If a patient is led to believe his life is far from ended, he may put off preparations for those who shall survive him. When, through misguidance, he discovers that he no longer has the time which he was "allotted," he may feel frustrated and foster deep regrets.
Preparations cannot be made without a previous knowledge of one"s illness and should one fall rapidly into his demise, there shall be no time for the a.s.sumption of his rightful choices.
Many people have confessed their more precious moments were spent after the knowledge of their forthcoming death. Life was lived to its fullest, since unimportant worries fell venomless before meaningful concerns. There can be rediscovery of those aspects of life which are so easily taken for granted; one can relearn to see the world other than through the tunnel vision of self-preoccupation. Look up and drink in the sight of a star-filled night; peruse the ground for the tiniest flowers, and catch and return a stranger"s smile. Savor the smell of an orange and feel the cool rain pelt upon bare arms.
Often the most elemental of things bring the utmost pleasure.
I had only two objectives to accomplish while in the hospital; education and recuperation. With regard to the latter objective, I pressured the doctor, to a certain degree, to note my rapid rate of recovery so that I might be able to sample hospital food. I wanted to make certain that I ate solid food in days, not weeks, as had been the case on my initial stay at St. Mary"s. My body cooperated with my scheme, and I was soon eating voraciously. I didn"t care what everyone else said... I thought the food was delicious.... even though my first meals were made up of liquids or soft food. It was a joy to be able to eat again, and my body was in dire need of replenishment; I was never nauseous following a meal... perhaps my stomach was too starved to concern itself with the extra energy it would have consumed in making me sick.
The ward in which I was recuperating was rather small for the four of us who slept there, and I was more than exuberant upon receiving the information that I would soon be moved to a semi-private room. The ward was buzzing constantly with activity, as the elderly women were given various medications, mental awareness quizzes, and frequent visits by the physicians. Visits by nurses would occur throughout the night and therefore afforded little true relaxation. Privacy was also a difficult matter, since curtains were the only form of separation from the crowd; I often wished to speak with my father, but felt undeniably hindered to do so, as I did not wish to evoke an atmosphere of secrecy nor did I want to impart to the general public one of my personal concerns of fear. Another observation of my surroundings, which I might add, I found more humorous than disturbing, was the fact that my roommates doubtlessly felt quite at ease due to their obvious lack of consideration for the more lady-like behavior customary in other social situations; they freely gave full reign to any of numerous gastro-intestinal noises which plagued their comfort, creating a laughable facet of hospital living that perhaps few would appreciate.
True to character, I tried my best to squelch any roars of hilarity and enjoyed the entire affair silently in the confines of my corner. My move to a semi-private room was a remarkable improvement, and I found my roommate to be amiable and very sensible. A middle-aged woman, she was hooked up to at least two machines to drain impurities from her system. Her unpleasant state was further increased by her husband"s bland concern; she was alone at the hospital, which was made even more apparent when her call to home spurred less attention than did the football game her husband was viewing on the T.V. Although she chuckled about the brief episode, I am sure the apathy on the other end of the line must have hurt.
Shortly after my placement in the room I was allowed to eat "regular"
food. To be quite candid, I was elated upon hearing the news and asked when I would be receiving the first sampling of solid fare.
Surprisingly, I was able to procure a snack that very evening and feasted royally. My nurse cautioned me, not wanting me to have difficulties later with indigestion, yet no such ill consequences occurred and I contentedly slept the entire night.
Having been placed on solid food, I rapidly gained strength and proceeded to exercise my body to further aid in its full recovery.
I still tired easily, however, and found myself obliged to nap on a regular basis; in this I have always been fortunate. . . I have an ability to sleep despite adversity. Sleep is the only drugless manner in which to temporarily release oneself from a troubled mind, providing of course, that the subconscious does not wreak its own havoc through the presence of nightmares.
The day came that I had been working toward with such intensity and fort.i.tude of spirit. . . that being the day of my release from the hospital. When the doctor made his morning visit he informed me that I would be able to depart early the next morning. I asked whether I would again see Dr. E. before leaving, and learned that a visit was in his plans. As it happened, he arrived shortly, and before my father had eaten breakfast; this allowed a one to one confrontation which I truly preferred.
