Friday, March 13, 2009

An Unwanted Journey: Day 1208 – More Dramatic Lessons


Coincidentally this week, my TV viewing has included shows dealing with cancer and dying. Tonight it was Grey’s Anatomy. Last night it was House.

The latter almost always demonstrates moral shortcomings in a big way. In this week’s repeat episode Sleeping Dogs Lie, a woman (Hannah) suffers acute liver failure which requires a transplant before a complete diagnosis by House and his team is possible.

The woman’s lesbian lover (Max) offers part of her liver in what appears to be a sacrificial and loving gesture. The moral quandary arises when House discovers that the woman suffering liver failure had been planning on ending her relationship with the other woman for some time. Should Hannah tell Max before accepting the transplant? Hannah doesn’t do so for fear of jeopardizing Max’s decision to go ahead with the liver transplant.

OK – there’s one moral failure. Then, as the show gets close to ending, we learn that Max had known all along of Hannah’s plan to end the relationship but went ahead with her offer of a transplant thinking that would make it impossible for Hannah to end their relationship. Moral failure number two.

On Grey’s Anatomy, in I Will Follow You Into the Dark, there are actually two story lines which deal with cancer. The first deals with two sisters and a brother dealing with a genetic form of stomach cancer. The second deals with Izzie coming to grips with her metastatic melanoma involving lesions on the brain and a prognosis of only several months, less than a 5% survival rate.

In both cases, questions about relationships are as important as any of the medical details about diagnoses and prognoses. Both nights found my wife and me discussing the importance of honesty and integrity and the maintenance of hope in the face of frightening medical statistics. What are the responsibilities of patients, family, friends, colleagues, and care-givers to one another?

I think it’s safe to pronounce unequivocally that the subterfuge of both Hannah and Max in the House episode is precisely where we don’t want to go. The show, in other words, is instructive in demonstrating what not to do.

In the Grey’s Anatomy episode, the family members dealing with proactive measures to prevent stomach cancer deals with how one balances fraternal love for one another with unnecessary pressure to conform. No answer is proposed, but the question merits much more thought.

One example might be situations of religious ideologies which propose that one’s eternal destiny is determined by decisions made before death, in which case pressuring family members to convert becomes a life and eternal death issue. How do family members deal with one another in the context of a diagnosis of cancer and a terminal prognosis?

The storyline dealing with Izzie’s prognosis is apparently more straightforward. Patients and their families must maintain hope one way or another. But the difficulty comes when we reflect on how we maintain hope. Certainly we cannot do so by maintaining ignorance.

In addition, patients need to take their time and associations seriously as they contemplate the time left to them. Sometimes it will be necessary to drop relationships in order to spend more time with those who are more loving and nurturing. No apologies necessary. Some people may be hurt in the process, but if we are told that time is short, then the company we keep is even more important to cancer patients with terminal prognoses than it is with the general public.

Is it just me, or is TV getting better these days?

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