What Doctors Do When a Patient Dies: The Dr. Joelle Hamilton Story


Update 2/8/17

What’s God Got To Do With It?

“Everything – this job would weigh anyone down without an abiding faith that God’s plan will come to pass.” That is Dr. Joelle Hamilton’s response to the title.

I’ve met some doctors who thought they were God. Not Dr. Joelle.  She knows a doctor is not God. A doctor cannot perform miracles.  She accepts that.

That does not mean she cannot work in partnership with The Almighty to give the patient every last moment on this earth that Our Maker has deemed to be.

She adds to that. “However He deems. The Lord gives and the Lord takes away, blessed be the name of the Lord.”

There are those who are too young, and do not think about death.  As you get older, the specter of death looms ever more prominent.

“As it does for those who are around death a lot”.  That is Dr. Joelle’s perspective that would be worth thinking about.

You say, I am a favored person of Dr. Joelle, she will give me more attention than others, because I have written about her. It doesn’t work like that.

Every patient is her favorite, and she devotes time to them on a medical basis and a personal basis. She sits there and writes on her chart as you talk, not leaving anything to chance.  In fact she writes so much, in order to accommodate it on her chart, she writes small, very small, and only she and an ant with glasses can read it.

“Yes otherwise known as micrography.” We mustn’t forget Dr. Joelle’s sense of humor or the fact she works crossword puzzles, and comes up with some words that haven’t been used since the time of Caesar and “The Ides of March”.

Might I suggest taking a Webster’s Unabridged Dictionary to her office for your appointment in case she uses a gem or two from her word collection.  The Webster’s Dictionary that is 6 inches thick, and weighs 15 pounds.  However if you know what the word quotidian means, you might not need a dictionary, because that indicates you have your own word collection.

But humor is short-lived. She turns quickly to what she does. “I think though that I do take seriously the responsibility for those in my care. I answer to you (or the person for whom I care) but greater than that, I answer to the Almighty.”

Dr. Joelle does treat atheists, if they should have an appointment, and leaves it for them later to determine whether they have conformed to their religious beliefs. She says it is a privilege to care for people of any faith.

I often do not write everything that I am aware of about a person, Dr. Joelle in this instance. How she tries to adjust to normalcy at the end of the day, and to be the same person she was that morning before she came to work, to go home to her family and be a Mom and a wife.

She describes the pressure of day-to-day, and the necessity to always be right, rechecking a situation 4 or 5 times, for the news to be sometimes is death.  Other people would cringe at the thought of having to do it. She is much more diplomatic in what she says than I could be, and I imagine most of the people reading this. Maybe that’s from practice over the years, but I have to believe no two cases are alike, and demand different approaches every day, a new way of telling someone.

She agrees. “They do really require a lot of different communication styles, or interactions – each person really is different.”

I do not mind talking about my case.  I’ve done it before. I’d hope someone who experiences what I have faced for years might learn something from what I have been through.

Dr. Joelle and I have had some trying times with my medical situation. The latest involving a few active cancer cells running around in my body.

I’ve taken Zytiga since May. The name Zytiga may not mean that much to many of my readers, but it means a lot to me, one of the strongest chemo drugs taken orally, and one of the best.

For several months until the end of November Zytiga and I set sail on a course of cancer remission (some doctors do not like the term remission which probably creates a false narrative of what is actually happening).

Then at the end of November my PSA spiked more than it should. Tests, as I have previously written, were performed. There was nothing outwardly revealing.

Early in this New Year (a slight delay because of the holidays) my PSA had stabilized, not gone down, but stabilized. What does that mean? That means I live for the next PSA.

What will my next PSA be?  I have no idea. Dr. Joelle has no idea. She does prophesy about those few loose cancer cells running around in my body, and that Zytiga has been in the attack mode from the end of November and continuing on those particular cells as well as the others it was already fighting. Does Zytiga continue to win the war? I wish I knew. Dr. Joelle wishes she knew.

I do have metastatic cancer, because it moved from my hip to my ribs some time ago. We are guessing that the cancer on my ribs is the demon that released those new, few cancer cells that are still roaming around in my body.

When you don’t have cancer, you don’t pay that much attention to it unless there is a close relative with it. When you have cancer, you tend to read whatever you can find.

