Rodney Roe's Blog

Still Trying to Make Sense of It All

Rodney Roe

Rodney Roe
Clayton, Georgia, USA
November 22
I currently place myself among the curmudgeons of the world. Always thinking about why things are, and how they may be better, I tend to rant at times, but mostly I just look for a reasoned discourse. I have previously worked as a cotton scout, grocery bag boy, cannery worker, and am a physician. I am married, have two daughters and four granddaughters. I retired due to vision loss in 2005 after a 30 year career as a hospital pathologist. Fortunate to have a wide range of interests, life following retirement has been good.

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JULY 18, 2011 11:55PM

Talking to the Dying

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I have a confession.  I’m a retired doctor, but I have a hard time talking to folks about dying.  I don’t think it is an uncommon problem for doctors and it is certainly a common problem among the general population of friends and family that has to deal with death.

The real problem, though, is talking about life to folks who are dying.

I have two friends who have breast cancer.  They did everything they were supposed to do and their cancers came back.  We don’t see either of them now due to distance, but we still talk with one on a fairly regular basis.  This friend who has a very unusual name, but whom I’ll call Sarah, is young.  We worked in the same art studio for years and were having lunch when she told us at 47 that she had suspicious lump that she was to have biopsied.

Sarah’s biopsy diagnosis was cancer and, being a pathologist I helped her through the whole process of understanding the diagnosis, prognosis, and options for treatment.  My usual dealings with this process were across the microscope from the patient’s doctor.  This was much more up close and personal. 

Of course, I spent the last 17 years of career in a county with about 90,000 people.  In contrast to the big cities where I had previously worked, I often knew the person whose diagnosis I was helping to establish.  This was a more emotionally wrenching situation than I had previously experienced, but also much more rewarding.

Sarah had no insurance – artists often don’t – and I had to give her advice on how to work deals with her doctors, the hospital, and encourage her to discuss all options for treatment with her surgeon, the medical oncologist, and the radiological oncologist.  She chose to have a ‘lumpectomy’, chemotherapy, and local radiation.

We worked together for another couple of years and then we moved away.  We went back for a visit and Sarah told us that her cancer had come back.  Her take was, “I was irritated when I first got the cancer.  Now I’m pissed.”  Our good friend has had brain metastases and radiation and now has a definite difficulty finding the right words when we talk.

Our usual greeting, all of us, is, “How are you?”  I say this to Sarah and she replies that she is fine.  She does not like to dwell on her problems, but occasionally she will let go. 

I have to admit to a couple of feelings.  I’m glad it’s not me.  I’m also angry that it happened to her.  Can I claim that she did nothing to deserve the problem?  No.  Sarah liked to leave early on Friday and meet her girlfriends for a drink, or two, or three.  She smoked.  Her husband is a drop dead guitar player who plays in a band and makes a living doing it.  It’s hard to travel to the venues where he plays and avoid alcohol, tobacco, and “other temptations”.

Still, my friend is a genuinely good person.  No one deserves to get cancer.

We can’t talk about the future.  We can’t really talk much about the present.  Sarah left the studio where we worked and tries to work at home, but it is hard.  Her husband, son and her son’s family are supportive, but they have to get on with life. 

We worked on a large collaborative art piece when there were five of us who were working in the same studio.  The work, consisting of a set of five frames, each containing the equivalent of about forty 5X5 inch tiles created using the artist’s own media, was recently bought by the local hospital’s cancer center.  The rest of us donated our part of the sale to the hospital foundation.  The money would have come in handy, but it just seemed like the least we could do for our friend to donate our share.  The work hangs in the hallway leading into the radiation treatment center.

All of this feels good, but it doesn’t make Sarah whole.  There is always the remote chance of a miracle, but none of us count on that.  Not us, not Sarah.  We all know that, despite the fact that she is much younger, we will probably outlive her.  We think about her grandchild growing up knowing a special person as an abstraction.

I’m, also, angry that we live in one of the most affluent nations on earth and we have good people who work every day who can’t afford health insurance; that we rank highest in cost per person for health care and 37th in quality of health care.  Not only do we rank below every industrialized country in Europe and Japan, we rank below Chile, Bolivia, and Dominica.  We can take comfort, I guess, in the fact that we have better health care than Zimbabwe, Mongolia and Turkmenistan.

Had we had the best system on Earth Sarah might still have had the same outcome, but she would not have suffered the indignity of having to beg for care, and to, perhaps, have gotten inferior care because she was not a person with good insurance.

Author tags:

breast, cancer, family, health

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When I first started seeing patients there was a common practice for doctor, patient and family to act as though nothing was wrong and to never talk about death, sometimes hiding the truth from others. That has changed without really addressing the how.
One thing to remember about death is that we all have to go. If you go a little earlier or later than someone else it doesn't really matter. It is the quality of your life that is important and that doesn't even mean if you are a good person or not. We all just exist and then we are gone.
zanelle, no one gets out of here alive, as you point out. I have a little problem with the concept of evil people having a good quality of life. That may be my hang up.
Last year, my husband posted a few hopeful essays early in his fight with pancreatic cancer, which he lost on March 1, 2011. He was John St. Crispin, and at home he was my love, my rock, my Rick. We are right about at a year since he was first diagnosed, and he spent a lot of his energy telling me sweet stories about how positive the doctors were that he was getting better, and hiding realities from me, protecting me from the truth. I finally stopped believing him and called his internist, apologizing for asking him to breech Rick's confidentiality, when he assured me he could talk to me and that Rick knew he was only going to live a few more weeks. I so wish he had not decided to protect me, and we could have talked more so I would be a little more prepared to move forward without him. He was only 54. There are so many things I would have said.