I read with great interest your response to "Cry Uncle" about whether it's a good idea to tell terminally ill patients the truth about their prognosis (10/19/07). I agree with your response but would like to suggest a couple of ways you might have responded more fully.
First, a doctor is not God and cannot predict with certainty how long a person will live. Also, nothing can account for a patient's will to survive. My mother was diagnosed with Stage 4B endometrial cancer in September 1997 and given a less than 5% chance of living two years. To that she said, "Oh yeah? Watch me." In the following 8½ years, she set small goals for herself: Attend a grandson's high school graduation, three grandsons' college graduations, two grandsons' weddings, my MFA graduation and a grandson's MBA graduation. And she achieved all but one of those goals. A grim prognosis only steeled her resolve to prove the doctors wrong.
Second, she lived every day as fully as possible until the day she died, which is consistent with the hospice philosophy. Knowing your prognosis allows you to live your remaining days in ways you might not otherwise think of. When hospice gets involved, its trained staff lets you LIVE, not just die. They help you get your affairs in order. They help you mend relationships. And they support the fulfillment of unrealized dreams whenever possible. Without knowing the truth about their diagnosis, patients would miss a precious opportunity to make every moment count.
author, Giving Up the Ghost
I was with my mother when the doctor delivered the news. He walked in the door and said, "This is the conversation I least like to have." I felt like saying, "Well, that's all we need to know. We'll be going now." But we stayed.
By the time we got home my mother realized the gig was up. Her first order of business was to start "Fannie May Therapy". She'd been watching her cholesterol for years. Diet and exercise did wonders for her cholesterol but nothing for lung cancer, which had spread to her brain. Chocolate and cheeseburgers were in. Oat bran was out.
One day she wanted tacos. So tacos she got. We hit a drive-through and she told them exactly how she wanted them. They said there was nothing like that on the menu. She yelled, "I'm dying and that's how I want them!" Done deal.
Years before, my folks and I went to visit an uncle of mine who was dying. They did the old "keep on fighting" gig. I waited with my uncle after my folks left. He was just so tired. I told him he really didn't have to fight if he didn't want to. I also told him that if there was anything he wanted to take care of before he died, now might be a good time to do it. He died two weeks later, but not before telling his grown son, for the first time in his life, that he loved him. I take no credit for that. It was my uncle's doing. But I think knowing allowed him and my mom to say "yes" to stuff they'd said "no" to for so long.
Sheri and L.M.: Thanks for sharing your personal and professional experiences with me. Upon receiving my terminal diagnosis, yours is the first book I'll look for, Sheri. I'm hoping it'll make me feel like a teenager, given that it's a young-adult novel. And L.M., I'm very familiar with "Fannie May Therapy" and have been exploring it on a preventative basis for quite some time. With my mother, it was QVC she turned to. She ordered so much stuff there were boxes piled floor to ceiling all over her guest bedroom, most of them still unopened when she died. Denial? Of course, but also a saying yes to however much life she had left.
If you think death's a box of chocolates, write to: MR. RIGHT, ISTHMUS, 101 KING ST., MADISON, WI 53703. OR CALL 251-1206, EXT. 152. OR EMAIL MRRIGHT@ISTHMUS.COM.