The medicine that kept her alive was not in a bottle

Sue wondered if all doctors subscribe to the same magazines, buy the same cheap furniture, post the same worthless insurance information.   She wanted to throw it all through the receptionist window.  The second opinion was a waste of time and she had little of that.  She was there to make her family happy, but was upset they could not cope, that they were not ready to face the truth, and so she would go through humiliation and fear … again.  Bad enough to die; worse to make big thing of it.

Her oncologist had been honest and direct.  Sue’s cancer had spread to lymph nodes and in lethal pebbles throughout the opposite lung.  Stage IV. No surgery possible. Too much to radiate.  Chemo might bruise the cancer, but offered no cure.

“How long do I have to live?” Sue had asked. “Three to six months. Three without chemo and maybe six with. You need to get your affairs in order.”

Tough, realistic and focused, Sue had everything in order in three days.  Will renewed, advance directive complete, even funeral home arrangements ready.  Now just one thing to do: die.  Sue had lived a wonderful life and it was over.

Her son arranged a second opinion consultation with a pulmonary neoplasm expert at a “world class” tertiary care cancer center, that “wrote the book” on how to treat lung cancer.  Very exciting, heady stuff.  Sue refused to go.  She drew the line at traveling to hear the same dire pronouncement.  A meeting with a local oncologist, just a mile from her house, was scheduled. A compromise that left her feeling compromised.

Husband, daughter, son and Sue crowded into the exam room, each with their own list and agenda.  When the doctor entered, he seemed to focus entirely on Sue.  Oh, he shook everyone’s hand, spoke to each, and answered all questions.  However, his gaze was on Sue. He seemed to be measuring her, studying her, trying to figure her out. Maybe even a little spooky. Moreover, he asked odd questions.  Was she spiritual?  What were her hobbies?  How many grandchildren?  About what was Sue passionate?

Still, she had that cough.  The x-ray showed pebbles.  The pathology report said cancer.  Surgery was impossible.  Radiation a bad idea.  Chemo almost as worthless as sand castles in a hurricane.  Stage IV cancer.  Just one thing left to do.

“Doctor, we need to know the prognosis.  How long am I going to live?”

“Do you really want the answer?”

“Yes.”

“Well, Sue, you have a cancer that cannot be cured. You have a cancer from which you will probably die. I have no idea how long you have to live.”

“I was told less than six months.”

“That might be right. Might be wrong.   Statements about time and life are much more up to God than me.  Really, look at the research; the only time doctors are good at predicting survival is during CPR.  However, I can tell you this.  Right now, today, tomorrow, you are alive. How you live that life and how long, is up to you.”

“I don’t understand.”

“Well, you can say, ‘Hey, I have cancer; I know what that means,’ and go home, turn out the lights, and wait in a corner to die.  If that feels right, that is OK.  Or else you can decide not the play the “cancer patient” role at all.”

“How would I do that?”

“You would grab each moment, love every sunrise and jump into each day. Revel in the life you have.  Exercise.  Eat.  Fight.  Get out and celebrate.”

“But, the cancer will still be the same.”

“Perhaps.  But, you can live the time that remains, and not die while still standing.”

The second opinion for the cancer was unchanged.  However, to Sue, the prognosis was different.  She went home and cried for a long time.  She decided that her affairs, after all, were not in order.  There were people to see, places to go, things to learn, letters to write, cookies to bake, prayers to say and wind to feel on her brow.

Sue died not long ago.  The lung cancer did not stop.  Nevertheless, in those four years since the diagnosis, Sue rejoiced.  She celebrated daily smiles, family travails, dry Thanksgiving turkeys, the moon on Caribbean waters, 43 books, long walks with blisters, bad April fool jokes and two grandchild births.

The medicine that kept Sue alive was not in a bottle. It was an elixir from her soul. She learned that those last years were not a part of death.  Sue healed and gained strength because she decided to live.  Whatever tomorrow might bring, sunrise or sunset, this moment, right now, is infused with the glory of life.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

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  • Suzi Q 38

    Good Story.
    This is a lesson for all of us.
    No doctor can predict the future with certainty.
    I like the idea of living as if it were my last year.

