I have two friends slowly losing the battle against cancer right now, so it’s been on my mind.
Like most life forms, cancer’s success is measured in its immediate propagation of itself. In this case, total propagation means destruction of its host and itself, and its subsequent lineage. This is not the long view of survival. Cancer, like most of us, doesn’t think that clearly about propagation.
Fighting cancer is trying to annihilate every cell of a foe that is trying to kill you. There can be no quarter given. Ultimately cancer has to die for you to live. It must be total genocide.
In each case, the patient must weigh the same decisions soldiers do – how far will you need to go to kill this thing? Can you bring yourself to go there? How great is your will? Are you willing to become whatever you have to, to win this war? And the unknown: How far do you need to go, to win?
For every person, there is a balance to find in their own character. How much focus is the right amount of fighting to win, but not lose track of or outright abandon the things that have made your life worthwhile? Where do you draw the line, knowing the position of that line may define how long you will live, and how well?
And, of course, winning is not always an option.
We talk about quality of life issues, but I don’t think we talk about them clearly, often. It takes so much courage. For many patients this is the last battle, the best battle, the one where they call on every shred of character they have developed in their years of walking on this planet. It is so difficult to talk about death, with all its finality – harder often for those who will continue after, who feel guilty for being healthy and are often overwhelmed by their impending loss. They are the ones who will implement the patient’s wishes. They have to know what those wishes are, and be strong enough to act on them. When you’re swamped by grief, that can be surprisingly difficult.
As an observer (only observer so far, please God) of this battle several times over, I’m hesitant to venture anywhere close to advising anyone. The best I can manage is to try to ask important, clear questions of my dying friends and accept and remember their answers.
Through such friends I’ve learned that my powers of denial are great, and there is no bottom to how desperately I can wish for something with my whole being whether it can come to pass or not. This is dangerous. The journey of those around the dying patient is part of the patient’s journey too, but I don’t want my grief and longing adding emotional weight to theirs. How often have I seen families that can’t bear to let their great-aunt Matilda die, and put her through hell accordingly? Just because there’s still life, doesn’t mean there’s hope. How do we live gracefully without it?
Those waging this war need every shred of energy for themselves and their fight. My purpose in being present, whether I accept it or not, is to help them fight by not distracting them from the battle. Let me spare them precious energy by taking care of small things for them, if I can; console those around them, if I can; and hardest of all, still be there when the shooting stops. My grief may be great, but I’ll still be standing. There’s no reason I can’t shoulder some of the weight of comrades wounded by the shrapnel.
My prayer for friends going through this: Let us walk this road with you, however long it is, whatever choices you make, accepting the limits you set (or don’t) and the decisions you make, whatever they are. Let us help you make the decisions you must without doing any of the deciding for you, even though our hearts are breaking and our beliefs challenged. And let us not avert our faces, but look on steadily and be witness to your life, your courage, and your grace, however hard it gets. It’s the last, best gift we can give you.