We get a good number of cancer patients passing through the ED, many of them in the later stages of their disease. I've watched family members and friends go through it, and it's horrible. Sometimes, however, even worse than the patients who are septic, altered, unresponsive, or consumed with pain are the ones who still look like they should be completely healthy. I took care of a relatively young woman recently who was pretty far advanced, but still cheerful and friendly. Surrounded by friends and family, she tried not to wince while I searched for her last remaining veins, never complained about being poked and prodded, and smiled and joked with the staff as she answered our questions. I hated the fact that instead of being out and living her life, she was stuck in an ER bed rattling off a long list of ineffective meds that she was on. The doctors tried to control her pain more effectively, but beyond that there was nothing we could do for her. It sucks.