"This was not the good death we were promised"

When my father was dying of pancreatic cancer last summer, I often curled up with him in the adjustable hospital bed set up in his bedroom. As we watched episodes of “The Great British Baking Show,” I’d think about all the things I couldn’t promise him.

I couldn’t promise that the book he’d been working on would ever be published. I couldn’t promise he would get to see his childhood friends from England one more time. I couldn’t even promise he’d find out who won the baking show that season.

But what I could promise — or I thought I could — was that he would not be in pain at the end of his life.

That’s because after hearing for years about the unnecessary medicalization of most hospital deaths, I had called an in-home hospice agency to usher him “off this mortal coil,” as my literary father still liked to say at 83.

When a doctor said my father had about six months to live, I invited a hospice representative to my parents’ kitchen table. She went over their Medicare-funded services, including weekly check-ins from a nurse and 24/7 emergency oversight by a doctor. Most comfortingly, she told us if a final “crisis” came, such as severe pain or agitation, a registered nurse would stay in his room around the clock to treat him. (continues)
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Resolutions of a Cancer Doctor

My mom was given a diagnosis of lung cancer this past year. And whether I liked it or not, almost midway through my career, it put me squarely in the position of being re-educated about cancer from the other end of the biopsy needle. It also gave me the opportunity to approach my patients with a new resolve in the coming year.

My mother lives in Rhode Island, and I live in Ohio. It took weeks for her to get her diagnosis, and I quickly found, as family members of my own patients have told me countless times, how difficult it is to coordinate the care of your loved one from a distance. Fortunately, my mom’s cancer was caught at an early stage, and I convinced her to come to Cleveland for surgery at the hospital where I work. She was discharged from the hospital following removal of the mass to my house, where she spent the entire month of May recovering.

For anyone who has never played the role of assisted living facility for a septuagenarian who has undergone a major medical intervention, it isn’t easy, either for the patient or her host. Our expectations for participation in physical and respiratory therapy diverged wildly. I had been raised in an era in which regular exercise was approached with near religious conviction. She came of age at a time when people joked about exercise: “Can’t you pay somebody to do that for you?” And it turns out that mothers do not want to be told what to do by their sons.

Even when they have medical degrees. And specialize in cancer. And are taller than she is.

And sons don’t like to see their mothers sick with cancer. Not surprisingly, it is nearly impossible to separate that emotional reaction from calm, clearheaded guidance to your own mother... (continues)
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