Chapter 8 - MARGARET'S WEIGHT LOSS
Margaret lost fourteen pounds during treatment.
That was concerning.
The oncology team had been tracking it.
Vanessa’s messages made the trend look behavioral:
refuses breakfast.
refuses supplements.
uncooperative with feeding plan.
The actual pattern was different.
Margaret ate more after pain medication.
Less when mouth sores worsened.
Could tolerate cold foods better.
Could not tolerate certain textures.
The dietitian notes reflected all of that.
But Vanessa’s home reports gradually changed the tone.
From:
poor intake due to nausea
to:
refusal
to:
persistent nonadherence.
Words changed the patient.
Daniel asked Dr. Shah:
“Would this have gotten Mom moved?”
“Not automatically.”
“What would happen?”
“We would assess why intake was poor, whether home support was adequate, whether she needed hydration, nutrition support, medication adjustment, or a higher level of care.”
“So Vanessa couldn’t just write ‘noncompliant’ and send her away.”
“No.”
Daniel felt relief.
Then shame.
He had imagined medicine as a button.
So had Vanessa.
Good clinicians ask why.
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The lie might still have influenced decisions.
It would not have controlled them alone.
