“Cancer is a word, not a sentence”. –John Diamond
I have spent another two weeks in the hospital with my mother, this time with even more devastating diagnoses–kidney failure and cancer, on top of her multiple TIAs and heart problems. We thought we only had to deal with the consequences of the strokes, high blood pressure, and minor heart attack. Now we are facing one of the most important questions both patients and doctors have to deal with today. That question is how to keep a patient safe and comfortable without using interventions that affect the quality of a person’s life at the end.
Because we have been at two very different hospitals this past month and met doctors from several different fields, I no longer have a very positive image of modern medicine. We are veterans in our family when it comes to dealing with cancer. We are well-educated and reasonable. We are also compassionate. Many of the doctors we have dealt with in the last month have been clinical and arrogant.
One very young neurologist (who is not my mother’s main neurologist) told her point-blank in a cold tone of voice that she had Alzheimers and we had better get prepared for the coming years. Her own doctor did not diagnose that. I would expect that kind of diagnosis to result in prescription medication and further evaluation. That did not happen. He delivered his diagnosis and walked away. I followed him and informed him that I was extremely upset that he would tell my mother that to her face without more testing. He informed me that his style was to tell it like it is. Be blunt, in other words, and ignore the fact that the patient in front of him was 89, had a history of strokes and high blood pressure, and was now in worse shape that when she entered the hospital because of his arrogance and lack of compassion.
A similar experience occurred in another hospital last week when my mother was diagnosed with cancer. Send her home to die, was the suggestion. Her kidneys would fail, she would go into a coma, and die peacefully. Not a bad way to go, according to the doctors. However, my mother was active, strong, with a fighting Irish spirit. She was devastated when she was told there was nothing they could do. Surgery had failed and the cancer was shutting down her kidneys and causing the strokes. One doctor told me he felt guilty because of the suffering that resulted in patients he had tried to save. He actually said, “One day I will meet my Maker and I will have to justify to him all the things I have done to patients. My brother and others have suffered before they died because I tried to intervene.” He said we have a problem facing death in this country. We use too many methods to prolong life. He had many regrets over that. I am upset that he interjected his own personal agenda into a decision concerning my mother’s life. She wants to live. She wants to do whatever will save her, but she also does not want to suffer the way my sister did.
Then into the picture came my medical oncologist and radiation oncologist, both of whom offered hope. They would give her radiation treatments, shrink the tumor, and open up the kidneys. She couldn’t handle chemotherapy, they said, but the new kind of radiation therapy called IMRT offered great hope. My mother smiled. She laughed. The nurses loved her. She took her walker and walked the hallways. She ate the terrible hospital food with enthusiasm because she wanted to be healthy. Hope changed her from an elderly woman lying in bed waiting to die to a happy, elderly woman who added joy to the lives of the nurses and hospital workers. Even if the treatment didn’t work, even if something else killed her, these days and weeks of extended life without discomfort or pain would be worth it to many people.
All four members of my immediate have dealt with cancer. My father and sister did not survive. I did. Why not my mother? It makes me more determined than ever to be an advocate for my mother, to protect her from those doctors who just give up on a patient, and I cherish the doctors who offer hope, even though it is cautious hope. I will take hope in any form to hold on to my mother for just a little while longer.