poured out before bed
“I think it’s important now to talk about the uncomfortable part of all of this – and that is your prognosis. The appearance of these metastases in your brain is not a good sign, as I’m sure you realize. We know that patients who have this kind of disease live on average about six months. I know this is hard to hear, but I believe that being honest will help you to plan the time that you have left so you live it as fully as possible.”
The whole family looks sullenly at the floor as Dr. Breathe talks. The silence as she waits for their response is painful.
“What questions do you have for me?” Dr. Breathe abolishes the stabbing quiet.
The patient’s son sighs sharply.
“Well for one, why are you talking about death?! Your job as a doctor is to talk about cure, not about dying! And two, how do you know dad will be average?! I’ve heard of people who they give months to live who live for years after that! Dad’s a strong guy – I could totally see him licking this and hanging around for years. So why would you put us through all the worry of this sort of talk now?!”
Dr. Breathe nods. “I hear what you’re saying. But it is important for you to understand that, as a cancer doctor, I am responsible for guiding you through all the stages of cancer – treatment and, yes, sometimes cure, but also recurrence, progression, and, finally, the process of dying. I don’t mean to cause pain, but I also don’t wish to sugar coat. There is always a place for hope. But sometimes that hope cannot be as broad as long term survival. Oftentimes hope is focused instead on meaningful – albeit shorter – survival. You are right that your father is a strong man. There is a chance – a very small chance – that he will live beyond six months, and that would be wonderful. But I think you should instead focus on making the next six months really count.”
The young man is about to continue his heated argument when his father places a hand on his bristling arm.
“John, it’s alright. She’s right, you know. We need to talk about this. It’s a good chance I’ll be gone in six months. I’m ready for that.” He swallows, clears his throat. “But I need to know that you all are ready for it. And I want to spend good time together during those months – just doing all the things we love like there’s no tomorrow. Heck, for all we know, you’ll walk out of work next week and get clobbered by a bus. And then when I get up there to heaven to meet you a few months – maybe seven or nine months – down the road, we’ll sit and laugh about the chances of survival.”