Dr. Joelle reinforces that thought.  “I’m sure it is the thought that never manages to escape – wondering or worrying about it.”

Cancer cells are just normal cells until they mutate which is a fancy word for change. Why do they mutate?  If you knew that, you could change the world forever.

“AMEN!!!” That may be the most profound statement Dr. Joelle made the entire time I was talking to her.

Dr. Joelle is a medical doctor, not a researcher.  It will be the researcher, who is often a doctor specializing in the research field, who will eventually discover that.

It’s almost as though cancer has a brain.  The first time Zytiga entered my body, my cancer started transforming itself, mutating again, into a form that is immune to the Zytiga.  Regardless of what kind of cancer you have, all cancers are constantly changing to outsmart the cancer drugs, and that includes the drip, drip, drip of the IV drugs.

I may be sitting here right now with my PSA going up again, which probably means Dr. Joelle will be telling me that my cancer has metastasized again, which is the worst news I could expect. There is another drug to be tried, if need be, and that would be the next course of action.

Why do I even bring my case up? The reason is that my case is only mid-range of the complicated cases Dr. Joelle has.  Imagine anything worse than mine.

Dr. Joelle asks no sympathy in what she does. She thinks this is what she is supposed to be doing, hematologist/oncologist, which as I have said before brings her the worst of the worst cases.

She does have release mechanisms that give her relief from her day-to-day.  I know the aggregate of all of those, but I do not choose to write about them. From time to time, considering her gregarious personality, she does post one of those on Facebook, where she looks like she is having a good time, but don’t be fooled. There is much beneath the surface.

God does give us a certain amount of time on this earth. Dr. Joelle would much rather her patients be cognizant of their surroundings and people among them. She will resort to palliative drugs if necessary, but prefers a clear mind if possible up until the end.

You may think this is not the doctor you would prefer if you have cancer, a really bad cancer. Do as you will.  As for me, I’m sticking with Dr. Joelle, no second opinion required, even if her current opinion is a very bad diagnosis.

I can look through life with miserable eyes, but sometimes I choose to be uplifting in the way I act, and what I say.

Dr. Joelle likes my one-liners, and at the end of the med sessions I always try to leave her with one or two. Perhaps the best yet is the one about the mandolin.

Through the density of her job, Dr. Joelle has found playing the mandolin is a good tension release. She’s taken lessons for three years.

One day as we were at the end of my appointment, I looked at her, very seriously, and said, “Dr. Joelle, do you mean I have to sit here and listen to you play the mandolin, or you won’t give me my PSA results?”

Here I thought all the while she would play, “Saint Anne’s Reel”.  She said that’s the one she practiced. Instead it would be the old folk song “Liberty”. Does she ever have confidence that she is ready to play it?  Well, just listen to her.

“And I think that Liberty will be up and ready for prime time.”


I thought she was shy about playing the mandolin.

Update 12/12/16

I knew the call was coming—From Dr. Hamilton, from Dr. Joelle Hamilton.

How does she prepare for the call? Anxious? Anxiety-driven? Does she make the call now? Does she wait? Procrastination? Why? Results won’t change. Wait. She’ll look at the scan again. Verification. She gets a second opinion. She dials my number. And hangs up. She dials it again. The phone rings. She hangs up again. She calls it a third time. It rings and rings.  What needs to be said? She’s said it before. Just say it. She confessed to this. That’s the only way I knew.  What she went through.

Doctors treat their patients, but there is always news about whether they will live or die. That is the nature of Dr. Joelle Hamilton’s chosen profession as a hematologist/oncologist, the worst of the worst in terms of percentage of people who die compared to other medical practices.

And there is no one else to inform the patients of their fate other than Dr. Hamilton.  No one.  No full time surrogate to go around to all the patients at Urology Centers and deliver that type news.

I’m sure there were courses in medical school to equip her and any other doctor for this very thing, but that was classroom theory.  When the patient must be told, there is only the doctor and the patient, and perhaps relatives whom the patient agrees should be present.  Privacy laws are such these days that protocol must be followed to the letter.  She cannot read to the patient the proper procedure for death from a textbook.

Dr. Joelle Hamilton had rather be face-to-face to deliver bad news, but this was Friday afternoon, December 9th, no way to make it to her office after I had been over to Brookwood Hospital for a CAT scan and a bone scan, and didn’t return home until late enough in the afternoon that my wife and I could not go to her office. And I certainly didn’t want it hanging over my head the entire weekend.

