A 10-year-old with a “bucket list”

After the death of Steve Jobs, a number of commentators noted how his technical genius and ingenuity increased exponentially after he was first diagnosed with pancreatic cancer. Given a finite time left to live, he delved into his work and revolutionized the world. He was able to accomplish much in his life knowing death was imminent.
But what happens when you’re just a child and you’re told that you only have a limited time left before you die? Are you able to comprehend what that means? Do you have a “bucket list” of the last few things you want to do or see?
For the past four weeks, my rotation was with the pediatric oncology service. Most of the patients I worked with were in remission and presented for their yearly checkup and a flu vaccine. Some were undergoing chemotherapy and were in the middle of their treatment cycle. Some had lost all their hair because of the treatments and some just had an upset stomach. But there was a girl whose life forever changed while I was there.
At ten years old, short and spunky, she had come in for routine post-chemotherapy follow-up. She had a history of a brain mass that was medically treated and surgically resected twice.
She had been in remission for almost a year. She had complete neurological function and her only complaint was that her head was hurting a lot more than usual. Head scans were completed and the radiology results confirmed our worst fears – her mass had returned and now it was invading the brainstem.
Both she and her mom knew it was possible for the cancer to come back. Unfortunately, they didn’t expect it to come back so soon, and if it did, her mother thought there were treatment options available. Her treatment options were already exhausted and the mass was now inoperable. As my attending and I sat down with the family to discuss her results and answer any questions, my little patient stepped out of the room. Her mom said she left because she didn’t want to hear that she was dying.
I followed her out to keep her company. She remained quiet for a while, but then said, “I’m sorry, I didn’t want to be inside. I don’t like seeing my mom upset.” I told her it was okay. But then she asked, “Why does God want me to die? Is it because I cussed yesterday? I really am sorry that I did.”
I didn’t know how to respond to that. Part of me was taken aback, surprised at how mature she was to know that the conversation across the hall between my attending and her family was about her death. But another part of me was angry. Someone must have mentioned to her that because of her cussing, she was being punished by death.
She began to cry. All I could do was console her. No words could mask the agony that she was feeling. She knew her childhood was coming to an end and there was nothing that could be done about it. As she calmed down, she said, “I just want to spend Christmas with my mom this year.” Her bucket list.
I cannot fathom what it is to have a finite time left in this world. I keep telling myself that I’m young, I have time left. But with patients like her and stories like Steve Jobs’, I‘m reminded that each of us has only a short time to fulfill our dreams and serve a purpose.
Speaking with my attending later that afternoon, I asked how long my patient will be alive. She told me at least four months…just in time for Christmas.

Hevil Shah, MPH, is a senior medical student at GHSU’s Medical College of Georgia. He may be reached at hevil.shah@gmail.com.

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