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Dying is not the worst problem with cancer
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Dying is not the worst problem with cancer

It's how you choose to live with it

January 19, 2024

This will start out depressing, so if you are not going to read to the end, you might want to stop now.

My Friday afternoon hospital visits to the cancer unit are unpredictable in regards to what patients I get to see.

A friendly nurse routinely suggests a few patients in the cancer unit. She selects them based on how the visit would be, given their level of care, and whether they would be encouraged by it.

Therefore, most of those visits are pleasant and upbeat, involving light-weight conversations around treatments, family and hopes for the future. Optimism is usually the order of the day.

They are usually happy talk, because the patients are carefully pre-selected for me.

I am not a trained counselor; I’m just a guy who was surprised by leukemia and stumbled his way through a half-dozen medical disasters on the way to full remission.

My wife’s polite accusation, that my principal interest is more about seeing the nurses than the patients, is pretty much on target.

On occasion, however, there is a more challenging patient situation.

I saw a lady a few months ago — I will call her Dede, nowhere close to her real name — who looked to be about 60 and had been ravaged by cancer.

Dede was bedridden, frail, and as discouraged as anyone I have ever seen. When I entered her room and introduced myself, she offered a few shallow raspy words.

At first I thought she had asked me to leave. When I turned to do so, she gestured slightly with a crooked finger. I took it as a “come here” command.

I approached the bed; her eyes were half closed and voice was so low I had to bend close to hear her whisper: “You can stay.”

I pulled a chair close and asked her something nonsensical and ill-advised, like, “How are you doing, Dede?”

She flicked her eyes toward me. “I’m dying.”

I studied her. “Can I ask you what your diagnosis is?”

She made a rustling motion that might have been a shrug. Of the words that followed, I think I heard “pancreas,” “liver,” “lungs” and “metastasized.”

Taken in context, these are a death sentence.

What does one say next?

I told her I had been in this unit myself, had spent 3 months in a bed like this one, had gone through the chemotherapy.

She made the inconclusive shrugging motion again. I wanted to cry; or maybe quietly slip out of the room.

After a pause, I asked, “Are you a woman of faith?”

“Yes.”

Another pause.

“Does your faith give you comfort?”

Slowly she turned her face away from me. “No.”

“May I pray with you?”

Pause. “I suppose so.”

I offered a short, wholly inadequate prayer. I think I asked God to give her comfort and peace, to ease the pain and offer hope to her. When I said “Amen,” she whispered a barely audible, “Thank you.”

I took it more as a social nicety than an expression of gratitude.

After a few words of parting, I left the room.

The discouragement has hung over me since then.

Dede had given up the struggle. She was already dead on the inside, both figuratively and nearly so literally. For her, it was a matter of simply letting the clock run out.

Interestingly, there was no family with her and no evidence of their having been there. No grand-child drawings posted on the wall, no cards on the table. No personal items to brighten the room.

It is the sort of end that no one wants, and that everyone fears.

To cut to the chase, how do we avoid ending like this? The question has presented itself to me frequently in the last two years. The following action steps are, like my prayer with Dede, wholly inadequate, but they may be a humble beginning:

  1. Hold friends close. Not everyone has family, but everyone can have friends. Cultivate those relationships.

  2. Expect life to be messy. You may not be the one in the cancer bed; likely as not it will be one of those friends you made. The same friend you thought would come and visit you, will probably be the one you will be called upon to go visit.

  3. Engage in volunteer work at a hospital, children’s hospital, cancer center, rehabilitation center or hospice. In today’s climate, this is not easy. In my case, it required a blood test, inoculations, interviews, formal HIPAA training and mandatory annual refresher courses.

  4. Make peace with God. At some point, you will have to name Him. The politically correct reference is to a “higher power.” I suggest that a “higher power” does not offer the anticipation of eternal life, and is not in the comfort business. It may be time to re-examine your Bible, and speak with someone who is familiar with it.

  5. Before the crisis — which will come on abruptly and without warning — decide what your attitude will be. If you lose the attitude war, you lose the war.

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I have found Psalm 32:6 to be encouraging and useful in contemplating how to prepare for medical disaster: Therefore let all the faithful pray to you while you may be found; surely the rising of the mighty waters will not reach them.

Clearly the passage refers to making prayer to God. The second phrase, however, is less clear. Some translations put it thus: surely in the rising of the mighty waters they will not reach him.

Which either means,

when the water comes up, the water will not reach the one who is praying; or,

when the water comes up, the prayers will not reach God.

I favor the latter: Pray to God while you may, because waiting for the flood is no time is start praying.

Real life is all around us, and is usually hard. We do not always get to choose the trials we face; only how we face them.

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