I knew Dr. Joelle, I don’t think she would object to my telling my readers that is what I call her, had already received the results of the scans, the CAT scan was the one I was most concerned about. I had talked to one of Dr. Joelle’s assistants on another matter, maybe an hour before, and she told me the scans’ results were in their office via computer, both CAT and bone scans.

The phone rang. I looked at the caller ID. It was Urology Centers. I knew it was Dr. Joelle.

I didn’t pick it up on the first ring, I went to the third or maybe third and a half, our phone goes to message on the fourth ring.

Frankly I don’t know what I was doing or thinking. Was my life supposed to flash before my eyes in those two or three rings? Well, if it was supposed to, it didn’t.

I was tired from the Brookwood ordeal, and I was sure Dr. Joelle was tired from a strenuous day, and it was not courteous of me to keep her waiting.

You must remember Dr. Joelle is in crisis mode almost every day because of the severity of the cases she treats. I doubt few of us can understand how she gets up in the morning and faces the day. She is lucky if she has only one death to deal with in a week.

When I picked up the phone, I’d know whether I would continue living, or have to get my affairs in order. How long would I have, a month, three, five, six? There was the uptick in my PSA, and no other logical explanation, the cancer had spread.

I was being a coward in not picking up the phone. Dr. Joelle was not being a coward. She was calling me.

How many of these calls had she made, or more than likely how many patients had she told their cases were terminal, face-to-face, not by phone?

She too has to prepare herself for this, it just doesn’t happen automatically after all these years, prepare psychologically, emotionally. There is personal pain for her, personal pain deep inside of her, because that is not just a patient sitting across from her, or lying in bed, it is a human being, a person who is important to many people, and there may be memories attached when they are gone, but the lack of their presence never ends.

Here are Dr. Joelle’s own words. “When I get a difficult result, I like to confirm the data. Sometimes if a radiologist is not aware of previous scans, I will ask them to make an addendum to the report after comparison. After all, these are life and death decisions. If I can pull up the scan I will do that if I need to verify the interpretation.  While it can be scary that the word interpretation is used here, there is a definite art to the science of medicine. It is like what is injected into writing.  There’s experience, judgement, and gut to it. Similar to scans or any other medical decision. Intuition maybe.”

She continues, “The bad calls or visits really do require mental and emotional preparation. I like to know bad news in advance and process it emotionally and scientifically. I call it chewing on it in the back of my head. Right now I am chewing on a negative path report (not mine) that I think is likely a sampling error (did not get the intended tissue) so it is important to explain it accurately so the patient is not misled into thinking ‘I am cancer free’ when in actuality they have cancer but we didn’t capture it with the little 2 mm biopsy needle.”

I thought this was interesting what she said in her own words.  “I also like to know bad endings of movies, TV shows, books in advance. While watching a series on Amazon (Justified) I read ahead the blurbs of content for each show so I will be prepared if something terrible happens. Then I don’t stand there shocked and stunned, full of inaction. Well, that is an exaggeration, as I should be sitting there full of inaction while watching a show. But you get the point. Preparation seems to me to be vital to decision-making. Unless it is an emergency, then do the best job with the best information available.”

Do my readers like to know the ending in advance?

The doctor, like the patient, holds out hope.  There is the point where the test results once verified tell the doctor the truth, the absolute truth, and nothing but the truth, and they must speak.

I’ve interviewed countless people over the years. Sure what a person is saying tells you what you need to know, but often times I can tell from how the first word is said, the voice inflection, what someone is about to tell me. Would that be the case with what Dr. Joelle was about to say?

People have anticipation in receiving phone calls all the time. But this was not an ordinary phone call. It was death. It was life. Some readers may think I am being over dramatic. Put your life on the line, and tell me how you would be reacting.

I picked up the phone. There was that inflection on the first word, and I knew. The conversation could have ended there. The news was good. It was not yet my time.

Scans are relative, and doctors and radiologists when they read the scan must reference it to the results of all prior known scans.  That even checked out.

