Bad News.

Delivering bad news is one of the toughest parts of the medical profession. Unfortunately, I have had to witness this twice since I started my Women's Health rotation. It hurts every time, and I honestly don't see it getting any easier. I have always gotten attached to people very quickly and for my own heart's sake I have to do better about keeping an emotional distance.

1. Leiomyosarcoma: Google it. It is a rare, soft tissue malignancy and in this particular case began in the uterus. Luckily, the CT scan was negative so it has not spread which is the only real silver lining. The patient is asymptomatic and it was an incidental (blessing) finding when her uterus was sent to pathology following a hysterectomy. She will need to see a GYN oncologist in Indianapolis to manage her case and will likely join a clinical trial because these cancers historically do not respond well to chemotherapy or treatment in general. It was just so shocking to the patient and her family because she feels great, but is then told she has a rare cancer which doesn't have a good prognosis. She is a wonderful person and has an amazing attitude which will help her fight this battle.

2. Miscarriage: This couple came in for an ultrasound for their initial prenatal visit....She was 9 weeks pregnant and there was no heart beat visible on the ultra sound. They did a transvaginal ultrasound just to be sure...still no heart beat. One of the hardest parts is knowing what you are looking at on the screen and knowing the news they are about to receive and you look over at this smiling, elated couple who has no idea . Everyone in that room had a broken heart in that moment. There were tears, questions, and disbelief. I almost lost it too.

I haven't been able to get these patients off my mind this week as I wonder how they are doing after receiving such bad news less than a week ago. I hope they are coping, I hope they have someone to cry to, a shoulder to lean on, and a support system.