Stage 4 cancer: Do doctors worry about delivering bad news?

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Once again I am awake in the middle of the night. 

Our house is small, and we have lived in it for 40 years. It is a comfort to me. I feel safe, cozy within these walls. Alone in my bed, I am covered with not just a quilt and comforter, but also a weighted blanket. It must weigh 40 pounds. I had heard they often provide a sense of security for a fitful sleeper. I have found that true. 

It is white and thick and shaggy and I named it Polar Bear. And yet, here I am, awake again. 

Tomorrow we will have the video call with a Stanford doctor who will tell us more about Michael’s cancer. We have waited and waited for this information. I wonder if the doctor is also awake thinking about this call. 

Do doctors absorb the fear we project? Do they worry about the phrasing they will be using? Surely they know we will be listening to the words spoken but also for the words left unsaid. The tone of the doctor’s voice.

I wish I could call him right now while in the dark of night. He would have his phone to his ear and I would do the same. Quietly, he would tell me that all will be well. Then we could each slip back into a dreamless sleep knowing the sun will come up in the morning and a new day will begin. 

I can hear Michael in the hall with his walker. I can’t tell if he is going back to his new sickbed, separate from me, or out to the couch to try to get comfortable. After waiting a few minutes and letting the quiet settle back in, I leave my bed. I am going in search of something to soothe my sour stomach. Cheerios and milk sound like the perfect solution. 

I am surprised to find Michael on the couch. He has made a fort of cushions and pillows trying to achieve a relatively painless position for sleeping. He waves his hand to me as I head into the kitchen. I wave back, but don’t speak. If he is close to finding that place of dreams, I don’t want to pull him away with my voice. 

In the kitchen, I am annoyed at how everything seems too noisy. The cereal pouring into the bowl. The refrigerator door opening and closing. The silverware drawer as I open it. 

I send silent apologies to Michael for disturbing his sleep. 

Back in bed, I eat most of the cereal and, after turning out the light, lie in the darkness and finally sleep comes.

In the morning, just before the appointed time for the call, I put on lipstick. I am in my pajamas and appear to have been up partying all night, but am determined to put on a light coat of dusty rose to impress the doctor. 

It’s for good luck. Michael is even more determined to impress the doctor and has taken a shower and put on clean sweats. Showoff. 

We sit side by side at the kitchen table waiting for the video call to begin. We hold hands. We look out the kitchen window. We wait. 

I wonder if later in the day I will think of this time as the minutes before the walls caved in on us, or will the news be good and I will be relieved to finally make it to this point in his diagnosis.

We stare at the phone waiting for the connection. The doctor comes on. He has a kind demeanor. We have never met, so he introduces himself and we do the same. 

Cut to the chase, I want to say. But don’t. 

He shows us scans and images and explains what he believes will happen next. A tumor board will look everything over in one week, and the following week, the team will advise us on what we might do. What is possible. He is not mentioning what stage the cancer is and I am triggered by that omission. I believe if I were him and the stage was early I would lead with that in this conversation. 

So, as he finishes his presentation, I ask. Can you tell me what stage it is? I am holding Michael’s hand. 

“It is stage 4,” he replies, looking and sounding as if he did not want to reveal that piece of information. I have sympathy for him. And again, I wonder if he was kept awake the night before, wondering how to give us that news.