Category: Dealing With Death

This category covers things that relate to death or dying. Death is unavoidable and there is no value in not talking about it or treating it like any other experience that we have. In fact, dying is one of the few experiences that every human being will have and almost as many will be faced with dealing with the death of someone we care about. Any lessons or knowledge that can be gleaned from these experiences should be attended to and treated as wisdom because they are hard earned and painful to acquire.

Reasons To Not Be Afraid

I’ve got a lot, but I am. I have been for years.

Sure, I can continue to wrack my brain, analyzing the hell out of my memories and ripping apart my actions looking for meaning, but that hasn’t gotten me any closer to the truth, happiness or to a level of satisfaction with who I am, my place in the universe and even a reason to keep going. It can’t, I’ve been lying to myself for a long time. I didn’t really realize it. When I was small I told myself a lie, a story, and I went with it. Then life became it, and finally I did too.

That isn’t good enough for me anymore. There is more to this world than these distractions I’ve been seeking and compulsively indulging.

My therapist suggested that I make 2 lists, one of the why’s and one of the what if I stop. I thought it would be tough, and it was kind of, I crumbled and cried and the self-loathing seemed to grow exponentially. But I had a lot to write and the ease at which it flowed out of me help me see that I have been ready for a sometime, but just afraid to step off the cliff and drop to my death. I liked the old me, but he was selfish, scared and offered only conditional everything. Those who knew me saw that things weren’t right, those who knew me really well would leave. My family and close friends were the only constants, and of the friends, only those who engaged me like an Adult, without judgement remain. And that was key unlocking the gate and convincing me to take the leap. I AM an Adult and it is okay to forgive myself for my past actions. Further self-judgment here is pointless.

The why’s of my compulsive behavior:

  • Predictable outcome – good or bad, I knew what would happen and there is some sense of security in that
  • It created a false me / them dynamic that helped me feel like I was different
  • It closed me off from other people, which helped me feel like I didn’t belong
  • It is wildly isolating, alienating and paradoxically not the person I presented myself to be
  • Being isolated allowed me to indulge my thoughts without outside perspective to balance them
  • It helped me feel different and deviant so not as good as anyone else
  • Doing it helped me feel a sense of shame that I could wear and feel inferior to others
  • It altered my emotional state temporarily so there was some escape for the emptiness / insecurity that I felt
  • It was childish and was a calling for some sort of love that I didn’t think I was getting
  • It was proof that I wasn’t okay and therefore not worthy of the things that others may enjoy
  • It helped me get a very nice body that I thought would compensate for my lack of confidence
  • It was easier to keep doing what I was doing vs. put the effort in to change

The what if I stop my compulsive behavior:

  • I will save money
  • My teeth, skin, and body will look better
  • I will feel my baseline, whatever that is, and be able to get the help I need to adjust that
  • I will improve my spiritual health as I become reconnected with the universe and the people on the planet
  • I will save a lot of time
  • I will feel my emotions clearly and in a timely fashion allowing me to properly engage and parse them for the information they are revealing
  • I will be free of the anxiety and guild associated with indulging compulsive thoughts
  • I will be able to recover from my fathers death more effectively
  • I will be acting with self-love and treating my body, mind and spirit with compassion
  • I will be acting more like my mentors
  • I will not be harming myself
  • I will have removed the monkey from my back and will have stopped doing something I am ashamed of
  • I will have gain the knowledge of just what these compulsive behaviors have been doing to me
  • I will be acting responsibly, I will be acting like an Adult
  • I will no longer be acting in a hypocritical way and this will restore my integrity
  • I will be thinking more clearly, my body will be functioning more clearly and I will be reducing a number of very serious health risks
  • I will be in a position for find a partner who complements my life but does not give it purpose
  • I will have a better idea of my actual worth and be able to take more effective actions to help me achieve my goals
  • My public self will match my private self and any dissonance between the two will be eliminated
  • I will not need to be living and managing two separate and incomparable lives

I looked at the lists when I was feeling absolutely crap over the last few weeks, picked an item and mediated on it. It didn’t take long for my chest to puff-up and for the fighter in me to come up to scratch. My actions are my choice so stopping is as easy as just not doing it anymore.

However, there is something going on inside my brain that this exercise was supposed to bring to light and my therapist was happy that it came out. I’m not necessarily afraid, but I am anxious.

