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Facing One’s Own Mortality

CheeseburgerI met a unique patient not too long ago.

She was having back pain. Yeah, one of those patients.
We helped make her pain better, but the story behind why she had her back pain and her attitude made a lasting impression on me.

The patient was in her 50’s. She had smoked through most of her younger life, but then decided to stop about 5 years prior to developing her back pain. Always seems to happen that way.

About 4 months prior to her visit, the patient began coughing up small amounts of blood. A CT scan showed she had advanced cancer. There was a large tumor mass about the middle of her lung and it appeared to be growing into the major blood vessels in her lung. She had seen several surgeons who all believed that the tumor was in too delicate of a place to try to remove. Chemotherapy and radiation therapy had only a minor effect on the tumor and caused the patient to have all kinds of side effects. So she was stuck. No treatment available.
Her oncologist told her and her family that at some point, the tumor would eat through the blood vessel and that she would bleed to death. It might happen tomorrow, it might happen in a year. There was no getting around it. Her death would be bloody and quick. The doctor suggested that the family keep several dark-colored towels around the house to mop up the blood. Pragmatic advice, but not exactly empathic or very encouraging.

The thing that made the biggest impression on me was the grace and dignity with which the patient carried herself. I was very interested in her story and how she was coping with her terminal diagnosis. She didn’t mind talking about it. As she relayed her story, it definitely wasn’t the typical progression through Kubler-Ross’ stages of dying.

She was depressed upon hearing that the cancer was no longer treatable and she was scared that she could die at any minute. She didn’t want to be around anyone or leave the house because she didn’t want them to witness her bleed to death. That lasted about a day. Then she became determined not to spend her last days sitting in her bedroom being afraid and depressed.

So she accepted her condition. She accepted that she wasn’t going to see her grandchildren grow up and that she wouldn’t get to spend another Christmas with them. She made an active effort to fully enjoy what life she had left with them.
She carried a dark towel around with her everywhere she went. She figured that when the time came, she could lay on the floor and vomit into the towel so that others wouldn’t see the blood or have to clean up as much.
She wrote notes to all of her family members on a regular basis. Small notes. But they all told the family members how happy they made her and how much they improved her life.
She also kept a note in her pocket that she planned to pull out so that anyone seeing her vomiting blood and dying in front of their eyes would know what was happening, why it was happening, and to thank them for trying to help but also let them know that there was nothing they could do to help her.
She was still afraid, but she really did appear to be enjoying her life.

As I shook her hand, she smiled and said “Thanks for making an old lady’s final days a little more comfortable, doc.”
I briefly thought to myself … “Is she really this happy on the inside or was it all just a show?”
Then she added “Now get me out of here before I need to use this towel. I’m hungry and a cheeseburger and cheesy fries are calling my name.”
She really was that happy on the inside.
And she changed my life for the better just by meeting her.

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This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on DrWhitecoat.com, please e-mail me.

3 comments

  1. cape cod stepmom

    Thank you for sharing. That is truly an example of “death with dignity”. May I only be half is brave when my time comes

  2. Yep. I only wish I could be her. I am afraid of dying, period. It is a fear that hasn’t left me in the last 2 years. I am young. Nearly 50. I have no health issues that I know of. No reason to have such a fear as this, yet I do. The thought can sometimes be momentarily paralyzing. I hope it changes.

  3. defendUSA– I think it can change. When faced with a shortened lifespan, seems like there’s something in you that makes death less scary. It’s like, okay, it’s coming sooner than I expected, but it’s going to come anyway, so bleep it, I am going to enjoy what I have. Maybe that’s just how the brain copes. I don’t know. Maybe it’s just that it’s easier to suck the remaining pleasure out of each day you have left than to rage, rage against the dying of the light.

    (apologies to one Mr. Thomas)

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