Having THE conversation - the proverbial Elephant in the room
So finally we had that conversation - the one thats been on everybody’s minds but not their lips. Well, to be fair I had spoken to him but on the fringes over the past few weeks. Clearly it didn’t register fully.
The leader of the team of doctors led the way last Monday 18/11 when he told him in our absence that the decision had been to cease all treatments.
What it means is that clinically he qualifies as a palliative/hospice patient. In local parlance, in his own words, so we just wait to die?
In the same breath, he added ‘but then isn’t everyone also in effect waiting to die’
The gems of (sad) wisdom that spout from him in the face of his (and universal) mortality.
I took pains to explain the rationale for that decision. He went through a major surgery to remove a 8.5cm/490 gm tumour on his left lung. He then went through a hernia repair procedure. In between there were numerous chemotherapy, radiation, radio therapy and lastly 3 sessions of immunotherapy.
The final regime was the 3rd line of treatment for him and it didn’t stop the progression of the disease.
I explained that if we push for further treatment - and of course its humanly possible but is it necessary or even helpful ?
The major downside is the negative side effects and painful procedures that might rob him of the quality of life that we and he particularly crave to be functional : to eat (which he enjoys very much), observe and enjoy things he likes (like his new home).
I told him the outcome of further treatment is not positive and won’t add much time to his life. Painful point but necessary.
He was in agreement (or at least nodded his head to show he understood)
On a surprising note, he had remained stoic and cheerful - another gem he shared with me - it always differ among individuals (with regards to how people respond to bad things that happen to them).
I asked him to tell us what he likes to eat and do - anything that we can realistically make happen, we would.
I also promised him that we would make it possible for him to go home to enjoy day leave from the hospice. More importantly I told him that the hospice would be the best environment where medical staff are qualified to calibrate his comfort care.
He had agreed to be stepped down to stay at the hospice given the other options are not practical nor financially feasible.
I left him with a heavy heart. Comforted by his still keen interest in the progress of my work and how I was coping as I had been spending the past months busying with the reno of his new home etc.
He was upbeat when I left, giving me his signature wide-smile and waving me off with a Thank You.
The elephant was a big heavy animal indeed.
Remind to self : we must not be so consumed by the raw intense feelings not to savour the moments we have with him as we did over last few years. Particularly the past 2 years.
Its easy to spiral downwards but we must be grateful for the many positives in our lives and particularly his.
