Taking Time, With Little Left

"The trickiest part of living is pretending that you don't know how the story ends…the cure for the fear of dying is living." -Jamie Weisman

He was one of my favorite patients and I was looking forward to seeing him again. His warmth, gentleness, and New England accent added to his charm. His news surprised me.

"I have another malignancy," he announced matter-of-factly. "Since my last appointment, I developed terminal esophageal cancer."

I was stunned. When patients have one head and neck cancer, they remain at increased risk of additional cancers, but he had been doing so well. This was truly devastating news. What should I say? He looked the same as always. "How can I help? How soon can they start your treatment?" I asked.

"Oh, before any treatment, I'm taking a few weeks off to go see my people back home. Maybe I'll consider something after that. We'll see."

His response reminded me of a passage in Dr. Roger Bone's booklet Reflections: A Guide to End of Life Issues for You and Your Family.

Amidst many practical tips to fellow terminally ill people, Dr. Bone suggests "making amends with everyone," "finding meaning in life and death," and taking time to "do something personal and meaningful…a visit to a favorite vacation spot, a childhood home, or perhaps, to an old friend you have not seen in years."

These seem like natural and reasonable things to do, yet, terminal patients suddenly have so many demands on themselves that such an excursion often never happens." How true. I have often pushed patients hard to begin further treatment regimens as soon as possible.

"I'm not afraid of death, Doc. I've had a great life."

A few weeks later I learned that he had, indeed, spent a relaxed, happy month in Boston. Now he was back in town and considering his treatment options. I know he plans to live in control as long as he can.

Bruce H. Campbell, MD, FACS
Professor of Otolaryngology and Communication Sciences
Chief, Division of Head and Neck Oncology
Interim Director, Froedtert & Medical College Cancer Center

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.