What Would You Choose?

walking

They couldn’t imagine being with anyone else.

We shook hands as I entered his home.

“Went to see the doctor yesterday,” he said.

Which I knew. This was years ago and he had told me the prior Sunday at church that he was going to see a recommended physician. An oncologist. As his pastor, I was visiting to see how things had gone, and to provide support.

“The doc was an okay guy. Didn’t ya think so, honey?”

Honey was his seventy-something significant other. Both had been married before. Both had gone through the deaths of spouses they loved. Both had told me, when I arrived a year before as their new minister, that they were sorry they weren’t legally hitched, but getting married might mean losing some retirement benefits. They couldn’t imagine being with anyone else.

“We just shack-up together,” he had said with a shrug and grin. She—his honey—rolled her eyes.

He had been in combat in Korea. Didn’t talk about it. She loved to chat about her grandkids. They owned a tidy modular home in a retirement “village,” pinched their proverbial pennies, and clearly adored each other.

Now he had cancer.

“Got me a little issue with bad tissue,” he joked.

In their cramped kitchen area, with a view of the vegetable garden she tended, he told me what kind of cancer it was, and then what the oncologist had explained.

All cancers are serious, most especially to the person who has an “issue with bad tissue,” but his had been identified somewhat early. His cancer wasn’t one that everyone rightly dreads. It also hadn’t metastasized, and apparently the youthful, friendly oncologist had been cautious but optimistic. (Cautious optimism must be a required subject in medical schools.)

Honey gave him an encouraging nod, and then offered me a fleeting, nervous smile. Tears rimmed her eyes.

“Doc gave me some choices,” he said.

I didn’t say anything, waiting for him to continue. Except for his stint in the Army, where only once he muttered to me that Korea was “the coldest damn spot in whole frozen world,” he enjoyed telling stories. He often made himself the butt of jokes. He’d tell everyone how proud he was of his son and daughter, and how meeting his “honey” was the best gift ever for an “old fart.”

He continued. “Doctor said he could cut me open and do some surgery. Might do the trick, might not. Or we could start some kind of treatments that would make me sick for a stretch.” He paused, rubbing his thinning hair, “It could make me lose the last of the gray, but that’s water under the bridge, huh?” He chuckled, glancing toward her. She wasn’t even trying to smile.

“And the third choice?” I asked.

“Do nothing.”

“Nothing?”

“Doctor said we could wait and see.”

“Have you decided what to do?”

“Nah, not yet. Glad I got choices though. Right, honey?

They offered me coffee. We chatted a few more minutes about grandkids. We prayed. A Sunday or two later, he told me after church that he had decided to do nothing. He died six months later.

+      +      +

What is the moral of this tale?

First, it happened. Second, the majority of it—because confidentiality is essential—is made up.

But what did transpire for that fellow who may have been a Korean War veteran, was that an oncologist gave him several options. And, for the most part, he chose “nothing.”

Was he wrong? Should he have gone with surgery? Or radiation? Did he and his “honey” spend heartfelt time discussing what was best for him, best for both of them, best for his side of the family (and her side of the family too)? I don’t know. No one ever really knows the private conversations between a loving couple. Maybe they argued. Maybe little was actually said. Maybe “honey” left it all up to him.

Regardless, a decision was made.

He wanted to do nothing.

Was it the right choice? Would I have chosen that path? Would you? Would you need more information? How much is enough information to make life and death choices?

A host of question marks punctuate the above sentences. For me, if there is a “moral” to this story, it’s that many decisions seem overwhelming when facing life’s end. Whether in the early stages of an illness and talking to a doctor you have just met, or sitting beside a hospice admit nurse who is confirming there are weeks or months to live, our next steps are based on too much or too little information; on hopes or fears or guesses or all three.

Maybe doing nothing will lead to additional time with a good quality of life. Or would that choice mean you die more quickly?

Maybe a surgical procedure or radiation treatments will add to your lifespan. Even with the likely side effects (weakness, nausea, etc.), you’ll have “bonus” time for meaningful moments with friends and family. Or would those choices mean non-stop misery for the final days?

We don’t know.

I think most of us try to make the right choices for what is best for “me.” I like to hope that families openly discuss options. I like to think that all medical professionals, long before and during hospice care, will be open and honest with what may happen as a disease progresses.

However.

Regardless of the excellent and coherent information physicians may share, in spite of the efforts each person makes to ask the best questions, and with the often helpful (and, yes, often misleading) data found in web searches, there will continue to be uncertainty.

Did the Korean War veteran make the right choice?

I don’t know.

But I do know he loved his “honey.” And his kids. And that the choice he made was his choice.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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Comments

  1. I don’t honestly know what I felt at the end of this article – it was puzzlingly poignant. Two things jumped out at me though:

    We cannot judge the choices of others.

    Even if we thought today what our choice would be in the future (under similar circumstances) , we really don’t know what we would do unless we found ourselves in the same situation.

    Thanks for the thought-provoking article, Larry.

    Thinking beforehand about these matters is much better than arriving at such a crossroads with out a clue.

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