Welcome. My name is Divine. This is episode 64 of the Divine Intervention Podcasts.

We're going to be continuing the 3806 series. It's going to be series 6.

All right, we'll pick up from question 47. A 57-year-old man who manages his own accounting firm has a five-year history of malignant melanoma that has been treated with local excision and immunotherapy.

He now is admitted to the hospital for evaluation of constant pain in his back and left

hip and an 11 kilogram or 24 pound weight loss. He and his wife of 35 years are worried

that the cancer may be back.

Pelvic and abdominal CT scans show multiple bony metastasis.

He tells you, I just want to die.

I can't bear this.

Which of the following is the most appropriate initial intervention?

A, adjust his analgesic regimen.

B, arrange for him to be transferred to a psychiatric service.

C. Begin antidepressant medication. D. initiate hyper-elementation. E. refer him to a cancer patient support group. So for this personally, we see this guy. The melanoma seems to spread. And he just has constant pain and he says i can't bear this

right so let's maybe fix his pain so i'm going to go with option a here adjust his an algisic

regimen this guy does not seem to have any psychiatric problems right i just fix the pain first

if he's still having this i I just want to die attitude,

you know, after the pain has been taking care of, then maybe you want to, you know,

refer him for like some psych thing, right? But I think option is the best answer here.

Again, antidepressant medication. It does not meet the five out of 9 Cicicke's criteria for depression.

Hyperalimentation is for weight loss, but this guy can probably eat just fine.

And then cancer patient support group, no, fix the pain, right?

That's the problem that is propounded in the question.

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