Is there no break from cancer around here? Just as I hoped that all of my patients and their famlies were enjoying a uneventful holiday weekend, I come to work to learn that one of my favorites---a middle-aged man with inoperable throat cancer---was in ICU over the weekend after "bleeding out". Tumors actually grow their own veins and arteries, damn them, and some of those blood vessels can be rather friable (fragile). My patient developed severe hemoptysis (spitting up blood) and was rushed to the ER. He's now out of ICU and out of the woods---temporarily---but the spectre of further bleeds looms large, as does the fact that the inoperable tumor is beyond the practical benefit of further chemo or radiation. With a tracheostomy for breathing and a gastric tube for receiving nutrition, medications and liquids, the notions of quality of life, pain control, and the ability to remain comfortably at home come to the fore.
I just lost a beloved patient to cancer not three months after my other sweet guy succumed to it as well. Now patient #3 is showing signs of decline, all when the week of the fourth anniversary of my best friend's murder is upon us, the actual anniversary being this Friday, December 2nd.
Ah me, oh my: death, illness and Winter sure can pack a triple whammy. All of this, however, is assuaged by the warmth of home, the love of family and friends, the dawning of the Solstice in just over three weeks, and the turning of the year, as arbitary as that may seem. Bono may have once sang, "Nothing changes on New Year's Day", but everything can change if one views it through the proper lens. My friend was murdered---but we've grown, he's moved on, and we're the stronger for it. So my patients die---we all must follow suit, and it's a priviledge to see them through the process. So the Winter is long---Spring and Summer are just that much sweeter for it.
Is there rest for the weary? If they seek it, it's in the very breath they take.