Seeing that I was not reacting to the option of treatment with feelings of great joy and anticipation, he then turned to the more sober issues of death via liver encroachment. Listening attentively, I made certain that all of my questions were adequately answered before he fled from the room.
Liver cancer, he said, was usually painless; if pain was a factor, my doctor could prescribe a remedy which would lessen the discomfort. As the liver dysfunctioned, it would lose its ability to metabolize body chemicals; unable to rid the body of poisons, lassitude would set in while the appetite decreased. Finally, sleepiness would overcome any effort to remain awake and eventually result in a coma until death.
I felt sorry for Dr. E. as he told me these facts. I could tell that this visit was extremely difficult for him since his eyes did not often meet with my own and he seemed eager to sprint from the room. I had been a "five years and cured" case; the fifth year after my first operation he dismissed me with a clean bill of health. We had given each other cordial good-byes, never thinking the next year would bring such disappointment.
Before he exited the room, the doctor restated that the chemotherapy treatments should commence within a month if they were desired, perhaps his way of punctuating the option which he knew I did not wish to take. I nodded in acknowledgement. It must be difficult for a doctor, one whose profession is that of helping people live, to find he is unable to offer a cure; it brings to the surface the fact that medicine, although miraculous in many ways, is not omnipotent. Once again we said good-bye, yet this time, I knew it would be our final farewell.
One of the more difficult tasks I had to perform was expressing to my family my wish to forego treatment. They needed to cling to the hope that there was something to be done for my malady, and were not pleased upon hearing my steadfast rejection of chemotherapy. Since I had foreseen, somewhat, their probable reaction, I was prepared for a lengthy duel and had therefore decided to write on paper the key directions that I wished the conversations to follow.
The two discourses which ensued were emotional, yet controlled. I knew I had a weighty task to perform if I was to gently but thoroughly bespeak my desires to my worried father, and later my mother and sister, and further persuade them to accept those decisions. I candidly explained my repugnance toward chemotherapy, punctuated by the facts that it had not worked previously and the doctor had related that although there were new drugs, none could cure my type of cancer. With all sincerity, I said I did not know how long my life would prove to be, yet I wanted to maintain a life of quality, for that best equated my idea of what life should hold for each individual; I desired to own a sense of peace which could never be attained if I continually chased the spectrum of miracle cures so prevalent in a world whose main objective, for many, is the procuring of wealth. Time itself meant little if it did not also have the amenity of joy, and in my 19 years I had experienced more quality than some individuals realize in a lifetime of 80 years; I stressed that my family was an important part, indeed, and inherent part of that quality.
I hoped that my family would be satisfied with my judgment, although their disapproval would not have altered my stance; I feared they would attempt to force treatment upon me through relentless conversation and in so doing, make life at home unbearable. This, happily, was not the case.
After receiving my dissertation, my father needed time to think and sort out the information he had just heard, and decided to take a lengthy walk into town for the duel purpose of eating lunch and trying to digest the disturbing truth which cancer brought to the surface; mortality does not concern itself only with the aged. While he was gone, I replenished myself with both food and rest. My mother was to arrive in the afternoon, and I fully realized I would have to repeat my performance for her and Sharon, my older sister. I wished to appear as normal as possible. I had curled my hair and applied my usual dose of eye make-up to improve any pallor which might have been visible due to the operation; I did not want my appearance to evoke unnecessary amounts of gloom or despair. Satisfied that I had done my best to improve upon myself, I settled back in the bed, clad in the glorious hospital garb which resembled pillow ticking and decided that I coordinated rather nicely with the rest of the decor.
When the entire group arrived it was already late in the afternoon. My father accompanied Sharon's family on a tour of the area, leaving only my mother and Sharon to visit with me directly. I noticed that my mother had lost weight, underlining the worry that was inscribed on her face; Sharon's face echoed that emotion, and I knew I must speak with care. It can be difficult to avoid mechanical speech when one is trying to maintain control of his emotions, yet to do so can prove to be less injurious to the listeners if they share one's feelings on the topic being discussed. Cold facts divulged without the benefit of a warm heart will only multiply the pain; there is no sense in hurting loved ones through callous explanations.
It was with painful resignation that my family members then present at the hospital accepted the future which I so desperately needed to control. More than my resistance to treatment, (for they too had witnessed the drastic effects which are inherent characteristics of chemotherapy) the family was besieged by the inevitability of my death. There was now the real possibility that I would die long before my parents, and in this they felt little capacity for contentment. At the close of our discussions, I believe everyone derived a handful of solace through the hope that "miracles DO happen"; there were reports of complete remission and cases in which the cancer inexplicably vanished, leaving no trace of its former habitation in the individual's body. Continuing research in the realm of cancer treatment was also a source of emotional sunshine to my family, and allowed everyone to look toward the homeward journey with anticipation.