Time Not To Think

I realize that I think differently now.  I find that I am not inclined to think about things as critically as I did before.  During the years of my marriage there was one thing that the entire family did, and that was think broadly and thoroughly.  There was nothing more infuriating to Kevin, my husband, than if one of us in his immediate family took anything bandied about in the public domain – newspapers, radio, television – and accepted it as fact.   He’d read and subscribed to McLuhan’s “the medium is the message.”  There was always more to every single story, the bias of the writer, the political affiliation, the personal life experience, the money that may have exchanged hands; to Kevin, there was always more to the story.  Maybe it was based on fact, but no story could ever convey all the facts.  The reader, if truly interested, should feel compelled to seek out the relevant facts.  The kids were raised this way, if there is one thing that all three of my children have, it’s critical thinking skills.  They can also debate, that too was a necessity in this household.  Speak up, hold your ground, explain yourself, and be able to take some criticism.

I was speaking with Kevin’s sister about this very thing the other day.  One of the missing elements in my life right now is the dynamic of discourse that I shared with Kevin. This is a loss that I feel daily.  He loved to debate things, to take them apart, sentence by sentence, and point out the gaps, errors or assumptions.  Sometimes he was completely off the wall in his perspective on a subject, but it didn’t matter, he’d give it his all no matter how whacked out his interpretation was.  This I miss so very much.  I find that I am unable to watch most of the television shows that we would watch together because they no longer have the epilogue that I was used to.  There are some TV shows that I don’t miss (for the last couple of years he was hung up on fractals – not riveting television). Others well, they were interesting (and usually related to art or music).  The conversation afterwards could be lively, since something he saw or heard might have resonated with him and Kevin would want to talk about it.  We saw and heard the content differently.  In fact, seldom did we process information the same; we were two very different people in our outlook and life experiences.

Sure there are lots of people around that I could talk about things with, but let’s face it, they’re not Kevin.  We had over 30 years together perfecting the offence and defense needed for our verbal skirmishes.  It was a battle of wits, of closing off opportunities before they could be exploited, of leading the debate in a direction where victory was assured.  Both of us were aware of each other’s tendencies, vulnerabilities and weaknesses; so it was a constant effort to work on self-improvement.  Kevin was always up for a good debate, always.  For me, no, sometimes I found it tiring and would prefer not to think.  Ironically, now I have all the time in the world not to think, and all I do is think, as well as wish that I had of taken greater advantage of the opportunities that I was given.

The Conversation

Dark, cold and the weight of the world on your shoulders.

Dark, cold and the weight of the world on your shoulders.

I’ve come to realize that there are certain conversations that are almost universal for cancer patients.  Just like the emotional stages one goes through, shock, anger, denial, acceptance – there are conversations that support each of those stages that must be remarkably similar.  There is one conversation that we had repeatedly in the few months previous to this.  It’s basis stems from  a meeting we had in early July of this year.  It was our first meeting with the oncology radiologist and occurred right after my husband got his cancer diagnosis.

In his mind, my husband had gone from healthy to stage 4 lung/bone overnight.  When we met with the oncology radiologist we asked a number of questions which resulted in a prognosis which I have summarized.  It is not a verbatim summary, rather it is what we “heard” and may not be exactly what was “said.”  But remember this is not about the radiologist – so what we “heard” is all that matters.  In short the radiologist said something like this: ‘You have Stage 4 Cancer.  Your prognosis is three to six months.  You will never be cured.  You will never go into remission.  Our work will be palliative, to hopefully provide you with a greater degree of physical comfort during your remaining months.’  Nothing wrong with this, probably based on years of experience and observation as a Rad.  However, let’s spin this differently and put it into a simple perspective.  It’s like a tennis coach saying to a player just before the big match, ‘The player you are up against is stronger than you. You’re going to lose.  It may go three sets or four, but you will lose.  Just make the best of it and soon it will be over.’

As a result of that meeting with the oncology radiologist we, my husband and I, have repeatedly had one conversation in particular.  It is a conversation that I think could have been avoided if the “facts” were presented differently. The conversation was never the same, but in general here’s how it went:

Him: “I don’t know what this is all for.  Why am I doing this?  I’ll never be cured.  What’s the point?”

Me: “The point is you don’t know what lies ahead – the radiologist doesn’t know what lies ahead.  The radiologist doesn’t know you.  All the radiologist told you in that meeting was the general statistics on this particular type of cancer.”

Him: “But I will never go into remission, I will always have cancer.  I will never not be without cancer.”

Me: “True.  But lots of people live with disease their whole lives and are never without them.  People with HIV will always have HIV, diabetics will always have diabetes.  Amputees can never get their limbs back. You have cancer.  It needs to be controlled and can be.  What we need to do is focus on progression remission.”

The thing is, I don’t think we ever should have had to have this conversation, no one should have to have a conversation like this.  It is a waste of energy at a time when energy is in short supply.  I think that first meeting back in July, a meeting which is embedded in his brain, has taken on monumental proportions.

Definitely the patient needs to know that their prognosis is dire, but even then provide some hope.  Qualifiers such as “at the present”, “at this time”, “based on the existing indicators” suggest that the patient can have some influence on their situation.  I am not suggesting giving false hope – lord knows we had no hope when we left that initial meeting.  I believe that medical professionals should be able to offer their observations and informed opinions when asked, but how they present them is quite significant.  When we were querying what the goal was with the treatment there was no mention of progression remission – this is something I went out and found while researching cyberspace.  And yes, most Stage 4 patients are unlikely to achieve this – but still some do.  Hope, even a glimmer of it, can make a difference in the outlook and determination of a patient.