Silent Echoes: Surrendering in the Wake of Loss – A Patient’s Perspective

By: Emma Fenske, DO

I saw my doctor every six months,
then every three,
then every month.

I could still walk several blocks with my dog,
though I was haunted by the weight loss—
weight I couldn’t hold on to.
My clothes grew loose, my mind wandered to darker possibilities.
By then, I didn’t mind seeing my doctor so often.

“By next time, let’s try to get down to two cigarettes,” she said.
I was already down to four,
barely finishing those.
But the only thing I seemed to drop was pounds.
Nutrition shakes couldn’t sustain me.
I looked like a shadow of myself—
almost skeletal.
How could I explain all this in a 30-minute office visit?

I was a good patient.
I followed the plan:
low-dose CT scans, FIT testing, labs.
For my age, I was in decent shape, I thought.
Especially when compared to others:
some incapacitated,
others are already gone.
At least I could still walk my dog.
She was eight now—aging, like me.

But lately, those close to me have started to pass.
And I can’t help but wonder:
“Is my time coming too?
Is the weight loss a sign?
I’ve survived so much—
wars, illness—
but maybe this is it.
Still, my dog needs me.”

The CT scan showed early lung cancer.
We would need to get a biopsy next.
My doctor called me herself—6 p.m. on a Friday.
“Nice of her,” I thought.
They said surgery wasn’t an option given how sick I was.
Radiation might help.
“Is cancer why I’m losing weight?” I asked.
“But this is early-stage, isn’t it?”

The first hospital stay wasn’t so bad.
My mind was clear enough to refuse discharge to a skilled nursing facility.
Friends who passed before me had warned about those places.
And my dog was waiting at home.

But at home, I realized I’d made a mistake.
I was too weak.
Even my dog seemed to mirror my frailty.
Eight years old—what is that? Fifty in human years?
She couldn’t stand, and neither could I.
Maybe it was time.
I called the vet. They would come that afternoon.

I mustered what strength I had,
not only to say goodbye to her,
but to face the truth:
maybe it was time for me too.
Everyone else was leaving—
Why not me?
My roommate took me back to the hospital.
I was almost ready.

Admitted to the ICU,
they told me it was walking pneumonia.
Antibiotics dripped through my veins,
oxygen flowed through my nose,
but I adamantly declined the breathing tube. 

From my hospital room, I could see the construction outside.
And then, my primary care doctor walked in.
She held my hand.
I don’t think she’s ever seen me look this bad in the clinic.
I’d lost even more weight.

How do I tell her I’m ready?
She remembered my dog.
She said she was sorry.

And that was it.
I was ready,
because those around me had already heard their exit cues.
Mine came from the kindness of my brother,
my roommate,
my doctor.

Funny—
I used to hate going to the doctor.
But now I’m ready.

Emma is a current PGY-3 in Internal Medicine at OHSU. She has a passion for narrative medicine, advocacy, addiction medicine, and end-of-life care. When not working, she can often be found running long distance, riding her motorcycle, or stopping mid-sentence to note a cute dog.