Eyeing the End

Five months ago, I was loath to take any sort of medication. Today, I have a pillbox.

In fact, the way things are going, I fear I’ll soon be declared a superfund site by the Environmental Protection Agency. A seemingly endless stream of chemicals pours into my body, most notably during my every-three-week chemo and immunotherapy sessions. What about the rest of the time? Depending on the day, I might down three or four pills in the morning and one or two in the afternoon.

As best I can tell, my stage 4 cancer hasn’t had any impact on my physical abilities. Indeed, most days, I feel pretty good. I’d always thought death would be easier to accept because of the pain involved and the endless interactions with the medical establishment, which would slowly sap my will to live. But so far, it hasn’t been that way.

That said, my treatment has been accompanied by a litany of side-effects. The latest: In early October, I landed in hospital for two days with a pulmonary embolism, which showed up on one of my regular abdomen scans. I’ve since learned that cancer treatments can cause blood clots, which are the second leading cause of death among cancer patients.

The blood clots are now being addressed by the blood thinners I’m taking. Still, their arrival has been a wakeup call. Before, I imagined I’d know the end was coming when my treatment plan no longer thwarted my cancer’s growth. But thanks to the blood clots, I can now imagine going to bed and not waking up.

End Game. Few topics are taboo these days, but sex and dying are among them. Yes, there’s plenty of chatter about sex. But not many folks talk in detail about their own sex life—thank goodness.

Similarly, there’s a fair amount of talk about death, but not many who are dying openly discuss their own demise. In this case, however, I think we’re poorer for it.

This lack of discussion partly reflects the nature of death. Some folks go suddenly—the result of accidents or heart attacks. For others, death is accompanied by cognitive decline, so they’re in no shape to articulate their thoughts about their own demise.

But as of now, I’m fully aware of what’s happening. Why don’t others in my position talk about their death? Is it denial? Shame? Fear?

Truly finite. We all know our time is limited. But my time is more finite than most, and that—I like to think—brings clarity about what’s important. I don’t want to waste time on life’s hassles, or allow my days to be consumed by anger or despair, or spend time with folks I don’t care for.

Instead, I’m anxious to make every day a good one. For me, that means doing work I love, helping others, and spending time with family and friends. In fact, I think this is the way we should all strive to live. Why wait for a terminal diagnosis to focus on what’s truly important?

Will I ever stop working entirely? Probably not. I feel like I’ve done enough. