August 22, 2008

When Hope is a Four Letter Word


It is hard not to succumb to peer pressure at sixteen when your cool friends are smoking on the back of the bus, swigging Boone’s Farm, or doing the nasty on the game room couch in their parents’ basement. “C’mon, just try it. It’s okay. Everybody is doing it.” But what about peer pressure when you are in your twenties and thirties and everyone around you is simply breathing, living life, planning for their future and you have end stage cancer? “C’mon, just keep going. You can do it. I know you want to,” your friends root. So how in this instance do you “Just say no”?

“Letting go.” This is more than just a cheesy affirmation when it comes to cancer. It is a euphemism for accepting your death. Jane E. Brody recently wrote an article in the New York Times titled In Cancer Therapy, There Is a Time to Treat and a Time to Let Go. Most interesting was a study revealing that last ditch chemo efforts do not stave off death. In fact, some doctors think that aggressive treatment at end stage cancer may actually hasten death. So why do patients stick to treatment when their days are so numbered? Brody discussed doctors’ emotional and even financial incentives for offering prolonged treatment, and dissected the question of how does a patient say enough is enough. I feel an additional reason that patients opt for prolonged treatment at end stage cancer is the massive peer pressure to stay alive that is put on patients by families, friends, and partners.

The 20 and 30-something cancer population’s patient enrollment in hospice is practically non-existent. I have sat on the beds and sofas of many young cancer patients and talked about the nitty gritty prospects of their death. Screw the idea of living a few more minutes or a few days longer; they expected to live decades longer. Most of those who I spoke with were aching to talk to me about the end of their life. The challenge for many was not in facing the end for themselves. The difficulty was in not being able to express their thoughts and ideas to friends and family, who lovingly and relentlessly cheered them on from the sidelines to kick cancer’s ass, as though they were super heroes instead of mortal beings facing the tremendous task of accepting death.

The question of when to “let go” is one that is strongly influenced by a circle of people surrounding the patient. Have any of you tried to speak with your friends and family about your death? And if so, how did it go?

Post to Twitter Post to Facebook

Comment(s)

Leave a Comment