Why would Dr. Joelle have any hesitancy in calling me with such good news? Why? Because if 50 qualified experts read the scan and pronounced the results positive, there is always the possibility of that one small spot, almost microscopic, that was undetected. And she doesn’t want to have to go back later, and temper the news. But folks, I’ll thank the Good Lord for what is known now and move on. And that I don’t have to depend on the fact that a small needle did not get the correct tissue to biopsy my results, as Dr. Joelle pointed out in what she said.

In my time of having prostate cancer going back to its origin in 2002, I have never had the PSA to be wrong. Never had a false glitch in the PSA, but here it was.

That did leave me with a dilemma. If I have been given more time on this earth, what am I supposed to do with it? Even that question cannot be answered by Dr. Joelle.

I asked myself that question three or four years ago, and went on to do a couple of writing projects, in view of the fact at that time I thought I had been given extra time here. At my age, writing is about the only thing I can contribute to society now, and whether what I do is important to people only they can say.

Now I have even more extra time, and I sit here dumb about what I am supposed to be doing. I have written over 300 stories for my blog, some of them in which people told me what I wrote about them was the best of what had ever been written about them. I know that’s an exaggeration, but any writer likes to hear that.

So now I face another type of problem. A much more pleasant problem than I faced just a few hours before when I did not know.

Oh, in case I forgot. Thanks, Dr. Joelle for giving me my life back.

As I look out the window at the last glisten and glimmer of twilight, I notice a slight light which I regard as Dr. Joelle’s smile streaking across the sky, for she is afforded very few smiles.  All of this my imagination? Perhaps.

Then again on this day of all days, this Friday, December 9, 2016, this day that began badly, and ended well, I visualize all things as possible.

Update 12/7/16

I was traveling along with my longevity (learned to spell that word without spell-check) when I got into early November.

Bam. A brick wall fell on me, I looked around to see if that brick wall had a name. I shuffled through the dust and debris and found a wooden plaque that said, “Fatigue”. The brick wall didn’t ask to see my driver’s license before it fell on me. How did it know who I was?

Me and cancer and fatigue have been traveling buddies for a long time. There has been and at times still is, fatigue, extreme fatigue, super fatigue, and my new one forever fatigue.  Forever fatigue is when you have to go to bed in the early afternoon because you basically have the energy to do nothing else. You struggle to get out of bed to eat supper, etc. Anyway you get the picture. That was a fatigue I did not know the parameters of.

I had an appointment scheduled with Dr. Joelle Hamilton on December 2nd, and I thought initially, well, this fatigue is like any other, I’ll get a break after four or five days. I’ll get two or three days with little or no fatigue.  I strung it out and kept thinking that would happen.

I didn’t want to bother Dr. Joelle because she always has a line of patients that go all the way out the door and around the block. Kinda looks like it’s the new iPhone on sale rather than a doctor’s office.

Finally I ran up to about three days before my appointment, and had to e-mail her that night to acquaint her with my forever fatigue that wouldn’t let go. I’ve seen bulldogs that when they bite, they can’t hold on for that long.

She called me the next morning. Now you have to remember Dr. Joelle is one of the sweetest, nicest, gentlest, soft-spoken people that I know in her conversations. The exception is when it comes to greeting me.

I realize Dr. Joelle took Protocol 101-105 in med school, and it says she must be PC in calling patients by their surname, but when there is so much formality in her voice as she says, “Mr. Nelson”, I feel like I should be wearing a tuxedo in order to talk to her. Mr. Nelson makes me feel older than I am, and I’m plenty old already. I’m always tempted to say, “Me Bob, you Dr. Joelle”, in the best basic Tarzan words.

Dr. Joelle is the only woman I know who, if she and I were stranded on a desolate island for seven years (the one where they thought they found Amelia Earhart), and we wound up with more recipes for coconut than Forrest Gump did for shrimp, would greet the rescue boat as it drew to shore, and the first words out of her mouth, as she looked at me, and then introduced me to the rescuers, she would say, “This is Mr. Nelson”.

She acknowledges my trepidation in her phone call to me, and said when I came over they would check me for everything. She’s done that before and before.

I get there and she goes through a check-down list. She listened to my heart. I was hoping she would say I had a kind heart, but she didn’t. She listened to my lungs, and asked if I had any additional habits since our last meeting. I told her I was trying to continue breathing more.

She said I needed to go for a couple of scans to see what the cancer was doing. I hadn’t had one for about six months. That would be a CAT scan and a bone scan.

