that resulted. He didn’t want a feeding tube. And it
becameevidentthatthebattleforthedwindlingchanceof
a miraculous recovery was going to leave himunable
evertogohomeagain.So,justafewmonthsbeforeI’d
spokenwithBlock,herfatherdecidedtostopthebattle
and go home.
“We started him on hospice care,” Block said. “We
treatedhischokingandkepthimcomfortable.Eventually,
hestoppedeatinganddrinking.Hediedaboutfivedays
later.”
SUSANBLOCKANDherfatherhadtheconversationthat
we all need to have when the chemotherapy stops
working,whenwestartneedingoxygenathome,when
wefacehigh-risk surgery,whentheliverfailure keeps
progressing,whenwebecomeunabletodressourselves.
I’ve heard Swedish doctors call it a “breakpoint
discussion,” a seriesof conversationsto sortout when
theyneedtoswitchfromfightingfortimetofightingfor
theotherthingsthatpeoplevalue—beingwithfamilyor
travelingor enjoying chocolateice cream. Fewpeople
havetheseconversations, and thereis goodreason for
anyone to dread them. They can unleash difficult
emotions. People can become angry or overwhelmed.
Handled poorly, theconversations can cost a person’s
trust. Handled well, they can take real time.
I spoke to an oncologist who told me about a
twenty-nine-year-old patientshe hadrecently caredfor
who had an inoperable brain tumor that continued to
grow through second-line chemotherapy. The patient
elected not to attempt any further chemotherapy, but
gettingtothatdecisionrequiredhoursofdiscussion,for