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. . . And a Time to Die

Most are familiar with the passage from that book in the Bible, Ecclesiastes.  It tends to put a lot of things in perspective and the one about the death is among the least appealing.  All sorts of prominent people have made that transition in recent months and Valerie Harper, so full of life and chutzpah in the golden age of TV, has put a personal stamp on her serious diagnosis of cancer:  She plans to keep on living and says, “it feels awful[ly] damn good to be open about (her illness), face it and see what you can do. If you die, you’re not a failure. You’re just somebody who had cancer, and that’s the outcome.”

There can be few darker days than when you learn that someone you love more than life itself hears that dark diagnosis pronounced.  There is shock, denial, sadness, anger and a whole host of reactions.  There is no one who isn’t touched by that disease either, personally or in their friends and family.

The cover story current issue of Time magazine is worth reading:  “How to Cure Cancer.” As one who has had a professional background in medicine, I expected to be informed on a few areas of recent advances, but I was unprepared for the breadth of research that has taken place since I left the field of medicine.

It has long been held that malignancies arise from many different causes which is a main reason that, although vast improvements have been made, there has been found no magic bullet.  For the myriad of diagnoses that are caused by a particular agent, it is not such a daunting task to find a preventive immunization or a type of treatment that is specific for that disease. Even problems as complex as HIV/AIDS are coming into the cross-hairs of a cure.

Malignancies are different.  They represent hundreds of different diseases, some deadly, some indolent but they all have one characteristic in common:  the loss of cellular growth restraint.  That has been an accepted fact for decades, but as the article in Time points out scientists are now banding together across multiple disciplines to discover what mediates that loss of growth restraint and allows cells that once functioned normally to run amuck. Through massive coordinated research in genetics and molecular biology, oncology and surgery the answers will be found.  If you read this article thoughtfully, you will come away with a sense of optimism that far transcends the announcement of a new cancer chemotherapeutic agent.

I have a strong personal interest in this because of many close friends and family members who are facing the same challenges as Valerie Harper.  It is discouraging to be able to do little more than offer concern and sympathy, as comforting and necessary as that may be.  I have found another way to be involved.

That is the hospice movement.  It is not a new idea; it dates back to The Middle Ages and comes from the Latin word hospes, meaning a place of shelter, of refuge.  It resurfaced in Europe in the middle of the last century and moved to this country shortly thereafter.  Initially, it was a refuge for patients with terminal malignancy when all treatment had failed.  It has expanded greatly beyond that to include any disease where the outcome is expected to be fatal.  There is one major misconception about hospice that needs to be dispelled:  It is not about giving up hope.  More, it is about making sure that comfort, dignity, and a sense of not being abandoned by caring professionals is constantly provided.

I have been able to spend time with hospice staff in talking with them about specific medical issues they might face in their work.  It is no surprise that they are all exceptionally well trained and many come from highly specialized fields of nursing where death and dying were are common occurrences.  Those in the medical profession are taught to cure when possible, to relieve suffering, and always be of comfort.  Hospice does that, as should every health care professional.

In the next decades, we will see cancer conquered and all will celebrate that, but death is a condition of life—we are all terminal and the need for compassionate care will never be replaced by science.

 – Hayden Hollingsworth


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