Today, one of my medical oncologists and I had the "big talk". She had, of course, checked with my team leader before doing so, but given the difficulties and life-threatening issues I continue to face, and given that I was on the list for this weekend of patients to be watched "very carefully", the time seemed appropriate.
"Crises tend to happen late at night, on weekends, or otherwise when the people you might want to be on hand aren't. I think I know you fairly well from other conversations and consultations we've had in the past, so I want to ask you about what kind of measures you would expect to be taken in case a clot causes irreparable respiratory failure."
And so it went. We talked about my wife and sons, about discussions I've had already with them about end-of-life concerns, about powers of attorney, wills, life values, etc. It wasn't a long talk, but one in which she could go back to my file and make a notation about the patient's wishes regarding so-called "heroic measures".
Those who regularly read my reflections of an unwanted journey will readily anticipate how I responded to such a question - "Nothing heroic, thank you."
But the simplicity of the reply doesn't really do justice to the magnitude or complexity of the issue at hand.
I will want a follow-up conversation and notation to be made for my file tomorrow...possibly several further discussions.
The importance of today's conversation was to reinforce the fleeting nature of even the most well-informed expectations about survival and quality of life in the face of medical treatment. Nothing can be taken for granted...nothing except, perhaps, the values by which I live and my approach to ultimate issues.
In a way, I'm an open book. Sure, I'm stubborn, opinionated, quick to anger (and those are just my good qualities). But when it comes to approaching ultimate concerns with realism, I think I'm mostly on target - not overly pessimistic, not overly optimistic. As Havelock Ellis once said, "The place where optimism most flourishes is the lunatic asylum." I may be crazy, but I'm not that crazy.
My realism means that most of what I say and do will change; it's provisional. Tomorrow will mean I may modify the nuances of what measures I want taken in times of medical crises. Inevitably, it means changes provoked by further conversations with my wife and sons and other people with differing perspectives and even values from my own. But that can wait until tomorrow.
One of the highlights today was a visit from my Mom and Dad, driving all the way from Barrie through the rain only to have to navigate around the rain-drenched Kitchener-Waterloo Santa Claus parade to find their way to the Grand River Hospital. I don't care how old I am (55 to be exact), there's nothing in the world quite like a mother's caress or a father's hug and kiss. All by themselves, these are two of the best drugs ever administered.
Another highlight was a visit from the CEO of the company where I work, taking time out from the countdown to the next major release of our company's software. Without a doubt, he's the best leader and executive for whom I have ever worked.
And then there's my wife, my best friend, my confidante, my partner, my "person". Her face, her smile, her confidences, her loyalty and affection - well, if there is any medicine better in all the world, bottle it up and sell it for millions.