I examined him, leading him to his bedroom so he could lay down and I could examine his abdomen. He required significant help even with the 20 steps it took to get to the bed. He let out a big sigh when he lay back on the bed. The diagnosis came quickly, as his liver was very large and had an irregular, lumpy feel.
I had little doubt: he had cancer in his liver, probably spread from his colon.
We went back to the den, where we initially had talked. "I am going to be square with you. I think you have a very, very serious problem. I think you have cancer in your liver. I'm sorry to have to say this the first time meeting you, but you seem to be the kind of person who would want the truth, even if it is hard."