What a field day for the heat
A thousand people in the street
Singing songs and carrying signs
Mostly saying, "hooray for our side"

Sunday, February 3, 2013

What to expect when someone is expecting death

Jay Lake, fresh out of the surgery fog, posted this past week about his thoughts about what the extra metastatic tumors means to his life and then about the response to his post.

Dude, let me just say up front that cancer fuckin' sucks.

Also, Jay hasn't been given that terminal diagnosis. He just feels it'll be likely sooner rather than later. There's still plenty of things that can happen between now and then.

So, what do you say to someone you know who is facing the end of their life? How to you act around them?

Well, if you've been down this road before, you realize that we are all in the process of dying. Okay, when you're young, like 16-21 or less, you're technically in the process of becoming alive and growing. However, once past 25 or so, you've hit the top of the first hill on the roller coaster of life. The whole ride may be in front of you, and there are plenty of other hills and loop-de-loops to look forward to, but no other hill will be as high as that one.

I've had a few friends that I said goodbye to fully expecting to see them the next day (or Christmas) only to have them die before our paths crossed again (car accident, suicide, cancer, fire, undiagnosed heart defect to name a few). So what's really the difference between health states? Not much. Except that with terminal diseases you get to hit the snooze button after the life alarm goes off. Only you don't know just how long until the next alarm comes. You know it will come, though. And that changes things a little.

Some people don't handle death very well. Part of that is our culture, which doesn't deal with death. Although our culture has at other times been more "accepting" of the only true outcome of being alive. Another part of it is millions of years of behavior. While death isn't contagious sometimes what causes death can be (heck, people in the US still die because of the flu) and death brings other things which you can catch. So, yea, there is a very human response to avoid death and the dead.

When someone gets that terminal diagnosis, it means a lot of things. One of them is that all your relationships are probably going to change. Some people will just consider that terminally ill person dead already. They'll get emotional (because they are in mourning) and then cut off contact. Some will deny the terminal diagnosis and they'll instead latch on to tales of outliers. Those people will be highly optimistic and grasp at any of the lottery winner anecdotes (miraculous cures, longevity, whatever). But a lot of that is they just don't want to deal with someone close to them dying. Some people will look for their own advantage (isn't that always the case?). Some people will leave because they're not able to deal with the pain of loss. Some people will get closer because they want to help.

So, what will happen? Who knows? They're are so many variables. Some people with terminal diagnoses will pass quickly, some will take years and decades.

But they're the same person they were before the diagnosis. They're still your friend, relative, coworker, whomever. There is a difference though.

They've hit that snooze button. And that tends to change things. They'll be sad, they'll be happy, they'll be needy of friendship, and they'll want to be left alone. They may want to talk about it, they may want to ignore it. And they may want or be all of that in the same afternoon.

Because of that snooze button you have an opportunity. You now have an opportunity to say all those things you may have been holding back. You can be more truthful than you've ever been before. But just keep in mind your friend, relation, whatever who got that diagnosis can have the same responses as other people. They may not be ready for you to be so open. They may not want to talk. And sometimes they'll think of themselves as already dead and disengage from everyone and everything.

So what can you do? Here's my advice. Recognize that we are all dying. This time you're with that friend or relation may be the last. Heck, even terminally ill people get hit by buses, you know. So be as honest as you can be with everyone. If you love someone, let them know. Forgive others as best you can. Try not to be judgmental. And live in the moment. Be fully alive while you can. Because we're all dying. Some people are lucky enough to know with more certainty about the how and when.

Be yourself. Be a friend. Cry, laugh, joke, mourn, talk, listen. Life is a terminal diagnosis. But we're not dead, yet.


Suzan Harden said...

Heck, even terminally ill people get hit by buses, you know.

Thanks for saying this. My paternal grandmother was diagnosed with colon cancer, but she never made it to her six-month post-op check-up. She died of an aortic aneurysm five months after her surgery.

Steve Buchheit said...

I'm so sorry, Suzan. But that's even more evidence that just because someone has been given a severe or terminal diagnosis, the final script really hasn't been written.

In case you don't know, I'm retraining for Radiologic Technologist. Just today we were reviewing films of SBF (small bowel follow through). One of the films our instructor pointed out the aneurysm on the descending aorta. It was very faint, and everybody including the radiologist missed it. Fortunately the Rad Tech student who took the image was studying it for class (our instructors can put a film up and then ask us anatomy questions) and saw something that didn't look right. She brought it to the attention of the attending doctor. Saved a life that day. It was very, very hard to see (even when we knew where to look).