![]() ![]() You should never have become a doctor.” I intellectually understood she was upset about the news of her cancer recurrence and had understandable anger at the dramatic impact this turn of events would have on her future. When I paused to see what questions or thoughts she had, she said: “I want to kill you. 1 I had done this many times before, and there was nothing that stood out to me in the moment about her or this clinical situation to make me think I was in danger-a fact that made what happened next even more shocking. I used the SPIKES protocol to review why we were there and deliver the test results. She had no known mental illness, no brain metastases, and had never been angry or violent with me. ![]() Truly, it was a delight to be her oncologist. We were on very friendly terms, and I enjoyed seeing her name on my clinic schedule, certain that beyond discussion of her cancer and test results, we would also get into some interesting conversations about life, the weather, or college sports. I had met her children, knew the names of her pets, and had discussed my children and pets with her. I had been her oncologist since she was first diagnosed with stage III cancer and saw her through surgery and adjuvant chemotherapy. I walked into the room to share this news with a woman who I had been seeing for about 3 years. As I suspected, the test confirmed recurrent cancer, and this time, it was incurable. I was seeing her to discuss test results 1 week after I told her I was concerned that her cancer had returned. I was in the middle of a busy medical oncology clinic. ![]()
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