When I Died

The last few weeks have been an existential stew/spew.

Here’s the thing: for most of my life I have not had a soul – I’m an atheist. Not having a soul and having lived a life with a concept of spirituality that was hard wired so to impulsively think “soul” and just tune out, I haven’t been engaging the world as effectively as a someone who is in balance with the universe and those within it. Obviously….

I don’t believe in prayer. Seemed kind of unnecessary to do something pointless. It would be to me I guess, but it isn’t to the person doing it. I say this not because those who pray tell me it isn’t pointless, I say it because I believe their prayer serve to cultivate something that is very important in peoples lives. It’s something that has been missing from my life for a very long time.

I have found a need for a spiritual piece in my life. I have lived an extremely good life, with a great family, great friends, great girl friends, a life with more privilege than 98% of the worlds population yet I don’t feel that way subjectively. My life has been series of temporary experiences most neutral, some great and some bad. But in general waking-up each day is both a blessing and a drag.

But it isn’t always that way. There have been times of extended bliss, when I exist in a child state with the brain of an adult; when I would play, shameless and with out fighting anything. I was okay and the world was okay. During these times I didn’t actually realize what it was that I was feeling, it just felt right and I floated along knowing what I had to do next, starting it with a smile and a sense of excited anticipation. Thinking about it now, those moments / periods were the times in my life when I was cultivating my spirituality in that my thoughts, feelings, movements and purpose were aligned and I was moving forward with pure intention.

For a long time I have blurred the lines between religion and spirituality. To foster a sense of each, one need only do the same things – align their thoughts, feelings, movements and purpose and move forward with pure intention. Praying is similar to mediation, particularly when you know the prayers verbatim and trance out while saying them. In each case, the attention is highly focused on something and this will have a very similar impact on brain waves. Going to a church retreat is very similar to going to any social event that has a theme – a Star Trek convention is not a religious experience in the traditional sense, but it has a lot of the characteristics and the same group-think mentality. Both events serve to create a union between many people and allow for the shameless existence for all participants.

I have always been a spiritual person but I have actively worked against this aspect of my nature because I am an atheist. It has become clear that I do not enjoy a lingering sense of peace due to my lack of attention to fostering a sustainable ME. A strong spirit will continue for a while even without active cultivation. But it needs to grow first, and before that, it needs to be encouraged and allowed to take root.

Spirituality then is about my relationship with the universe. Relative to the rest of the universe, I’m moving really quickly away from everything. Relative to what is on the earth, there is a very dynamic interaction of everything. The essence of my life, of my spirit, is mostly here on earth. Most of what I actually interact with is contained within my body. Most of the nurturing needs to be spend on aligning my thoughts, feelings, movements with my purpose.

When I gave-up the notion that I had a soul I died because that washed away most of the objectiveness about spirituality. This prevented me from seeing the benefit that altering my thoughts, feelings and movements will have on creating a unified ME that has the power to continue to exist even when I am not thinking about it.

Why Losing My 67 Year Old Father Is Only As Bad As Sad

When Natalie got killed many years ago there wasn’t anything anyone could say or do to make it right or make it feel better. It was going to be unpleasant because there wasn’t much of a silver lining to see. There still isn’t, there never will be because 21 is an awful young age to die for someone who should have come much closer to their life expectancy.

Some death is like that, unjust and tragic. It’s outside of the natural cycle of things and you do what you can to manage the whole thing. It will remain that bull shit event in the past and you may be able to manufacture a meaning out of it, but you’re just as likely to end up addicted to drugs to numb the pain. The waves of this type of death ripple forward into the future, carried along on impossible “what if” questions.

Cancer in someone who is almost 70 is not the same thing as dying at the wheel of a drunk driver at 21. Someone dying closer to their life expectancy is at worst unfair. The ripples from the death of a much older person are from the past and they’re good because they are the answers to the “what if” questions. Some think this too clinical, a little Vulcan, unkind or uncaring and I’m good with that. The thing about thoughts on how I should carry my business is that they aren’t of any consequence to the catalyst for in this situation. Cancer controlled what happened.

I had an honest and complete relationship with my father, I challenged him as a person and as a dad, I am not the same type of thinker as my father so he’s had to learn how to engage me as I have had to learn how to engage him, we always liked and respected each other and while there may have been things that we didn’t like about how the other acted, we cared enough about each other to not really care that much about those things and to actually learn why the other person felt or acted that way. We were not the same but we liked how the other was.

