Denial. I watched it happen in real time yesterday. I saw the pilot light of cognizance and admission flicker out, and the numbing calm of denial sweep in like a fog in the night.
Being prepared is not enough, sometimes.
With a week's notice, the conductor, porter and engineer daily explaining the trip and standing on the platform at the appointed hour...The train of the unknown pulled into the station with a smoky fury of screeching, sparking wheels and rails. It towered over Russell's consciousness, a stark reality hitherto ensconced in the ethereal future.
"All aboard!" means "Get on the train."
As the doctor saw Russell's darkness set in, he spoke to me in clinical terms to raise his own comfort level. I became the translator.
"We knew this was metastatic cancer from the beginning." Even if we name one cancerous area and develop a treatment plan, it will mutate to escape the treatment and move to another place to become another type of cancer.
"The cancer is unresponsive." No, the chemotherapy did not slow it down. It did calm the lymph nodes. The cancers continued unimpeded along the lung and the bone at the same pace they were traveling before chemo began.
"We have to talk about radiation." No guarantees of pain reduction. Definite killing of the microbial healthy tissue. Definite reduction of breathing capacity. Likelihood of novel centralized and/or localized pain. Short version: Major risk, definite destruction and no guarantee of pain relief.
"Do you want a CT of the head?" No. Knowing for certain would not make the symptoms go away or change the reality of the cancer destroying the vertebrae, the ribs and the lung. If it is traveling along the nerves, as it has the bone, we have already unsuccessfully completed the treatment prescribed for it.
"You need to go home and discuss the decisions you need to make."
A Glimmer of Recognition
"So, we are doing chemo today?" No. Chemo is no longer a choice. It has destroyed more good cells than cancer cells and made no significant impact. Chemo is just making you sicker than you already are.
"So, we are going to do radiation?" No. The risks far outweigh the chance of a benefit.
"So, can I travel?" No. You want to go to New York. You cannot be off of oxygen long enough to fly. You cannot stand long enough to get through security. You cannot sit long enough to fly. You cannot sit long enough to come to the hospital. If you need to go somewhere, call an ambulance.
"So, where are we going?" Home, Russell.
And hospice begins.
Ann Marie
Lord, grant me the serenity to accept the things I cannot change,
The courage to change the things I can change,
And the wisdom to know the difference.
May today bring a light into your life, that you may know your blessings.
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