Whether through avoidance or mere circ.u.mstance, the doctors never paid any visits when my father was present. They would make their daily rounds early in the morning, long before he had arrived, or at night when he left for his motel. This seeming "avoidance" could have been due to the fact that I was no longer of child status, and the doctors felt that decisions should lie heavily on my behalf rather than confusing matters by including the emotionally wrought inclinations of my relatives.
Personally, I was relieved that I was able to confront the doctors alone, thereby allowing a fluid question and answer session, uncomplicated by concerned family members who might have misunderstood information, or in their excitement, failed to hear other facts and necessitate repet.i.tion; these group encounters are seldom low-key when they do occur, and thus I found myself ill-prepared to deal with such intense conversation while still drained from the operation itself.
When Dr. E. entered the room I had prepared myself for ingesting a fair amount of information and sat upright in my bed with a pad of paper and a pen to capture all that he was about to tell me. Moreover, the days which I had just spent in the hospital were not simply taken up in leisure time activities such as watching television or browsing through magazines; I had devoted a great deal of time to serious thought.
I feel that everyone has a limit as to how much he will endure, both in the physical and emotional sense. Since physical well-being reflects one"s emotional health and vice-versa, the body will set its own limitations if one is but aware of them, and of course, heeds them.
It is not living, but the quality thereof, which for me determines my capacity to endure physical or mental pain. Life with excessive pain is merely existence, and it is precisely that mode of existence which I shall always wish to avoid. Life for the sake of life is merely the fearful abhorrance of death, the final cycle in earthly existence.
Undergoing a full year of chemotherapy was sufficient time for me to grasp a clear idea of the drugs and their side effects. I knew at 14 years of age that I would never again be placed under such physical duress; I knew that my emotional health would be in turmoil. To once again attempt to prolong life through such dreadful means would be a price too high to justify.
If one cannot say "Enough!," he is reduced to a mere sh.e.l.l of his former self through treatments which cannot cure; the illness itself is not so cruel. Moreover, one who accepts treatment without a hope for a cure dies in pain multiplied by the lack of peace which reflectance would have brought.
When cancer was once again found to be the culprit behind my distended stomach region, the decision whether or not to accept treatment was virtually incontestable. My only objective was to leave the hospital and return to my redefined life; I desired to regain my strength before it waned as a result of the cancer itself, and this was possible only if I had no treatment. I felt that this was the beginning of the end of my life, and I did not wish to relinquish any of that time toward the pursuit of impossibilities; treatment is a poor word to bestow upon an ineffective poison which would deplete life"s quality.
The doctor wore a distinctly business-like air as he proceeded to explain the details concerning my general state of health. I methodically wrote his words on paper so that I would not forget any relevant details in my later discussions with my family and friends.
The available treatment was chemotherapy, and although there were different drugs in addition to the former lot, he professed that none would actually cure my type of cancer. The result of undergoing treatment would be the temporary shrinkage of the tumor, with the hope perhaps, that a new and promising drug would be discovered in the near future; the side effects would echo those which had so delighted me on the previous encounter. I could not help but wonder if the time lost during the administration of treatment is subtracted from the days which one supposedly gains from having it.
Seeing that I was not reacting to the option of treatment with feelings of great joy and antic.i.p.ation, he then turned to the more sober issues of death via liver encroachment. Listening attentively, I made certain that all of my questions were adequately answered before he fled from the room.
Liver cancer, he said, was usually painless; if pain was a factor, my doctor could prescribe a remedy which would lessen the discomfort. As the liver dysfunctioned, it would lose its ability to metabolize body chemicals; unable to rid the body of poisons, la.s.situde would set in while the appet.i.te decreased. Finally, sleepiness would overcome any effort to remain awake and eventually result in a coma until death.
I felt sorry for Dr. E. as he told me these facts. I could tell that this visit was extremely difficult for him since his eyes did not often meet with my own and he seemed eager to sprint from the room. I had been a "five years and cured" case; the fifth year after my first operation he dismissed me with a clean bill of health. We had given each other cordial good-byes, never thinking the next year would bring such disappointment.
Before he exited the room, the doctor restated that the chemotherapy treatments should commence within a month if they were desired, perhaps his way of punctuating the option which he knew I did not wish to take.
