By Lisa Thornton

Patient is pleasant 77-year-old male in no apparent distress. Arrives to appointment alone via public bus. Alert and oriented to person, place, time. 

Treatment regimen detailed. Infusions twice per week for three weeks, then three weeks off. Repeat for four cycles. Would start not this coming Monday but next. 

Reiterated benefits of quitting smoking. Patient again declines smoking cessation program, states “Fuck you, doc, what else am I going to do for one more year?’

Possible side effects and adverse reactions to treatment outlined. Statistics provided on risk vs benefit. When faced with numbers, patient agrees to treatment. Awful choice to have to make. Never easy.

Patient expresses financial concerns. Assured that nursing staff will support in investigating financial assistance options. Patient expresses trepidation about loss of independence, ability to safely perform activities of daily living. Will discuss housing and care options with social work team. 

Patient states he fought in Vietnam. States he will inquire about VA benefits. States it was hot. States it was hard to breathe. States they never saw the enemy. In the meantime, place pharmacy order for meds. 

Patient declines assistance to lobby. Patient states “I never want to see you again, you bastard, but I guess I’ll see you next Monday.”

Hard conversations, these. Never easy. 

Follow up in ten days. 

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Lisa Thornton is a writer and nurse living in Illinois. She has work in SmokeLong Quarterly, Bending Genres, Ellipsis Zine and more. She was a finalist for the 2022 SmokeLong Quarterly Award for Flash Fiction and has been nominated for a Pushcart Prize. She can be found on Twitter and Bluesky @thorntonforreal.