Neuro: Another tragic story

So a VERY cute 16 year old boy came in to the ER today, and we got called for a consult. As usual, I was not informed why and instead of looking at the chart, I just barge into the room and start asking questions (i really gotta learn better).

Turns out the kid hasn't been himself over the last several days. He's been more tired and sleeping for literally days at time. His mom hasn't been able to wake him up without considerable effort. He has said he doesn't feel well about a week ago. And he has even missed school over the last several days. Upon exam, I can only wake him when I get mean and cause pain. He only rouses enough to tell me to get away and answer maybe 2 questions. Oh and I also discover he was diagnosed with leukemia a year and a half ago and has been doing chemo.

I come out completely baffled and the resident pulls me aside. Yes, I knew he has leukemia. No, he wasn't really okay on exam. No, I haven't seen the MRI. Apparently, many kids who are on chemo for leukemia can get a weird problem. Its not really a side effect but we don't really know why it happens, only that is more common than we want it to be. Its a brain tumor, sometimes filled with blood sometimes just dead brain tissue, it grows for about a week. Everyone looks around all somber-like.

They show me his MRI.

This doesn't get better, they tell the parents. And the mom nods, as if she knew all along that her son was dying. We can keep him in the hospital if you want, but there is nothing we can do for him but keep him comfortable. No, the mom says, we'll take him home. He's not having any pain.

I walk out of the room, flabberghasted. 16 and dying? He didn't look like he was dying. But he also didn't really do anything at all. And now all I can think is, he would have been a real-heartbreaker if he'd had the chance to grow up. Happy Valentines.