All of this is to say that my dad was a good guy who loved his family and friends and he had a great relationship with Des, my mom and me.

As adults we talked about a lot of the things people don’t really chat with their parents about. I asked my dad what it would be like to have a son die – unjust, unfair and something that he’d get past but never over. I asked him what it was like when his dad died – sad, a real existential struggle to piece together the rightness of his father and the wrongness of losing him at 60. I asked my dad what he thought the purpose of life was – I don’t know, I don’t think it has one other than what we give it. Try to have as much fun as you can without hurting others. Why didn’t you focus on making more money as opposed to focusing on delivering what you promise – because you’ll just spend the money and have to live with yourself for not being your best. What mistake did you always make – I didn’t stick at anything long enough to reap the rewards of being really good at it, once I did it, it got boring. What mistake do you always see me making – you feel the need to get into relationships. When you die, what do you want me to do – keep building the panel business, look after your mother, maybe be a little sad, but don’t dwell on things. Life was going to end, it has to. The world doesn’t need that many old people.

I laugh at the last answer a lot. My dad knew he had his run and that it would end eventually. He was satisfied with it. At the end it was peaceful. A comfortable wind down chatting with the people he cared about, eating great food and maintaining the perspective that his time had come and that it is good to not linger when it does.

Grief Is Like A Concussion

For someone who hasn’t experienced grief it is tough to get a handle on what it is like to go through.

Astounding is the amount of pain you can feel and the lack of control you have over it at times. Science covers it – the experience of grief is chemical and it is dynamic in both time and make-up such that you experience different things at different times and the interval between the spontaneous grief moments is random. You cannot expect a linear recovery when a loved on dies. Some moments will be filled with a paralyzing sadness, then you may feel a wave of guilt followed by laughing. Your wit can be sharp and draw out the humor of the situation then you can seems to chew on your words unsure of what they mean and why you are saying them. Healing from it is not like the recovery from a broken leg.

Healing from grief is like healing from a concussion as the symptoms and nature of the injury are very similar. With head trauma, the brain has been injured changing mental function and forcing recovery / adaption. With grief, mental functioning has been changed forcing adaption and an enormous revision of your world view. In both cases, other people can’t see the injury and both are all in your head.

The experience of a concussion isn’t nice. You feel wrong and dumb. There’s something missing from the way you think, it’s slower, not as sharp and the spontaneous answers seem grid-locked inside a haze. Emotionally you’re fine, then you’re crying wanting everything to be over, then the mania or elation, followed by being fine….It is crazy behavior. It feels real enough as all of it happens, but during the fine times the lows don’t seem possible.

The part of the reason why I find healing from grief so unpleasant because the pain is coming from inside me and in an ongoing way. With a traumatic body injury, a broken leg for example, there is a linear improvement once the injury has been stabilized. With grief, months later the pain can feel as fresh as the moment when you first heard the news.

Someone could get good at the grief process because it is a skill. There’s a way to manage it that reduces the stress to those around you while letting you continue to be fairly productive. But as processes go, it is one with no clear end point. Flesh and bone heal in 2-3 months, the brain recovers when all of the old functionality has been restored through reorganization and rewiring.

7 Days To Die

When we took my dad to the hospital on Sunday January 22nd it was to get his cough looked after. It didn’t seem serious at the time.

He had pneumonia and was put in single room. On Monday evening, he, Des and I hung out and joked around. It was easy to laugh, my dad was laughing as hard as us. The jokes were funny as they came from and went places. The back of my head hurt from laughing. As I said good bye I was looking forward to seeing an improvement in the pneumonia at lunch when I saw him next.

Tuesday at lunch didn’t reveal the improvement in energy I had been excited to see. There wasn’t the same vitality that had been there the night before. The symptoms of the pneumonia seemed to be less, he wasn’t coughing as much, but he didn’t really want to get up. His appetite dropped and while he ate the hospital food and some of the stuff we brought from home, he wasn’t attacking it anymore. Before I left that evening we chatted trying to get out by the weekend. We believe what we want to believe and that colours how we remember things. I know I felt that there was a good chance we’d be home for Saturday or Sunday and he could be back to dying from a brain tumor.

