The most touching thing that happened to me at work over the last few weeks was a handshake. You might remember the patient that gave me this handshake. If not, you can read about him before or after you read this story. I wrote about him a few months ago in my “I Spoke Turtle” post. His name is Mr. J. I thought I would come almost full circle to tell you about the beginning of the end of his cancer journey. From my side of things, the end started with an impactful handshake.
I met sixty-one-year-old Mr. J in July 2022. He had 2-month history of abdominal and back pain and accompanying weight loss. After several investigations he was diagnosed with incurable pancreas cancer. I saw him in consultation to discuss palliative chemotherapy. We decided together to give chemotherapy a try.
My first impressions of Mr. J played out throughout the entirety of our relationship. He seemed humble. He was calm. He spoke softly. He listened hard. He chose his words carefully. He asked for the answers he needed. He was kind. He was in so much pain, yet he was grateful.
Treating Mr. J had an additional challenge. We did not speak the same language. He speaks and understands Korean. I speak and understand English. “Google Translate” is great for short interactions or word finding problems but it is not a feasible tool for fifteen-to-twenty-minute conversations about cancer symptoms or treatment side effects. But we managed, Mr. J and I, with the help of his daughters. He would bring one of his two daughters to each appointment. We talked through them and with them and I think we managed well.
Despite our best intentions and efforts, it was extremely hard to get treatment into Mr. J. We started off well enough using our most aggressive option for his type of cancer. Not without side effects, we managed to get four cycles into him in quick succession. The monitoring CT done after these initial doses showed promise. His cancer was not growing. With that result, he decided to take a treatment break to see if the presumed side effects of treatment, mostly fatigue, would dissipate. They didn’t, instead worsening, thus pointing to his cancer as the culprit.
Along with fatigue, his constipation and pain crescendoed, landing him in hospital three times within a couple months. We would manage to give him one more dose of chemotherapy before we both knew he was fighting a dominant foe. His cancer won. We made a plan for him to have pain and symptom management expertise but no further active cancer treatment. It was only eight short months after his diagnosis date. I discharged him from my care this week with palliative care support and the information he requested on medical assistance in dying.
A sort of miracle happened the last time Mr. J was in to see me. I had a resident working with me in that afternoon clinic. It is a common occurrence for a resident to be in my clinic. I work in a learning hospital affiliated with the university medical school in my city. Medical students and residents get scheduled into my clinic almost every week to learn how to see, talk to, and treat cancer patients. Coincidentally, or perhaps not, the resident that was working with me the day Dr. J had his last visit with me was Korean!! She was fluent in their shared language. I could not believe it! The universe served us this beautiful, precious gift to help us talk about death and dying.
As I was standing to leave the clinic room this week, Mr. J stood too. He outstretched his right hand in a gesture to shake my hand. I obliged. When my hand met his, my hand felt remarkably small. His hand was warm and soft. While we squeezed our hands together ever so gently, Mr. J took his left hand and wrapped it around the back side of my right hand, as if enveloping our handshake in a comforting hug. My right hand had all but disappeared in his gratitude. While holding our hands, he bowed ever so slightly and said thank you.
I said the only thing I could think of in that setting. You’re welcome. Our hands then dropped. I left the room a little more human than when I entered it.
Thank you, Mr. J, for your gratitude. I hope our handshake meant as much to you as it did to me. I also hope the middle and final parts of the end of your cancer journey are peaceful.
Author Notes:
A handshake can mean so many different things: hello; nice to meet you; goodbye; it’s a bet; great to see you again; see you soon; nice doing business with you; it’s a deal; thank you.
I’m a sucker for a proper handshake. I think we can learn a lot from a handshake: confidence, strength, kindness. No thank you to the flimsy variety. We all know those flimsy ones, or we should . . . a half a hand, or worse, a limp one, little to non-existent pressure, not getting solidly into the thenar web space (that skin between the thumb and index finger that to me is the sweet spot of a good shake). Man, the flimsy ones can leave me with an awkward feeling. But give me a solid right hand in right hand, with the proper pressure, and a small shake and I’m hooked.
The Covid pandemic was hard from many reasons, one of which was the limit it placed on humans to be physically near to each other unless part of a “bubble”. In my doctor world this translated into masking, literally hiding our faces from our patients, and whenever possible, not touching people. The not touching included handshakes. Not only could my patients not see my face, but I lost the ability to greet them and say good-bye in a way that I believe offers the suggestion of partnership. This week Mr. J reminded me of the power of touch.
At home with those closest to me, I’m the biggest softy for a delicious snug hug. Hugs soothe me and calm me and make me feel better about, well . . . about everything. My favourite people know I hold a hug longer than most people, every single time. A few extra seconds is gas in the love tank, mine for sure, hopefully theirs too. Sometimes, I wish I could hold a hug forever and never let go of the comforting moments they afford. That type of touch, where a full, deep breath can be taken into the lungs and where you can almost feel the beating of the other person’s heart, is so precious. There is a lot of safety in these hugs. It’s rare to share a hug with a patient, especially these days. In lieu of a hug, I hope the handshakes I share with them squeeze them in a way they trust I will do the best I can for them.
I am curious to know, reader, what does touch mean to you? Do you have a favourite handshake story?