I nodded in acknowledgement. It must be difficult for a doctor, one whose profession is that of helping people live, to find he is unable to offer a cure; it brings to the surface the fact that medicine, although miraculous in many ways, is not omnipotent. Once again we said good-bye, yet this time, I knew it would be our final farewell.
One of the more difficult tasks I had to perform was expressing to my family my wish to forego treatment. They needed to cling to the hope that there was something to be done for my malady, and were not pleased upon hearing my steadfast rejection of chemotherapy. Since I had foreseen, somewhat, their probable reaction, I was prepared for a lengthy duel and had therefore decided to write on paper the key directions that I wished the conversations to follow.
The two discourses which ensued were emotional, yet controlled. I knew I had a weighty task to perform if I was to gently but thoroughly bespeak my desires to my worried father, and later my mother and sister, and further persuade them to accept those decisions. I candidly explained my repugnance toward chemotherapy, punctuated by the facts that it had not worked previously and the doctor had related that although there were new drugs, none could cure my type of cancer. With all sincerity, I said I did not know how long my life would prove to be, yet I wanted to maintain a life of quality, for that best equated my idea of what life should hold for each individual; I desired to own a sense of peace which could never be attained if I continually chased the spectrum of miracle cures so prevalent in a world whose main objective, for many, is the procuring of wealth. Time itself meant little if it did not also have the amenity of joy, and in my 19 years I had experienced more quality than some individuals realize in a lifetime of 80 years; I stressed that my family was an important part, indeed, and inherent part of that quality.
I hoped that my family would be satisfied with my judgment, although their disapproval would not have altered my stance; I feared they would attempt to force treatment upon me through relentless conversation and in so doing, make life at home unbearable. This, happily, was not the case.
After receiving my dissertation, my father needed time to think and sort out the information he had just heard, and decided to take a lengthy walk into town for the duel purpose of eating lunch and trying to digest the disturbing truth which cancer brought to the surface; mortality does not concern itself only with the aged. While he was gone, I replenished myself with both food and rest. My mother was to arrive in the afternoon, and I fully realized I would have to repeat my performance for her and Sharon, my older sister. I wished to appear as normal as possible. I had curled my hair and applied my usual dose of eye make-up to improve any pallor which might have been visible due to the operation; I did not want my appearance to evoke unnecessary amounts of gloom or despair. Satisfied that I had done my best to improve upon myself, I settled back in the bed, clad in the glorious hospital garb which resembled pillow ticking and decided that I coordinated rather nicely with the rest of the decor.
When the entire group arrived it was already late in the afternoon. My father accompanied Sharon"s family on a tour of the area, leaving only my mother and Sharon to visit with me directly. I noticed that my mother had lost weight, underlining the worry that was inscribed on her face; Sharon"s face echoed that emotion, and I knew I must speak with care. It can be difficult to avoid mechanical speech when one is trying to maintain control of his emotions, yet to do so can prove to be less injurious to the listeners if they share one"s feelings on the topic being discussed. Cold facts divulged without the benefit of a warm heart will only multiply the pain; there is no sense in hurting loved ones through callous explanations.
It was with painful resignation that my family members then present at the hospital accepted the future which I so desperately needed to control. More than my resistance to treatment, (for they too had witnessed the drastic effects which are inherent characteristics of chemotherapy) the family was besieged by the inevitability of my death.
There was now the real possibility that I would die long before my parents, and in this they felt little capacity for contentment. At the close of our discussions, I believe everyone derived a handful of solace through the hope that "miracles DO happen"; there were reports of complete remission and cases in which the cancer inexplicably vanished, leaving no trace of its former habitation in the individual"s body. Continuing research in the realm of cancer treatment was also a source of emotional sunshine to my family, and allowed everyone to look toward the homeward journey with antic.i.p.ation.
I felt exhausted. Though I truly enjoyed seeing my mother and was grateful that my sister"s family had made the time-consuming trip, I was happy to grant their leave to partake of supper. As they departed, I sunk back into the bed with a sigh of relief. It had been quite a day... and it was not over yet. I attacked my dinner tray as if it was the only food I had seen in days; it is amazing how an emotional strain can deplete one"s energy as thoroughly as partic.i.p.ating in a rigorous activity.
