Sunday, September 22, 2013

Death Is A Period Occuring At The End Of A Sentence

You are dying.

I have reviewed the Cat Scans, spoken to the specialists, and studied the labs. There are many possible treatments that could be offered, but I fear they will not stem the course of all that is happening already. The tumor is too advanced, the metastases, too malignant.

I know there are many questions about chemotherapy, radiation, and feeding tubes. I would caution you to think of death as the inevitable endpoint. There are many things we can do between now and that endpoint. Some will increase your life expectancy, and some will cause pain and discomfort. The trick is to decide what is more important to you: quantity vs quality. Many life prolonging treatments come at a price. Chemotherapy causes nausea and fatigue. Radiation has many untoward effects. Feeding tubes get infected and accidentally pulled out.

You must feel like all hope is gone. But I want you to know that I have great hope. Let me explain. In my experience every person, young and old, healthy and diseased, wakes up each morning with a plan for the day. Although sometimes those plans are unreachable (you will not be able to make that last trip to Florida), others are quite possible. You should expect to spend each day with your pain controlled and in a safe environs. My goal is for you to experience pleasure, no matter how small. This, I can do for you.

I do not know when you are going to die. Doctors are poor at estimating such things. But I would like to help you focus on the life each day occurring around you. Death is a period at the end of a sentence, not a parenthesis or quotation mark.

Although my role in "curing" is over, I will by no means abandon you. In fact, I will be even more engaged. You need me more now than you did when I was treating your high blood pressure and colds. We will travel this road together.

And on the day when death finally comes. You will be cared for, likely pain free,

And surrounded by love.


John Mandrola said...


All your stuff is good. This one is terrific.

I'm always searching for better ways to explain end of life.

I was especially drawn to paragraph 4.


Jim Salwitz said...

Really great.
Thanks very much.

Anonymous said...

Thank you.

The Van Deventers said...

A truly sensitive and wonderful piece.

Would that you lived in our neighborhood

Anonymous said...

A truly wonderful piece.

Would that you lived in our neighborhood...we are 'dying' for physicians like you.

Knot Telling said...

Excellent, excellent post. I am living with metastatic disease. What you wish for your patients is what I wish for myself.

opwfredericks said...


I've tried to think of something inspirational to write here, but your words are enough.

O.P.W. Fredericks