She sent me over to the blood-extraction station. The nurse normally takes a tiny syringe or two from most people, but she was taking a quart of blood from me for the many, many tests. Do you realize how large the syringe is when the nurse takes a quart of blood, and the length and size of the  needle?

Most people are in and out in a jiffy with barely time for a greeting with the nurse. It takes a while to draw a quart of blood, in fact enough time that I knew the nurse’s history dating back to the 14th century before she was finished.

I told her if she had any of my blood left over after all the tests, to save it for me, and I’d pick it up next time. I realize Dracula is pure fiction, but on those spooky nights when the wind is howling, and the torrential rain is falling, and a black carriage appears in the driveway, I see no reason why one cannot have a supply stashed away in the fridge when the doorbell rings.

Dr. Joelle asked if I had any more comments or questions. I told her I preferred longevity over croaking, because I had just learned to spell longevity without any assistance, and thought that knowledge should not go to waste.

Anyway the day comes for the scans, and I’m thinking to myself, what a great Christmas present I am about to receive—the cancer has spread.

Dr. Joelle, quite the optimist, assured me before I left her office on the 2nd because of my down PSA thanks to the wonderful drug Zytiga (with one confusing exception), that she’s betting my cancer has not spread, but they had better take a look. I asked her if that was Las Vegas odds on the no cancer spread. I saw that glint in her eyes, and immediately stood up because I thought she was going to swat me in the head with her clipboard. I knew when I stood up, she couldn’t reach my head because she’s only a tall 4’ 11” or a short 5’ 0”.

I’m over there for the scans, and they bring out these two 20 ounce plastic cups of a mix I must drink for the CAT scan. It’s something masquerading as lemonade with very little sugar in it. Even though I’ve done this before, I keep forgetting that after you take about three or four sips, you realize it’s 120 proof lemons, and I become cross-eyed from the tangy taste. I am fortunate though because when the scan tech comes to escort me back to the scan room, she shows me the real one of the four doors that I see.

This concoction has a metallic taste just below the surface that reminds me of the taste in my mouth when I was IVed with chemo years ago.

I suggest that I think a $12 box of buttered, movie popcorn would be good for me to munch on while she is doing the scan. She will have none of that, and proceeds.

Then the CAT scan is over, and they turn me loose to go to the cafeteria to eat before I have the bone scan. This is at Brookwood Hospital, and the times I’ve been in Brookwood, I do not recommend the food. However, the cafeteria is a different matter, because the food is good.

Then I’m back for the bone scan which is a minor inconvenience in the scheme of out-patient.

Now I go home and sit by the phone a day or two, waiting for Dr. Joelle to call me with the results of the scans.

The phone finally rings, it is Dr. Joelle, and she says, “I have the results of the scans.”…………………………. Stay tuned.

Update 10/30/16

Why do you do it?

“You only have to look into a child’s eyes once,” Dr. Joelle Hamilton says, with an emotion that is on the precipice of showing itself.

This is why Dr. Joelle Hamilton takes her medical knowledge and ability to other countries, both for children and adults, but it is the children whose innocent, penetrating eyes staring back at her that is most unnerving. When it is time for shots, the older children try not to wince, and the younger ones cry, some of the children having never seen a doctor before, but then Dr. Hamilton talks to them in the universal language—she hugs them.

2001 India and Peru

2009 Dominican Republic twice

2010 Dominican Republic, Haiti post-earthquake

2012 Dominican Republic

2013 Honduras

2015 Haiti

So many countries, so many languages. “The good news”, she says, “is that medical words in Spanish, Creole, French, English, and even Hindu are often so similar that most of us pick up the language pretty well.”

She breaks it down so succinctly, “It is always a privilege to take care of people. I am blessed to have been able to go in the name of our local Presbyterian Church (and our agency Mission to the World) to share God’s gifts with His people. Matthew’s Gospel also points to caring for those who do not have plenty – and our responsibility to share the gifts given by God.

While caring for people in India after their earthquake 2001, we simply prayed to ourselves when we served as it was a threat to our translator’s health and safety to share that we are Christians. In other places, we pray for people with their permission, but I also want them to feel free to simply receive healthcare. God knows who each person is, and if He wants me to care for a person in a different way, He has unusual ways of letting me know!!!”

