Between the lines: an oncology diary no one assigned

Abstract

Section snippets

Prologue

It was a quiet summer, and I was determined to switch off—no clinics, no case logs, just rest. One afternoon, while unpacking a forgotten tote bag, I came across the black diary I had carried through my oncology postings. I opened it casually, not expecting much. But the pages pulled me back to bed 32, where Meena once lay. To questions I still could not answer and to moments I had never spoken about. I did not find case summaries. I found pieces of myself I had left behind.That summer, I

The prognosis conversation

Mr Iqbal was aged 83 years—a retired Urdu teacher with a dignified stillness about him. His history read like a ticking clock: stented triple-vessel coronary disease, diabetic nephropathy with chronic renal failure, and hypertensive cardiomegaly. He walked daily to the mosque until his speech began to slur and his left hand lost subtlety. An MRI revealed an advanced, infiltrative insular glioma; non-resectable, poorly accessible, and silently devastating.The oncology consultant offered

The diary: my quiet curriculum

Hospitals have official curricula: anatomy labs, clinical skills, and pharmacology. But beneath all that runs a quieter syllabus, one without PowerPoints or page numbers. I found mine in the pages of a small black diary tucked into my coat pocket.It began as scribbles, quick notes between rounds, fragments of feeling I did not know where else to put. Over time, they became confessions. No one teaches you how to carry a patient's silence or what to do with the guilt that seeps in after loss.That

Epilogue: the diary revisited

Weeks later, bed 32 was empty.The sheets had been changed. The monitor unplugged. The drip stand stood like a question mark beside the bed. But Meena's absence felt louder than any alarm. The new patient in that bed had no idea whose silence they had inherited.That night, I flipped through my diary and found the last line I had written about Meena:“Her pain seemed bigger than her body. But she smiled when I said she looked strong. Maybe we both lied a little. Maybe lying was mercy”.For my final