importance. Even after the treatment is completed, patients are advised to come back for a checkup every three months for the first two years to make sure there's no recurrence. My patients expressed that they wish to continue seeing me since I'm so nice and they like me. They chose me, they said.

And I realized that I felt the same way, that I would like to continue seeing them—not that I want to hang out, but I'd love to see how they are doing a few months or even a few years from now. Lung cancer generally has a poor prognosis, but some people battled against it and survived. My teacher told me about a patient who had so far lived for more than a decade after the surgery, and every year he came to see him, waited for hours outside his outpatient department (my teacher is a famous surgeon with lots of patients), just to see him, give him some fruit he grows himself, and wish him a happy new year.

I wish I could have that kind of relationship with my patients too. Not that I want free fruit, but doctors and patients have something unique and intimate, even though we may not know much about each other's lives outside the hospital.

There was, however, this one patient I know very well. He is a great photographer, one of my close friends, loves coffee and coffeehouses as much as I do, and we used to go on short overnight trips with a group of our mutual friends. When he called me one evening in April, I was just thinking that I hadn't seen him in a while.

He gave me a copy of the CAT scan of his chest. I knew with one glance that it wasn't good.

I arranged for him to be admitted to the oncology ward the next day, have a sonography-guided biopsy of the tumor, and I decided that I should be the one to plant a chemo port for him—I had done this small procedure for over 400 times and I sincerely believed I was the best at this job. A chemo port is a small device buried under the skin for the administration of chemotoxic agents and it can be implanted while the patient is awake.

This is all routine work for me, but for the first time ever, I found myself worrying about the pettiest things when it came to him. Should he stay at a two-person room (cheaper) or a single-person room (more private)? Is the temperature in the operating room too cold? Does he like the music we play? Should he stay in the hospital and wait for the pathology report, or should he go home first and come back when the result is back? Is he bored during his stay? Maybe I should ask him to leave the hospital for a few hours and join me and my husband for dinner, since this is our part of the city. What if he doesn't like the doctor I suggest for him? What if he is unhappy with anything but is too polite to tell me because he doesn't want to be a bother?

My friend was diagnosed with Hodgkin's Lymphoma and is now cured. He comes to my house with lots of upscale gadgets and makes coffee for us, we still hang out often, our friendship seems to be going strong, but he now refers to me as his lifesaver instead of Chris.

Sometimes I wonder what would happen if things hadn't gone well; would I be able to offer him the best advice and not let my emotions cloud my judgment? Would he be able to swallow all hard feelings if I had made a mistake? Would he be able to speak his mind if he had doubts and complaints? Would I be able to let go if things had taken a wrong turn?

More importantly, is it a good idea to be the doctor of your friend? How about the other way around? Should doctors be friends with their patients?

I have colleagues who are very open about sharing their social media, phone number and even address with patients, and some of them even go out with patients' family members afterwards when they're no longer the patients' doctors. I agree it might improve the patient-physician relationship if they can see that we're human beings behind that white coat, but I always prefer keeping my personal and professional life separated.

I want to be kind, considerate, and friendly, but I'm not their friend. My patients can receive the best treatment I can possibly offer, I'll always look out for them, but they don't need to see photos of me barbecuing over the weekend or videos of me dancing (horribly) when I go clubbing.

The door was pushed open once again. The person to visit my outpatient department this time was the 17-year-old girl who experienced a spontaneous pneumothorax, which is air in the pleural cavity that causes collapse of the lung. I did a mechanical pleurodesis for her and it would decrease the chance of her having another episode in the future.

Stitches were removed and the wounds looked to be healing well. Her parents told me that she was going to have a big test a few days later and I wished her luck on that.

"You don't need to come back anymore after this visit," I told them.

They understood. Her condition was taken care of, and a pneumothorax isn't like cancer. She doesn't need routine checkups unless she feels unwell.

"Hope I never see you again," I said.

They all laughed. They thanked me with grins before leaving.

I sat in my chair and smiled to myself. Some people aren't meant to be in my life forever. We shared a short time in the hospital together, she left feeling good, and we'll both try our best in our respective fields. She was a wonderful, cooperative patient, she never complained, and she trusted me.

I hope she has a great life ahead of her.