What is this mystery we call death, and why do we fear it so? When the Grim Reaper comes calling, do we merely hitch a ride to some solitary truck stop in the Great Beyond, or are we delivered to a better place than this Earth could have ever provided, even in the best of times? Ask a body ravaged by cancer, and the answers will be forthcoming and clear. Ask the witness to a body’s decay, and the answers, while shrouded in doubt, will nonetheless unfetter a geyser of hope.
Cancer is a terrible adversary. In most cases, it is one whose indomitable, yet malign, spirit is every bit as pure as the good intentions of the Echoers of Hippocrates’ Oath. It cannot be begged, borrowed, or stolen. It may be placated, bargained with, or postponed, however, depending on one’s point of view. It will inevitably lead to demise. How we reach that inexorable terminus is as much a function of how we view life, as how we live death.
We are told on a quotidian basis that medical times are good, that new cures are on the horizon, and that a leap of faith will win the day. Tell it to the captive audience of a cancer ward. There, statistics mean nothing. There, the salutary effects of a smile and a gentle hand are as fleeting as a snowflake in mid-afternoon sunlight. A gift book, a box of chocolates, a bouquet of flowers, and the sincerest of sentiments mean nothing, when the path to the unknown must be trod alone. “Read? Why should I read? Don’t you know that I am dying?” are the words of the condemned, and the reaction to the feeble attempt on our parts to convince the all-knowing incredulous (or perhaps ourselves) that it is business as usual. How callous can we be!
Age brings wisdom and a good dose of religion, to boot. Resigning oneself to a fate, in the face of the American Cancer Society’s rosy proclamation that from 2002 to 2004, cancer deaths fell by 2.1 percent per year, runs countercurrent to the flow of the human spirit. The human papillomavirus vaccine, a decline in hormone replacement therapy (HRT), recognition of the anti-cancer power of vitamin D, gene mapping, new radiation techniques, a keener threshold for investigation of suspicious symptomatology, easier lung cancer surgery, and targeted breast cancer treatment are all testimony to medical progress, eliciting sighs of relief while at the same time failing to efface a healthy dose of skepticism. Go tell the good news to the throngs of the faithless, who have traded in a belief in U.S. medicine for a last-ditch, pitched battle on Mexican soil across the border, employing therapeutic weapons the U.S. Food & Drug Administration (FDA) has yet to approve.
To deny or feign ignorance of the recent advances in oncology would be tantamount to ignorance. To state categorically that we are well on the road to a cure for cancer, that the chips in the ante are sufficient to fund further wide-sweeping research, and that the speed of medical progress is adequate to support a last leg is no less reckless. People continue to die. This year, for example, 680,000 women will be diagnosed with cancer, and 270,000 will die from it. Perhaps our time would be better spent preparing the living for death, instead of giving false hope of living to the dead. After all, “seeing is believing” holds water only when “believing is seeing” is not an option. We need to ask caregivers and patients alike whether their interests and sentiments are best served by a “Can, Sir,” when a “Cannot” might be the most charitable and loving direction to follow on the short road to remaining days, weeks, months, or years of painless and autonomous life.
This year in Texas, 95,310 people, like you and me, will receive what they perceive to be a death sentence. Only 37,000 lonely souls will, however, perish under the weight of the unshackled cancer juggernaut. While we owe much to selfless researchers for aiding, abetting, and writing a new lease on life for many, questions continue to linger, compounded by a hemorrhage of blood and dollars on distant desert sands. Who will, indeed, be responsible for providing some measure of solace to individuals and families buckling under the pain, suffering, depression, and anxiety of terminal illness? Who will bear the rising personal and societal, economic costs of advanced medical technologies and research? Who will convince our knights in white armor that “terminal” does not mean “terminated,” and that a diagnosis of cancer should reinforce, not sever, close physician-patient ties?
If the money is just not there, then lip service should not be, either. “Can, Sir” is a fortress wall we hide behind, to shield us from our own worst fears and insecurities. When we do finally venture out into unfamiliar territory, our prodding, piercing, and radiation are no match for the simple, dignified, inner strength of those about to leave one world for another.
© 2007, Albert M. Balesh, M.D. All rights reserved.
In honor of Kalli Rose