Original Story—10/01/16

In the discussions of my cancers, they have centered around me, and have not included much about the doctors involved. I think I owe them a tip of the hat, and a few words about their work.

All of my doctors at Urology Centers of Alabama, which is based in Birmingham, have kept me alive using one treatment or the other, but now comes Dr. Hamilton with her super med called Zytiga.

Dr. Hamilton is a hematologist/oncologist.  If you don’t think realizing that she is the next doctor you will see at Urology Centers doesn’t scare the hell out of you, you haven’t fully grasped the situation.

Having an oncologist is bad enough, because you think you might be about ready to die. With a hematologist/oncologist you know you gonna die.  Unless………………………………….

Let’s backtrack here to my first doctor at Urology Centers, Dr. Albert Tully. I always call my doctors by their first names with doctor in front of it. I’m not sure when I first saw Dr. Albert, but I do know he diagnosed my prostate cancer in 2002. He sent me over to Dr. Roland Dumas at Brookwood Hospital for radiation treatment of the cancer.

When Dr. Albert retired, then came Dr. Tom Moody. I like the sound of the word remission when there is talk of cancer, and I may have had some of that, at least for a while.

Then in 2008 or 2009 my PSA started performing like a yo-yo, and I had to go for a shot every three to four months for cancer because of the fluctuations in the PSA. Sometimes if my PSA was within the 4 or less range, and wasn’t yo-yoing, I got to skip the three or four month shot, but picked it up on the next three or four month cycle.

For you men who think a less than four on your PSA is the trigger for treatment, let me tell you as someone who knows, it’s the vicissitudes of the PSA, and not the absolute of 4 or less. You get a PSA that’s going up and down, and doctors have more concern for that than an absolute less than 4.

What always impressed me about Dr. Tom, I had to call him Dr. Tom II because my Internist that I had gone to longer was Dr. Tom I, what impressed me was the work that he did in the communities, especially in the Black Belt to begin with, of going out on a Saturday in the Urology Centers RV when he could be sitting in comfort in his own home, and taking the blood to run PSA tests on men that eventually ran into the thousands, number-wise.

Initially Urology Centers paid for this testing out of all the doctors’ pockets, until finally they were able to obtain a federal grant that paid for the processing of the blood work by an outside lab.

Dr. Tom II saved more than one man’s life. I know because I wrote about him in a story I did for “Senior Living”. Then Dr. Tom II retired from Urology Centers, but not his PSA work.

I became a patient of Dr. Bryant Poole a little over a year ago, and his Physician’s Assistant Ashley Martin.  I have other doctors outside of Urology Centers, but if there is a finer medical duo than these two, I have never met them, and don’t think I ever will.

Dr. Albert and Dr. Tom II are urologists. Dr. Bryant is an oncologist. Dr. Hamilton, or Dr. Joelle as I call her, did not join Urology Centers until June of this year, and that’s when I became a patient of hers.

Dr. Bryant could have kept me as a patient, and I would have been fine with that, but he very unselfishly felt that adding a hematologist for my treatment was in my best interest, and I will always remember that as one of the kindest acts I have encountered on my journey.

Before I met Dr. Joelle, I had a picture in my mind of the person I was about to meet.   I was aware that one of the local colleges had the retired Commandant of the United States Marine Corps as its President, and I thought, goodness sakes, they’ve gone out and found the retired Five Star General of the Army. I stood at attention and practiced my salute in the mirror. I thought about asking Dr. Bryant and Ashley about Dr. Joelle, but I didn’t know whether I could withstand the shock of reality.

Then came the meeting day. My wife and I were in the patient room with the door closed. There was a timid knock on the door, and this diminutive lady, maybe five feet two and a 100 pounds on her overweight day, enters the room. Her overweight day is when she has discovered a half gallon of Blue Bell Ice Cream in her freezer at home, and eats a bowl of ice cream, not the whole half gallon, well maybe two bowls of ice cream.

At first I brushed it aside as another nurse come to get another quart of blood for testing.

“Hello,” in a very soft angelic voice, she said, “I’m Doctor Joelle Hamilton.”

What I thought at that very moment is that I was already dead, and just didn’t know it. Then I thought what an amazing feat that Urology Centers had been able to pull off.

Then I thought about the things I should have done in life and didn’t in anticipation of this moment arriving.

Then I thought about the things I had done, and wish I hadn’t.

