Meeting my first patient

It was the day I met my first patient. She was a French woman in her mid-60s, who had been admitted for an elective anastomosis after the removal of a locally advanced cancer of the rectum a year previously. She had received radical surgery, chemotherapy, and radiotherapy. This had necessitated her using a stoma bag. She looked healthy, if slightly overweight, but she said she was attending an exercise class.

I took her history, observing the standard procedure outlined in the briefing session, but I was puzzled as to why I had to ask so many apparently irrelevant questions. I presumed it was a safety measure to cover every conceivable eventuality relating to the health of the patient. I also met her husband and we talked about France, where I spent much of my childhood, before scrubbing up to assist in her operation.

I went to see the patient a day after the operation, and she was obviously in pain. The doctors reassured her that this was normal. They ensured that she had active bowel sounds and that there was no postoperative ileus and then encouraged her to start eating as soon as possible. Despite not being hungry, she forced herself to eat but vomited up what she swallowed; she did not manage to pass any stools. Anxious to cooperate with the medical staff, she persisted valiantly. Over the next five days when I visited her I noticed she was pale, and her condition and appearance did not seem to improve.

One day I overheard her speaking in French to a friend on the telephone, proudly stating she had broken wind. This was a good sign of clinical progress. In spite of her …