Do I Have Months (Weeks, Days) to Live?

In the weekly review of our new patients, time contradictions are frequently part of their stories.

A nurse or social worker will include a variation of, “Just before he went to the hospital, his physician told him he had months to live.”

I immediately think . . . of course that’s what the doctor said, since Medicare regulations unambiguously state a person appropriate for hospice has six months or less to live.

My thought occurred in split seconds, and before I’m finished thinking it, the same nurse or social worker continues their summary with, “However, while our patient was in the hospital, his surgeon told him he had less than a week to live.”

Months to live . . . one doctor said.

Less than a week to live . . . another doctor said.

Isn’t there a gap in those two “predictions” as long as the season of summer, a time chasm that could be the difference between your best friend (who lives across the country) visiting you again or never again, or it means you might get personal business (credit card debts, letters to loved ones, quarterly taxes, a final trip to the ocean) all in order . . . or left in chaos?

How can that contradiction exist? Why can’t the doctors agree with each other and be on the same page, especially when they are talking about your life, or the life of someone you love?

The answer is found in an irritating, unsatisfying cliché: doctors are only human. In or out of a spotless, wrinkle-free white lab coat, they are like you and me. One doctor might view a fellow human with pancreatic cancer or congestive heart failure and guess (and it is always a guess) how long he or she might live. The next doctor, reviewing identical information, draws a different conclusion. After all, doctors are influenced by personality traits (optimism vs. pessimism), dread about death (some avoid any end-of-life conversations) and a pass-the-buck mentality (there must be another physician in another office that can deliver the bad news . . . but it won’t be me). The same can be said about patients.

Each. Is. Different. (Patients are only human.)

A lot of folks—or at least this is how I would think—assume the doctor providing the information that I want to hear is the more accurate, knowledgeable physician. I’d prefer to live for part of a year rather than a month or less, so the fool who gave me the short straw must be misinformed. Must have gone to a below-average medical school. Must be overly pessimistic.

In the span of a week in August five years ago, while my mother was dying, various doctors thoughtfully concluded that Mom had days, weeks and months to live. I can say now that none of them were lying. But back then, consumed with wanting to do everything possible to ensure my family had correct information, and could make the best decisions for Mom’s needs, I staggered between concocting “future” plans for her care and fearing the next seconds would be her last breath. In other words, I was a basket case.

Now—half a decade removed from that anguish—I reflect back, grateful for one constant when I was so unsettled with contradictory information and ever-changing decisions. Even with pessimism gleefully yanking the rug out from optimism’s next step, I told Mom I loved her every day, every possible moment. I told her when I knew she’d hear me. I told her when I hoped she could hear me.

Listen carefully to the wonderful/awful, faithful/fickle (a.k.a. very human) physicians that are helping your family. They will give too much/too little information. They will linger to explain a concern or bolt from the room at the first opportunity. Never hesitate to ask the experts their opinions (a.k.a. guesses), but remember some avoid delivering the “worst” answer while others sugarcoat a confusing “safe” answer.

You and I can only be sure of one thing: that we have today* to spend time with the people who matter most in our lives.

______________

*Without reviewing prior hospice-related essays, I’d wager this last sentence’s conclusion about “today’s importance” anchors the end of a bunch of ‘em. Am I’m plagiarizing myself? Repeating myself? Don’t I have nothing new to say? Any of those three are accurate! But here’s reason #4: today is always the only day we truly have. I keep headlining that truth because, like nearly everyone, I need a constant reminder of the value of right here and right now.

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