To Accept What Cannot Be Helped

At 80, a woman with a fatal disease knows she doesn’t want to die in the hospital and discovers, with her family, what that really means

By Ann Hulbert

“Your hands are so wrinkly. Are you going to die?” my nephew asked my mother when he was about three. “Yes I am,” she answered, pausing to stick a knitting needle behind her ear and take his small, smooth hand in hers as they sat on the couch more than 15 years ago. “And you never know when it might happen.” Here she resumed work on the row of whatever it was she was knitting and added, “I’m an old toad, you know.” Daniel looked stricken. Telling this story, my sister rolls her eyes, knowing the rest of the family won’t be surprised by it. “Promise me you’ll pull the plug when my time comes” is a refrain we’d been hearing from my mother for ages.

Two years ago this coming June my mother—“an 80-year-old in a 60-year-old’s body,” the pulmonologist told her—was ambushed by a diagnosis of Stage IV adenocarcinoma of the lungs. It had already spread to her spine and left hip. Barely two weeks earlier, she’d gone out west for another grandchild’s college graduation and hiked along a cliff on the Oregon coast. Could she really have inoperable lung cancer? The pulmonologist, to whom she was referred by a GP alarmed at what he saw on her chest x-ray, needed a CT scan to be convinced. In the windowless examining room at the hospital in Brooklyn, my mother said sadly yet matter of factly, “Well, I guess that’s pretty much what I’ve been expecting to hear. We’ve all got to go somehow, don’t we?”

We all do, of course. But I don’t think there are many bustling, nonbelieving souls like my mother who are ready to face that fact when rudely confronted with it. In her case, facing it meant ruling out treatment—the chemotherapy and radiation that the pulmonologist urged to ease pain and eke out a few more months. “If geezers like me have lots of tests and treatments,” she told the doctor, “there isn’t going to be enough money to spend on the other end. This health-care mess isn’t going to be fixed if we aren’t ready to get out of the way.” Nonplussed on his little stool, he shook his head and raised an eyebrow. “Well, I’ve heard that view before, but never from someone in your situation. People generally change their tune when it suddenly applies to them.”

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