Kerry Reynolds, MD

Associate Medical Director of Oncology and Program Director of Oncology Virtual Medical Home, Physician Case Manager, Advance Medical

This is what an Oncology Medical Home looks like and this is the essence of what Advance Medical can be for patients. This gentleman, with a 10 year old son, had rectal cancer that had spread to many places, including his liver, and he had had multiple lines of therapy but his cancer raced through all of them. Memorial Sloan Kettering noted there were really no other option so when he called us he was grasping for any potential therapy to stay alive given that his rectal cancer had spread to his liver. I walked him through those waters noting that we would look for everything but also allowed him to talk through his feelings, his fear, and how he could support his family. That allowed him to think about palliative care and he did engage in hospice. We still provided him with an expert medical opinion but unfortunately he was never strong enough to try those therapies as he was failing quickly. Today, I called to check on him and reached his wife. He was at home but no longer himself as he was actively dying. His wife noted how important our conversations had been to him in the last weeks to months. She said it gave him both hope and perspective at the same time. When I listened to her, I heard the desperate sound in her voice in utmost despair. She was trying to care for him at home while he was actively dying, she had no help, she was up all night and day every day, she could not think straight, and she was at the brink. She was just spinning and had no help or direction. We spent a long time coming up with a strategy. I always recommend there are 2 caregivers at home 24 hrs a day when a patient is actively dying because it is hard, really hard to care for someone with organ failure, that is in pain, unable to transfer their weight, and needing help with all daily activities. We talked about any potential friends or family members - there were none. We then came up with a plan to call a private RN firm that could provide 24 hr assistance for at least the next 3 days. Also had her call the hospice and get a consultation with a counselor given her extremely trauma and grief and discuss transfer to inpatient hospice if the RN at home does not work out well. She was forever grateful for that call at that moment and her voice lifted. She said she didn’t know what else to do and didn’t know who to call. She now has a plan and a chance to get some sleep tonight and be there for her son. I was able to care for both of them in despair at different times and it was beyond fulfilling. I would say that kind of connection is hard to put into words.