Wednesday he was moved to a double room although it didn’t make much difference. My dad slept most of the day, only getting up to go to the bath room and when the staff needed him to do something. He talked quietly and very little. It was almost peaceful because I didn’t know what I was seeing. To me Dad was sleeping off pneumonia, the medication was working and rest was what was needed. I left optimistic again for Thursday.

I would have missed something about this day had Des not pointed it out when it was happening. The patient that my dad shared the room with on Wednesday night moved out before noon on Thursday. The staff seemed to change the way they engaged my father. I didn’t really notice it at first, although I realized I had seen it when Des said “they seem to be regarding this as a palliative case now.” They were.

Friday was the same thing. The family at the hospital as much as they needed to be. The doctors and nurses doing what they do. IVs to help with this and that. I’m starting to feel my grief cycle ramp-up. Great early, good for most of the day and then the low points later in the day. The walk to the car as I go home this night chills my optimism more than it chills my skin. I know he’ll be there in the morning, I just don’t know how much more of this he can take.

Saturday, mom and I meet Des at the hospital. Nothings changed. The IVs are current. Dad is breathing and resting. Lunch, some other stuff, talk with the nurses. Do whatever it is we do, but as the day progresses, it feels different. The day light fades, and I have what I believe are to be my final moments with my father. It’s close to 10 pm as I get off the phone with an old friend who had shared a mutual fondness with my dad. The room is quiet except for the IV and the oxygen. My dads breathing is slower and lacking the consistency it held this morning. I hold his right hand, look at his face and wonder why I didn’t think it would be like this in the end? When we were in Ireland and he would pick me up and carry me, I couldn’t have imagined that between that moment and this one, the path our time together would take. Strobbing through my mind are pictures I have of my dad doing the things I remember. Laughing, working, driving, cooking, teaching, everything that my brain seemed to ever experience with him taking its moment to reveal itself and the memory that has become a piece of my personality.

There had been a linear decline over the last 7 days. I don’t know how someone leaves a parent knowing that they’ll never see them again but I did. When the phone rang Sunday morning I knew why I left.

Being Honest About Time

Seeing life slip away can be beautiful. It has a big impact on the willingness for honesty and there’s a dramatic shift towards being authentic. Why pretend anymore? There’s a big difference between having 6 and believing you have 500 and knowing you have 6. When you know you have 6 you’ll enjoy them fully and you’ll not let anyone take any from you.

And I suppose that we all think we have 500 so we float along enjoying some, sharing others, and allowing some to be stolen from us.

Cancer is greedy. It takes more than it’s fair share of the 500. It takes more than what we let others steal. But it gives something in return those who steal do not, it illuminates the end of the timeline. The flash of the terminal diagnosis shines brightly on what you have left so following the path to the end is very easy. You clear your schedule of the stuff that steals any of the time that remains.

You call in your troops and they shield you from the nonsense. The family pick to block obnoxious one on ones, musical chairs to maintain the wall of one between the cancer and the cancer, it’s a play book being written with each visit from someone who never mattered to us and always seemed to cost us energy.

It’s a sad sort of dream team simply because it is needed.

I’ve been left wondering after a well played game why I’m in this situation and what other things have I been letting into my life that share the same root cause.

I really want to be liked by other people. At least I used to want this. I’m not sure it’s worth the cost anymore; not to assume it ever was. I’ve normalized this habit though. I’m more aware of the interactions with people that leave me feeling unsettled than I am about the ones that leave me feeling nothing. In the last 3 years I’ve started to tread away from these types of interactions in favor of ones that leave me feeling good but I still have a tough time telling people to get away from me or just ending “friendships” that never worked.

The new awareness that death comes sooner and that time becomes more valuable as you near the end is forcing the issue about the pointlessness of wanting to be liked by other people. Almost everyone I know now will not be there when I die. The people I am choosing to generate mental friction about are not even aware of it and none of them will be there in the end. Wanting to be liked isn’t working for me anymore so I’m giving up on that habit. It hasn’t been authentic for a long time.

How Doctors Die

How Doctors Die: It’s Not Like the Rest of Us, But It Should Be by Ken Murray is a very interesting article about how doctors respond to the news that they are terminally ill. It goes into the costs associated with keeping someone alive when their bodies can no longer keep the disease in check – financial, social and suffering costs.

