Sheallowedthattheycould,butitdependedonthedrug.
Thediscussionbecamedifficultformeormyparentsto
follow,despiteallthreeofusbeingdoctors.Therewere
toomanyoptions,toomanyrisksandbenefitstoconsider
witheverypossiblepath,andtheconversationnevergot
towhathecaredabout,whichwasfindingapathwiththe
bestchance ofmaintaining alifehe’dfindworthwhile.
ShewasdrivingexactlythekindofconversationthatI
myselftendedtohavewithpatientsbutthatIdidn’twant
tohaveanymore.Shewasofferingdataandaskingmy
fathertomakeachoice.Didhewanttheredpillorthe
blue pill? But the meaning behind the options wasn’t
clear at all.
Iturnedtomymotherandfather,andsaid,“CanIaskher
about what happens if the tumor progresses?” They
nodded. So I did.
The oncologist spoke straightforwardly. His upper
extremityweaknesswould graduallyincrease, shesaid.
Hislower extremity weaknesswould also advance but
respiratory insufficiency—difficulty getting enough
oxygen—fromtheweaknessofhischestmuscleswould
become the bigger problem.
Will that feel uncomfortable, my father asked?
No,shesaid.He’djustgrowfatiguedandsleepy.Butthe
neckpainandshootingpainswouldlikelyincrease.He
couldalsodeveloptroubleswallowingasthetumorgrew
to involve critical nerves.
Iaskedherwhattherangeoftimelookedlikeforpeople
to reach this final point, both with treatment and without.