Then Dr. Joelle reached out to shake my hand, and I said to myself, “Do angels really shake hands with people?

Dr. Joelle is one of the most thorough doctors I have ever run into. All of my doctors at Urology or otherwise are always thorough. I guess as a hematologist she has to go that one step further, order that one or more test to be sure.

Doctors are busy people, but Dr. Joelle and I have been able to sneak in a word or two after she has discussed the med angle. I was able to ask her something about doctors I have often wondered, but never asked.

She is the first lady doctor I have ever had, and maybe I thought she would be more revealing than all of my gentlemen doctors who might like to display a tough exterior, and would not want to be totally forthcoming on what I was about to ask.

“Dr. Joelle,” I asked, “when one of your patients dies, what do you feel, I mean behind the scenes that no one else other than your medical colleagues see?”

When I was in Brookwood Hospital with a cluster of blood clots threatening my life in May, Dr. Bryant had come by early in the afternoon of my discharge day to see how I was doing. I was only in Brookwood from about 7 one night to five the next afternoon.

He didn’t have to see me, because the way it is set up now, an in-hospital doctor, Dr. Bell in my case, was technically responsible for my care, and not Dr. Bryant. Dr. Bryant was concerned personally for me. I knew then doctors have compassion that sometimes they cannot show in an office setting.

I was certain that Dr. Joelle had visited her patients in the hospital over and over, though not necessary.  I could tell. I am a writer. I read people very well. That’s my job, otherwise I would be a lousy writer. There are varying opinions about that.

Dr. Joelle allowed me into the inner circle of her and her colleagues. A privilege not everyone enjoys.

She revealed that when a patient dies within their group, regardless of whose patient it is, they sit down in a gathering and console each other. In fact there had been an unexpected death recently, a patient of another doctor in the practice, and that had hit the doctor of that patient very hard. They all came together to try and console that doctor, fully realizing that very thing could happen to them the next day. In this instance they found time early, but in some cases, because of their complex, complicated schedules which include operations if they are surgeons and emergency treatments for all of them, the therapy sessions are delayed.

Dr. Joelle was quite reluctant to tell me of her own personal situation when other colleagues are not around, and when she had visited someone in the hospital one day, and during the night they died, and she had been informed of it the next morning. But she did finally tell me.

All day it would be on her mind, and it would follow her home, and into a sleepless night.

Then she cries.

She cried twenty-four years ago when her first patient died, even though she had used everything within her God-given talent to save that patient.

And she still cries now.


  • I only found your blog this morning, and already the two posts I have read touched me because I am currently experiencing similar situations. The first was about BCBS (need I say more?) and then I read this.

    First, you are in my prayers, and I hope that your cancer cells are obliterated, never to return. I am a cancer survivor, but I was lucky enough to only require a radical hysterectomy and not endure the torture that is chemotherapy and radiation. My father, a Vietnam War veteran, thanks to Agent Orange, had prostate cancer. He died in 1999 at the “ripe old age” of 58. Now, my poor mother is undergoing treatment for rectal cancer. It is a seemingly never ending doom that appears forever locked in the DNA of my family. I fear what that could mean for my beautiful son someday, although at 29 he believes he is immune to ill health.

    I am glad that you seem to have an amazing group of physicians who care for you. Thankfully, my mother has also found a great oncologist/hematologist, and is treating her with IV chemo and radiation in preparation for surgery in a few weeks.

    God bless you, and thank you again for your moving and touching posts. I will definitely be checking your blog regularly.

    • Thanks for your comments.

      I cannot imagine an almost entire family having cancer. At least I have been lucky there.

      I had my family to take care of me, wife, daughter, son, but three members in your family have been battling cancer, and that has not been the case for you.

      I do hope that your health is such now that you will be able to lend moral support to your mother. Your father dying too young is unacceptable.

      I asked Dr. Hamilton, and she said she has treated many cases of Agent Orange over the last 20 years. In my day Agent Orange was known as DDT, and it was used to eradicate weeds. How anyone in the Pentagon could have approved that for mass spraying in Nam I have no idea. That was a case of the Brass not bothering to go out in the fields to see what was going on.

      I had a good report on my last PSA, so I’ll hang around for a while longer.

      Please let me and my readers know how your Mom is doing.

      Radiation is not so bad, but chemo is the devil’s brew.