One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

The author recaps a number of stories about doctors who get the news and simply stop working and spend their remaining time doing things they like that make them happy. He feels that for many of them, having seen the suffering caused by futile care for years, the choice to just say “no thanks” is not just easy but the only choice they can make and still do no harm to their patients (in this case themselves).

The article reminded me of doctor Mark Greene in the TV show E.R. He had ended up getting cancer and having a new wife and a young child he fought it and beat it into remission. It did however come back and he made the choice to not fight anymore. It had been hard and he didn’t want to do it again. Dr. Greene spend his dying days in Hawaii with his family and died peaceful in bed.

When I watched the show I remember thinking that it was odd that a doctor would choose not to fight again given that he had been successful the first time. But there was also something that resonated with me that sometimes the distinction that you have a battle to win is simply not true. Even if you are not sick, you will never be new again. Your body has been falling apart since you were born. If you are sick, you will never be cured, even if they cut it out, zap it with radiation and stop the bad cells from dividing. Getting cancer is a one way street and no matter what they do, it can come back. You can fight the toughest battle, but without a new body, the old one has that weakness and the cancer has time on its hands.

There isn’t anything wrong with fighting, there isn’t anything wrong with wanting more time for yourself or your loved ones. There isn’t anything wrong with being grateful for the warning and having the time of your life as it winds down. That’s what a lot of doctors do and I get the feeling it’s what most of my dad’s doctors would do.

“I Was Given Three Months To A Year To Live As Are All GBM Patients”

And it is really tough to hear anything other than “dead soon” in those words. That is the acute emotional reaction to news of a brain tumor in you or someone you love. But the symptoms of the disease are treated, they go away, the mind returns and you then get to the business of what to do about it.

You cannot predicate the future so the doctors say weeks to months. The doctors that have the tools to do something about it – radiation, chemo or surgery – have more optimistic predictions as they have some power to cut out, kill or retard the tumor cells ability to replicate. The rest of us float in a fog wanting it all to be a dream.

But the doctors can’t predict the future so they have to say weeks to months. 5 years is 60 months and there’s a 4% chance of that. They encourage you to get your affairs in order because it’s just good practice and because it forces the family to have the conversations that are easy to avoid otherwise. Being alive in 5 years is a possibility. Being alive in 1 year is a good likelihood. Feeling better than before being diagnosed is an almost certainty with treatment. But the decision to undergo treatment needs to be made and it should be made with some level of understanding of what the treatment is like.

I happened across a site by and about a guy named Ted who was diagnosed with GBM in 2006. An interesting first hand account of what it is like to get treated and to live with a non-growing tumor in your body. I particularly liked a section written by his wife:

Personality Changes:  Ted’s attitude had gotten really bad right
before he was diagnosed.  He was angry all the time and kept telling
me he had no passion for a cause anymore. Fortunately his anger wasn’t
directed at me.  He seemed to be angry at the world but at the same
time he felt numb.  He went from the energizer bunny to not wanting to
see anyone or go anywhere.  At one point, I asked him what he had
done with my real husband.

The day before he was diagnosed I actually told him I thought he had a
brain tumor.  So I wasn’t as shocked as he was when the doctor told us
that he did.

Mood swings:  After surgery the doctor predicted mood swings.  I was
really concerned.   He did have a few, but as he has healed, the mood
swings have virtually disappeared and he has gone back to pre-tumor
behavior.  I have him back.  It’s wonderful.  I will always be
grateful to the surgeon for bringing him back to me.

Having seen a lot of the passion my father had for live disappear over the last 6 months it’s reassuring to read that it is cancer. The foundation of the world shakes when one of your mentors seems to give up hope for anything. It’s nice to know that the hope and passion are still there, they’re just being blocked by a tumor.

Visit to the Juravinski Cancer Centre – For Glioblastoma Multiforme (Brain Cancer)

Today was the first visit to the Juravinski Cancer Centre in Hamilton for my dad, with my mom, brother and me. This was the first time I had visited a cancer center and the last few weeks are the first time in almost 30 years that I have actually given cancer much of a thought.

I like the center. It’s clean and it was warm and I had the thought that it would be a comfortable temperature in the summer. There is a hospital like feel to the place and there’s no mistaking that you are in a health care facility. Missing though, thankful, was the chaotic semi-shell-shocked movements and anguish you get from the masses in emerge. At a cancer center everyone is there for a reason and everyone inside the building knows it. It’s all about the cancer and the people it’s killing.

