I am not especially superstitious but it tends to be a Friday afternoon when the collective mass of the hospital shudders to the realisation that the weekend is upon us and important questions are unanswered.

My patient is a man in his early 70s who has kept deteriorating after major cancer surgery two weeks ago. Instead of the progressive recovery he was told to expect, he has grown worse. Now he looks listless, with dismal blood pressure and failing kidneys.

The surface questions for me, an oncologist, are about fitness for chemotherapy and options for dialysis but really, the underlying request is “please specify that he is dying”.

To be so objective and transparent about a patient I have never met is practically hard and emotionally wrenching. But in these high-stakes situations, you sometimes need to cause grief to save grief; there is no avoiding the task at hand.

At the bedside, there is a lanky man I assume to be a son. When he says he is “only” the grandson, I look again and notice the young face, no older than 20. Oh dear.

The patient opens his eyes, reports pain and closes his eyes. Discovering that he doesn’t speak English just makes my task harder.

“I am the oncologist,” I begin gently.

Alarm cramps the grandson’s face but he is one step ahead.

“Wait, you need to talk to my mum.”

While he texts her, I scrutinise the monitors, talk to the nurse and formulate my words. It’s frankly unfair how little time it takes to sum up the gravity of a situation. Emergency workers excel at this; oncologists are compelled.

When he hands me his phone, the screen is split into four windows. Important family meetings shouldn’t be held on FaceTime but, given the alternative of no meeting, it will........

© The Guardian