I can’t stress this strongly enough: Whenever you are about to discuss bad news with medical personnel, make certain you have someone along with you — someone rational who comes equipped with a notepad and an excellent memory. Don’t leave home without this person.
Why? Because however intelligent you are, however stoic and philosophical, and however good your memory, everything flies out the window when the bad news to be delivered is about you. Also, and this is no small matter, doctors tend, when the news is grim, to rush through the details. The details are vital. You need an ally to slow down that narrative, get answers, and also ask the very painful questions.
What kind of questions? Well, the first thing everyone, even the most dazed and frightened patient usually asks, is: “How long do I have?” Rest assured that is likely the one question your doctor will never answer with any exactitude. Or at least not with certainty. In the first place, they hate being specific about the future, because hey, who knows? In the second, they hate being proven wrong. The one response you will forever recall is, “Eighteen months — more or less.” Actually, you will forget the “more or less.”
Trust me, if that response turns out to be flat wrong in either direction, they know you’ll never forgive them.
Your rational companion needs to ask all the other equally important questions, the ones that can be answered with a greater degree of reliability. What types of medication are recommended? What are their likely side effects, if any? What is their cost (another are medical professionals generally don’t plumb)? Is chemotherapy necessary? Or radiation? What will be done for pain, if there is any?
Any reluctance to answer these vital questions means only one thing. You need to switch physicians.
As important: You need to find out how long you’re likely to remain active and productive. This is not simply so you can give your boss adequate notice. This is so you have time to plan the future: your will, your “Advance Medical Directive” (aka “a living will”) which spells out in what circumstance you might desire — or decline — extreme measures to stay alive; your written directives outlining who you want to make critical decisions in the event of incompetence; your final instructions about the people and things you leave behind.
In other words there are a thousand things the dying have to do. Only the very lucky ones will have the time and energy to accomplish what is necessary.
In our culture it is commonplace to envy the heart attack victims who die in their sleep, to hunger for the unconscious event that forever severs us from living. But I think it is the aware who are the lucky ones. They get to control a portion of destiny — not the beginning, but the end.
And really who could ask for more?
In our culture it is common to envy heart attack victims who die in their sleep, peope hunger for the event — unaware that it is one that separates us forever from life. But I think it is the aware who are the lucky ones. They come to control a part of the destination - not at first, but in the end.