The way this place worked today was simple. It’s a clinic and there are a team of doctors and health care providers who are specialized in cancer treatment. Our team had a neurosurgeon and a neurologist because of my dad’s diagnosis of Glioblastoma multiforme or GBM (brain cancer) – I would imagine that they’d have a specific type of surgeon and specialist for different types of cancer – along with an oncologist, 2 radiation doctors and a nurse.

The nurse introduced herself, chatted and collected a detailed health history, current medication, information about how my dad ended up in the hospital, symptoms, and she asked for any imagining that had been performed. She asked if we had any questions and left with the CT and MRI results.

The oncologist was next, he came holding, among other things, a picture of one of my dad’s MRI images. He chatted about about the key stuff – the last 6 weeks and ultimately what the neurosurgeon has said at the hospital 2 weeks ago – GBM, a brain tumor that cannot be removed. This doctor agreed. He showed my dad the MRI and pointed to a thing in the center that doesn’t look like anything else on the page.

He preformed a complete neurological exam and explained the next hour. The team of doctors would meet and review all of the information and then would be available to discuss the opinions on treatment and the prognosis. “Come back to the same room in about 30 minutes.”

He was nice, like the nurse. It sounds silly to say “nice” but that’s what they were. Try walking into a room with a time bomb, hand it off to a family, and still have them think you were nice. It was completely professional and if it hadn’t been for why we were there, I think we would have talked about how nice the whole thing was while we waited to hear what could be done about it.

Some food at the cafeteria / lounge that had a piano but no singer. The family chats back and forth about stuff. I’m looking around and starting to feel strange because as I look at each group of people I’m trying to guess which one of them has cancer. If you haven’t played this game, you don’t really win when you guess correctly. There’s a table of 3 people, one is dying, the two that aren’t are going to be grieving their asses off soon. You can’t guess who is who without looking at their faces and when you do, you see a 21 year old son with his mom and grandmother, mom’s in a wheelchair because she has cancer. I felt rage deep inside that made me want to wreck something for what’s about to happen to this poor kid. I suddenly wonder what type of cancer killed the cafeteria singer and as I do, my eyes meet Des’ and he’s just seen the kids future too. I glace away towards my dad unwittingly winning another round of the stupid game my brain is playing.

We head back to the room and the doctor returns. He presents the treatment options. The tumor cannot be removed so my dad will never be cured. If he wants to fight it, they’ll remove as much of the tumor mass as they can, give a course of radiation and chemo, some recovery time and then more radiation and chemo. He’s free to do nothing about it, and that isn’t an unreasonable choice. The nurse and doctor spoke candidly about GBM and what’s in store when you battle it. Your life lengthens by months. But they have to open your skull and cut pieces of tumor out while avoiding causing serious brain injury. The goal of this is to create enough space for the swelling caused by the radiation and chemo to fill without causing cognitive impairments.

The fight is brain surgery, then radiation and chemicals to kill cells. Give the body some time to recover from all of the trauma and go at it again.

It’s reasonable to say no thank you because it can be a rough ride, with no guarantee of doing much. And there are no halfway measure. You’re 100% into the fight or you are not. It’s becomes a philosophical issue more than a problem to be solved by science because with cancer, the science isn’t strong enough to offer guarantees. You throw the kitchen sink into the battle or you don’t. Either way, you are now dying from something.

The team of doctors came in and answered all of our questions. They removed the shame from making any choice while offering 100% of their focus to fill their piece of the treatment puzzle. Again, it was really professional and the conversation was honest and caring. The time-lines are estimates, the tumor is serious, the treatment is not a cure and it can be rough. Consider your options and we’ll talk next week. After the thank yous and the goodbyes we head home and they go to meet their next round potential soldiers in the fight against cancer; which is good because these are the type of people you would fight for and they are also the type of people you would not feel bad saying no to. They made it clear that there is only one right choice and that just happens to be the one that my dad will make.

I’m not sure if I’ll ever be back to the Juravinski Cancer Centre in Hamilton. Right now that’s up to someone else. But if I go back it won’t be with a sense of trepidation or fear because my dad would be in good hands there.