Tell Me What’s Happening

Five months into my oncology fellowship, I was tasked with my first solo consultation during the first week of my palliative rotation. I entered the room and was struck by how young and calm Jane was. At age 34, she was being treated for cervical cancer that had now metastasized to her brain. She had come into the emergency department with her aunt the night before, reporting intractable shoulder pain and increasing bilateral lower leg weakness. Recent magnetic resonance imaging results showed that Jane’s disease had progressed to her brain, spine, and shoulder. She was wearing a fentanyl patch on her shoulder from a pain physician in Boca Raton.