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The Best Option of Care

Updated: Mar 30, 2020

DANILEA M. CARMONA MATOS, MS3

San Juan Bautista School of Medicine


As aspiring physicians, we look forward to providing care. We find joy in serving and finding solutions that can better our patient’s outcomes. With this mindset, I set out for my first-time shadowing opportunity at a local Hematology and Oncology clinic. Dr. Y., knowing I was just a first-year medical student, would use basic science to help me understand the medications used and their mode of action. Before each encounter, she made time to discuss the patient’s case and where she was at with their treatment. It truly felt empowering to see how much we could do for this patient population. However, the most important lesson came in with Mrs. M.


Mrs. M. was a 94-year-old female patient accompanied by her son. She had been diagnosed with multiple myeloma a few years prior. Although she had shown signs of improvement, that day, results showed that the M spike at the gamma region had significantly increased. Unfortunately, despite their best efforts, it seemed the disease had significantly progressed. I could see tears in the patient’s eyes as her son held her hands. They hoped for a miracle treatment that would make it go away, even I did. However, there it was - the best option of care was to fully transition into palliative care. Dr. Y. assured them, she would continue to look for options; however, being 94 years old and with such delicate health, available treatments could possibly lead her to a more delicate state rather than help cure her disease.


That afternoon, I found myself facing the truth about our limitations. The truth was, there was a treatment; the problem was, it wasn’t appropriate for Mrs. M. While we may feel empowered through the many ways to care for disease, we must never forget the importance of being humble in considering the best way to provide a life with dignity through our care. Unfortunately, there will be times when aggressive treatments can leave our patients closer to death than to a cure. Like Dr. Y., I hope I will too look for options until I have exhausted them; however, I learned that in doing so, I should never leave aside life and quality of life for that matter.

Acknowledgements: The author would like to thank Ms. Rachael E. Guenter, Dr. Martha E. García Osorio, M.D. and Dr. Estela S. Estapé, Ph.D. for their review and valuable suggestions on an early version of this Letter to the Editor

Disclosures: The author has no conflicts of interest to disclose.

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