  • Elizabeth Corcoran

    That was absolutely beautiful. Thank you.

  • meyati

    I guess for some people this platitude is a new concept. It shouldn’t be. I got rid of the team leader because he was the opposite of the good doctor above. He promised me that if I had radiation, that in about 5 years that i would go to him and beg and cry for the radical surgery that he proposed. I told him that he could not be certain of that. He said, “How can you say that? I’m an oncologist and I do know you will be in begging.” I told him that either one of us could die or move. He said that if i had the surgery, I wouldn’t die. I asked him if he ever heard of car wrecks, falling off a ladder or being hit by space junk? He wanted me to see a shrink. Tomorrow I’m seeing my new team leader that is on the same planet that I live on. I asked a counselor to join us. I’ve been fighting with the counselors and Nurse navigators. As my 26 year-old grandson says, he seems to be less of a douchebag than the others. He doesn’t realise that we’re going discuss basic treatment-I’m allergic to bandaids, I was bit by my dog, they put stitches in and bandaids on. I told them that i just finished radiation for aggressive cancer at the ER.I begged them 3 times not to use bandaids. Within 48 hours, I was hospitalized on IV antibiotics, because of the allergic reaction combined with the infection. I was chugging antihistamines too. I had my hand tied up for about 2 weeks. My son bought an IV stand. I’m allergic to acetaminophen and NSAIDs. At least they allowed me to have codeine sulfate and saw that I did quite well with it. It seems like the HMO isn’t charging me for either the ER or the hospitalization. The nurses at the hospital slipped me those stretchy cotton cuffs that you slip over the arm. I begged to use those at the ER. So the good counselor will find out why I’m suspicious and argumentative of medical staff. By the way, when I got home, the coonhound checked me out, ran and got the rawhide bone that I trying to take off my bed, and he dropped it at my feet. What really gets me, is that tomorrow, your medicare money is going to pay a doctor to do a nurse navigator’s job, get my medical history. When I first went in to see the god-complex, he obviously recommended radical surgery. He left with the instructions that she would take care of the details. I asked her about lab work to get a basic foundation. She said, “He didn’t order any,” and walked off. Between that and trying to get a new oncologist-the war was on. It’s literally my life.

  • Sacramento

    Thank you for sharing that lovely story.

  • Julie Saeger Nierenberg

    This is the best blog post I have read in such a long time. Thank you for so perfectly presenting the story of Sue. My father, also diagnosed with terminal cancer, chose to LIVE fully each day until he died. He requested that I write our story, the tale of his journey facing imminent death and our journey of acceptance, love and loss. I would be honored to share the little book with you. Please write to me if you wish to receive a copy: julie-nierenberg@hotmail.com. Again, thank you for this well written tale!

  • Angellinda Landowski

    Thank You for sharing. My thoughts are with your family. I’m so sorry for your loss. You have my heartfelt sympathy. When I was told I had Triple Negative breast Cancer it was one year after my husband lost his job & insurance. I thought- there’s NO way I can’t afford all of the tests, ‘scripts, care, nutrition, and complementary care. We’re living on Love & a Prayer with zero income! But I never found my expiration date anywhere! Who knows? I might still be good after my expiration date?! My husband begged me to live! I’m a woman of my word and am still here. I wish everyone their healing. For those that are hurting/missing/.grieving loved ones. May you find comfort and Peace. Sending my care!!

  • drjoekosterich

    Wonderful article. We will all die- it is the life we live and the way we live it that matters. Sue in choosing to live rather than wait to die shows us all a great example

  • Theresa Santoro

    100 percent believe in this . I have been witness to this several times. A great lesson for everyone walking on the planet today.

  • Sara Stein MD

    Beautiful and true. Thanks

  • Wy Woods Harris

    Listening to our souls is the Best way to Living Well Eternally!