There's a very old joke about the definition of joy mixed with sadness: It's watching your mother-in-law drive off a cliff in your brand new Cadillac.
Sometimes life mixes joy and sadness in the cruelest of ways.
On call in the delivery room. The senior OB/GYN gave me the heads up on a parturient that we would be seeing later. The young woman presented to the OB department in labor in her first pregnancy. The admitting doctor noticed a swelling in her neck that she had never noticed. After the relevant tests and consultations she was diagnosed with lymphoma. Her chest film looked similar to this one:
She decided to proceed with a vaginal delivery. At one point she requested an epidural but upon reexamination she had progressed quickly and was about to give birth, so the epidural was not necessary. After giving birth she was brought to the OR for a retained placenta and to suture some tears in the birth canal. I decided on a spinal anesthetic in order to avoid intubating and ventilating (even though there were no clinical signs of respiratory compromise). The procedure went well.
During the entire time there was something unsaid in the air. We knew and she knew. We knew that she knew and she knew that we knew. But no one mentioned the ogre in the room. I brought her to recovery (I had briefed the nurse there before we started the procedure) and presented her to the nurse. I conveyed my congratulations and wished her:
Which is a short version of the wish to meet only at joyous occasions.
To which she replied, "Amen".