While I was alone with my roommate, we opened the curtain which separated the two halves of the room so we could talk and feel more in tune with the world. I felt extremely lucky to have been placed with such a personable lady, as television is a poor excuse for companionship (unless one is sharing a room with an unpleasant and irrational whiner!) After my family had departed, she expressed that she had been rather awed by my duo performances. She said she "admired" my strength and ability to verbalize my feelings, and although I graciously accepted her compliments, I told her it had been a topic about which I felt quite strongly. When one"s decision is incontestable, and is fueled by past experience and anguish, the future can quite easily be foreseen.
I believe that one has made the correct choice if, after his decision has been voiced, he feels an overall contentment and freedom from excessive amounts of mental duress. Everyone must live with a patient"s choices, but only he dies with them; this is why it is crucial for a patient to voice, and the family to heed, his personal opinions regarding his future.
Later that evening the troop returned from their meal and converged on the room. Since it was rather small to comfortably house six visitors on one side, we made our way into the hospital corridors to see those sights which happenstance would reveal. We eventually found ourselves in a quiet waiting room which boasted several comfortable and very accommodating couches, as well as a few tables upon which the numerous fragments of jigsaw puzzles were scattered. At this point, any form of diversion was welcome, especially for Sharon"s kids who doubtlessly felt a trifle suffocated in an atmosphere where everything squeaked with cleanliness and relentless order; I"m sure they were not the only ones who felt intimidated as they pa.s.sed through the marble hallways.
We entertained ourselves as best we could, electing to remain in the vicinity of the carpet and couches until it was time for them to leave.
Engaging in small talk and battling with the jigsaw puzzles until totally infuriated at our lack of progress, the night fell away. When the visiting hours had reached their end, my parents and company bid me good-night and left memories of the day which had just elapsed, as well as renewed excitement for my release from the hospital. I reviewed the day"s events as I lay tucked between crisp sheets and a mound of pillows; it had been an exhilarating experience, yet one that brought little actual joy except the knowledge that one has been understood and has found peace with himself.
I greeted the morning with exuberance, and the physician in a likewise manner; it was as if I radiated undiluted joy. I watched as he methodically checked my lengthy incision, and then a.s.sured him that I felt fine when he quizzed me about various details concerning my general recovery. Well aware of my excitement, he cleared my pa.s.sage for dismissal and had me sign any necessary papers bearing witness that I had indeed left the ward on that day. As I rattled off my happiness for going home, he smiled, knowing the elation was no personal reflection on him, and said, "Home"s always the best place to be."
When breakfast arrived, I attacked it with customary glee and then turned my attention to packing. I also took great pleasure in making myself presentable through the application of some eye make-up and donning civilian clothes; it seemed that my release from the hospital was not final until I had my shoes, instead of bedroom slippers, on my feet. I am sure that it is quite psychological, but I think that white smocks make an individual feel worse than his physical health should dictate!
I did not wait long before the family arrived and the time had come to be escorted from the building. Amid the rousing excitement, I wished my roommate a speedy recovery and presented her with one of my floral arrangements; it filled the s.p.a.ce where her husband"s bouquet should have stood. Looking back, I hope it brought more happiness than sorrowful longing for those unforgettable considerations which were never hers to enjoy.
My dismissal was something akin to a landmark affair for me. Although I was in the hospital for only a week, the freedom to walk in the cold November wind embellished my spirit with a feeling of vitality.
Standing amid the elements of nature, it was not difficult for me to accept the cycle which bonded my existence to all living things. To be consciously aware of life"s complexities was living in its truest sense; in life is both urgency and tranquility, yet when viewing life as a whole, there is little difference between the two. Thus the cycle is congruent; though it changes, it remains the same.
It was in this state of mind that I left Rochester, Minnesota. Later that day I was welcomed by my brother, Norm, who then received the "news" with the added support of my parents. We were generally in good spirits, which evoked a rather frustrated, "I don"t see what you"re all so happy about!" a.s.sertion from him; that we should be pleased when no remedy was available was disconcerting. . . with time, however, he was able to understand the importance of quality in life. He also was one who did not do those things which would bring turmoil to his life. If one continually succ.u.mbs to the notions and desires of others, his own thoughts are rendered meaningless, and likewise, is his existence.
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Essay: Suffering