Thoughts At Large

Passionate thoughts on random topics

Category: suffering

Sharks and Cancer

quint

So, eleven hundred men went in the water, three hundred and sixteen men come out, the sharks took the rest…”  Quint, Jaws

It has been a very difficult year and a half. First, in November of 2014 my father died after a brief but excruciatingly painful fight with lung cancer which had spread to his bones. Almost one year later, last September, my wife died after a long fight with breast cancer which had spread to her lungs. And then only six months later, my dog died after a painful fight with a soft tissue cancer which had spread to his bones. One year, then only six months, part of me wonders what horror will befall us in three months. But I have to believe that the pain and suffering have ended now.  I can’t help but appropriate Quint’s quote to, “So, five of us went to Texas, three of us come home, cancer took the rest…”

Cancer has targeted my family for far too long now. I don’t want it to have any more power over us. My children have spent fully one-third of their lives living under the threat of cancer taking their mother and then their dog. Almost their entire teenage years, years difficult enough without cancer moving in to live with us, has been spent living under that dark cloud. They are 21 years old now and, in spite of these added pressures, will both graduate on-time from the University of Texas at Austin, each with over a 3.5 GPA. How they have been able to stay focused amazes me and is a testament to their strength of character.

I know people have had it harder than we have. I don’t claim to have a corner on suffering. And I am grateful for the seven years we were able to steal from cancer by moving to Texas and seeking treatment at the M.D. Anderson Cancer Center in Houston. I’ll never regret that decision. But if we could have a break from any additional pain for a short time, that would be great.

Each of us is dealing with these losses in our own individual manner. Certainly, grief counseling has helped, but we still face a world in which neither Lisa nor Delbow will walk with us any longer. We have had long discussions about faith, heaven, philosophy, and all of the accompanying topics. We disagree as much as we agree but the discussions are always lively and fascinating. I hope that we can each find some comfort in our positions.

Finally, there is the issue of moving forward. The house, already quiet from Lisa’s absence is now even quieter without Delbow’s rambling about. The kids are on spring break this week, so I have a respite before facing that still house alone. I now have six months of experience without Lisa and living alone. I hope this serves me well when the kids return to school. But before we know it, school will be over, graduations will have been concluded and we will be packing up for our trip back to Rhode Island. I hope it goes well and we can begin our new lives healthy. No sharks, no cancer.

Coming Around For Another Bite

Two Novembers ago it took my father. In September it took my wife. Now it wants my dog. I hate cancer. Why won’t it leave us alone? I am reminded of the quote from Christopher Hitchens who, when confronting his cancer diagnosis wrote, “To the dumb question “Why me?” the cosmos barely bothers to return the reply: why not?” So it is with my family. And so it goes.

Susan Sontag warns us of anthropomorphizing cancer, but it is so easy to do. Without a face, your foe it is that much harder to fight. What made Jaws so powerful was that the animatronic shark kept breaking forcing Steven Spielberg to come up with other ways to present the omnipresent danger through the use of camera movements and ominous music. The unseen monster is far worse than the seen. So we put a face on cancer and try to fight it from the outside while it destroys us from within.

So now we are awaiting the results of the biopsy which will tell us if the tumor is malignant. If it is, we will be faced with the difficult decision of what to do next. At twelve years of age, my wonderful dog has already battled cancer twice, had both back knees rebuilt, and had his eye repaired in Chicago. He’s been through it all. And yet his only concern in life is that he loves us. We will be faced with the difficult answer to the question: for whom are we going to submit him to more medical treatment? If it is for him, we will proceed, cost be damned. If it is for us, we will need to regroup and face the ultimate question of when is more surgery, radiation, and recovery too much for him leading to the inevitable decision whether to put him down. But I’m ahead of myself. We need the biopsy results first. We’ve been down this road before and will make the right decision when we have all of the facts and in spite of the perturbations it will cause.

We will be forced to answer the tough question: for whom are we going to submit him to more medical treatment? If it is for him, we will proceed, cost be damned. If it is for us, we will need to regroup and face the ultimate question of when is more surgery, radiation, and recovery too much for him leading to the inevitable decision whether to put him down. But I’m ahead of myself. We need the biopsy results first. We’ve been down this road before and will make the right decision when we have all of the facts and in spite of the perturbations it will cause.

I hate cancer. Leave us alone. Even sharks need time to digest their latest meal.

Inhuman

PainPublilius Syrus in the first century B.C. wrote “when Fortune flatters, she does it to betray.” Plutarch reinterpreted this as “I see the cure is not worth the pain.” Somewhere over the past two thousand plus years we have lost the connection between humanity and the humane.

Setting religion aside and ignoring the politics and ethics of Dr. Kevorkian, it is, none the less, barbaric how we treat our loved ones at the end of their lives.

We have somehow bridged the moral abyss with compassion for our beloved pets by “humanely” putting our beloved pets out of their senseless misery, ending their meaningless pain, answering their pleading eyes with the selfless, heartrending compassion of euthanasia.

We have somehow sanitized capital punishment of the worst criminals from fatal and barbaric corporal punishment to a “humane” (although still debatably barbaric) dream-like sleep out of existence.

And yet, we allow our loved ones to face “natural” death filled with a fear, pain and confusion making anything that happened at Abu Ghraib look like Walt Disney World.

This suffering is multifaceted. Of course, there is the physical pain, which is no better controlled today than it was 50 years ago. The opioids still rule as the best we have to offer. The problem is that they are systemic, meaning that they travel throughout the entire body. If the pain is in the hip, the hip gets the morphine, but so, too, do the little finger, the ear lobe and the brain. The result is that the little finger and ear lobe are no better or worse, the hip suffers an incomplete relief of pain and the brain suffers the confusion, paranoia, nausea and narcolepsy unnecessary to treatment. This is the best medicine has to offer in 2014? The other suffering it brings is to the family members who must endure watching the physical suffering of those they love hampered by the incomplete relief of pain. Meaningless suffering is the worst kind. Love of another means the willingness to shoulder their burden. The helplessness felt by the family member watching their loved one jerk in pain or crying out as they try to move them or comfort them is an indelible stain on their soul.

The suicidal mission of cancer adds to the frustration. Bent on destroying its host, even at its own annihilation, cancer never rests. To paraphrase Siddhartha Mukherjee from his book The Emperor of All Maladies, cancer cuts the brake lines of some cells and jams the gas pedals of others, stopping the natural cell regulation process and sending the cancer cells into a proliferating frenzy steamrolling every other cell in its path. In his or her clearer moments, so too, the cancer patient undergoes a civil war; one side, engrained in all of us, pulls us to live, to continue fighting, while another force, armed with logic, understanding and ultimately love, forces the patient to begin facing the inevitable truth with no regrets and peace.

In his book Man’s Search for Meaning, concentration camp survivor and psychologist Victor Frankl describes inmates of the camps as surviving long stretches if they could find meaning in their suffering.  Some held on to the hope of outlasting the Nazis and returning to their loved ones (should any of them have survived), others found peace looking up at the sky and imagining conversations with their loved ones wherever they might then have been. Life was worth living if they held a kernel of meaning in their suffering.

I have searched and considered and yet find no meaning in the suffering loved ones endure at the end of their lives given the current state of medicine. Pain is pain and on a scale of 1 to 10, anything above a 1 means the medical field has failed. The root word of both humane and humanity is human, from the Latin humanus. However, we reserve those words for our treatment of pets and prisoners, not our loved ones. For them, and for ourselves, it is inhuman what we put them through, for them and for us it is nothing short of torture.