cancer, hospice, and a conversation about life

The Sunshine Skyway, Thursday

IMPERATIVE: I'm backed up with work this week. But first I have to write this post. My brother Geoff has run into a few more negative results in his ongoing cancer journey. So I headed down to North Bradenton for a lunch time visit and we chatted for a couple of hours. Our conversation has been working on my heart and mind and I'm having a hard time thinking it all through. So I guess I'll take my own best advice and simply put one word in front of the other and see where it leads.

WATERS OF ETERNITY: But first I had an errand to run in Tampa. Then I continued on down I-275 and over the Sunshine Skyway. Just before the big rise I pulled over to the waterside park to catch my breath and take in the view. I immediately thought about "passage," and "crossing," and the way the waters of eternity lap so closely against the margins of our lives. Mortality placed itself firmly in the front of my consciousness.

Getting over the hump...

When I got back in my car I opened the roof and the windows to let the fresh air breeze through. I wanted to feel liberated - not restricted - on my way over. I didn't think that I was driving my vehicle across a metaphor so much as breathing in a little understanding. We are more connected to eternity than we think, most of the time.

CANCER: I'm going to share some thoughts from my conversation with Geoff, and I want you all to know why. Before I left we talked about confidentiality, and medical privacy, and the limits of public information. But my brother is insistent that I help to tell his story.

The reason why - Geoff said - is that his experiences, what he is learning through this struggle, and what God is teaching him about abundance and "living like we mean it", are his gift to all of us. This conversation about life and eternity is appropriate wherever we might be on our journey toward life beyond life.

"I am an open book, Derek," Geoff said, "and I want you to help turn the pages."

Geoff behind a table-full of medicines

FIRST THE HARD NEWS: The change for Geoff over the past two weeks is threefold -

• First, the liver cancer has proliferated - is proliferating.
• Second, Hospice has been prescribed in order to help manage pain and coordinate care.
• Third - and this came out just yesterday - he now has bone cancer too.

It had only been a few days since my last visit, but I was taken by the visible evidence that the reach of the disease has shifted. Pain, difficulty in movement, loss of appetite. It was all revealed in the way he got up from his chair to greet me.

IMPORTANT CONVERSATION: We talked a lot about the meaning of life. We talked about vitality, and how it is a much bigger concept than physical fitness. We talked about fullness, about what Paul referred to as, "The Life that is truly Life." Here's the passage:

Command those who are rich in this present world not to be arrogant nor to put their hope in wealth, which is so uncertain, but to put their hope in God, who richly provides us with everything for our enjoyment. Command them to do good, to be rich in good deeds, and to be generous and willing to share. In this way they will lay up treasure for themselves as a firm foundation for the coming age, so that they may take hold of the life that is truly life... 1 Tim 6:17-19

It turns out that my brother truly is rich.

And we talked about healing, and about medical interventions when the end of our physical life is right there, lapping up against us like the ocean against the shore.

"I'm entirely open to the idea of God healing me physically," Geoff said. "But that would be God's decision. Believing that God can heal doesn't change the fact that I need to make reasonable decisions about my care that work in my best interests, given the continued progress of the disease."

strong cords that hold us together

CLICHÉS THAT RING FALSE: Let's make sure we understand what's true here. The language we use to talk about these kinds of issues turns out to be critically important.

• First cliché: Many people say they don't want to talk about Hospice because, "Hospice helps people die." But it's actually more true to say that, "Hospice is helping my brother to live!"

Effective pain management and loving care typically increase both the quality and the length of life.

• Second cliché: Another common red herring idea is, "We don't want you to give up..." Believe me, the choice to forego aggressive interventions in favor of Hospice care is not "giving up." Hospice care happens to be a reasonable treatment choice.

Let me repeat that. When a treatment choice is palliative rather than invasive, the team of care-givers is making a reasonable medical decision. THEY ARE NOT GIVING UP!

If a Hospice-referred cancer patient is driven to aggressive treatments they are uncomfortable with because someone else is unable to handle a difficult diagnosis, the following scenarios tend to play out:

1. First, the treatment will likely make the patient feel worse and result in additional suffering.
2. Second, the patient's chosen path will have been compromised and the rhythm of their life compromised.

Looking back...

SACRED RHYTHM: This is a crucial point. The path to the passageway from time to eternity is typically a long one. Finding peace at the latter stages of the journey is critically important. Coming to terms with the fact that this life is temporary is an important element in understanding that the fullness of life transcends time and space.

The fullness of life transcends time and space.

Geoff with his daughter, Hannah, and Granddaughter, Haley (Thanksgiving 2011 - photo by Alisia Hess Thompson)

Geoff and I talked about the fact that his life has found its rhythm. His confidence and his peace are so much more real than the pain and the breaking down of his increasingly fragile body.

That's enough for this post. There will be more, because my brother is courageous enough and generous enough to think about and to love the rest of us, and to talk about the end of his life without fear.

57 years into the conversation... and now he's a pretty good theologian!

Peace - DEREK