Better, you wonder, to be given six months to live, or to die instantly?
Not the type of question generally resolved around the lunchroom table at work. Hardly a philosophical debate to be squeezed into the commercial breaks of the Sunday-afternoon football lineup. But it is a consideration that forces its way into the consciousness of a family having experienced both sides of the equation in just a few years.
The news came out of the blue. A mother-in-law, feeling a little off, checks in for routine blood tests in North Bay. Her white-cell reading is a bit high. The doctor arranges further testing at a Sudbury hospital. While admitted, she develops swelling and a rash. Blood tests show the white-cell count has soared. Drugs are administered to lower the count. Bone-marrow tests are scheduled and conducted. Then the results.
The attending oncologist is reputed to be excellent. Like most health-care professionals, he is incredibly busy. Bedside manner is not his strong suit, but both patient and family happily accept his experience and credentials over a cheery disposition.
Three days after the bone-marrow test, the doctor drops by the private room on his rounds. Jackie, the 73-year-old patient, wants to know her condition. "Did you get the test results back, doctor?" she asks. "Yes, and it is not good," comes the blunt reply. "You have a very rare form of cancer. It's called T-cell prolymphocytic leukemia. It's very aggressive. There is no cure. Expectation for life is six months with immediate chemotherapy treatments. Without treatment, maybe two weeks."
In a dizzying 30-second update, Jackie's world changed. And so did that of her family.
The human spirit is resilient. We bounce back from adversity. We pick ourselves up and dust ourselves off when knocked down. Time and again, we get the chance to regroup, rebuild, recover. There is always a sense of hope.
Against that backdrop, words such as "terminal" and "incurable" hit like a tsunami when they crash into the lives of a family. The very sound of such words pierces the heart. But hope is not easily surrendered. A patient and a family is determined to fight, to pray, to beat this.
Three years earlier, Jackie had lost her husband of 52 years – at age 71 – to a heart attack that struck as he slept. Romeo was a fun-loving man. Loud, confident, entertaining, proud and caring.
The unexpected phone call in the night is one of life's dreaded moments. A family rushed to North Bay, as minds and emotions raced. Sudden death is non-negotiable; hopes and prayers can't change it.
The sudden loss of a loved one unleashes a tangle of feelings for a family. It's a shared experience with highly personal impacts. The relationship plays back in the minds of the grieving. There is the solace of cherished memories and words shared. There is the regret of missed opportunity and things unsaid. More likely, there is a mix of the two.
There is no script for reacting to the news of a six-month life projection and imminent death of a loved one. People cope with the stress differently. Roles are informally assumed. A daughter who lost a husband to cancer eight years ago becomes a voice of experience. A son steps in to balance visceral impulses with a calm and rational perspective.
For Jackie and her family, a new reality of medical procedure had begun. Along with the practical exercise of end-of-life preparation. It had been made clear that chemotherapy, in this case, was not intended to cure. It was to prolong life so that affairs could be put in order.
A family tried to familiarize itself with a new world of procedures and medical terms. Maybe it was a mistaken diagnosis. There might be a miracle. The more knowledge gained, the stronger the advocacy for a parent in need. But the effects of eight months of aggressive treatment on an aging body had taken a toll on her kidneys and liver.
On Aug. 26, understanding the new prognosis, Jackie told her children that she was ready to stop the fight. It was her time. Surrounded by a dozen family members, she passed away peacefully the next day.
The eight months of life after Jackie's diagnosis provided the gift of treasured moments and memories. It also provided times of incredible anguish.
In the company of family and friends, she laughed at times, as she had never laughed before. But sleep didn't come easily. One can only imagine what goes through the mind of someone given a few months to live, in the quiet moments of private thought.
For the family it was a time that tapped every emotion. Love was expressed between parent and children, grandparent and grandchildren. It in some ways allowed a family to better understand and appreciate each other.
There was, in the case of Jackie and Romeo, both rich blessings and agonizing pains in their respective losses. Six months, or die instantly?
In the end, the answer may lie solely in the minds and hearts of those who have lived the question.
Derrick Coyle lives in London, Ont.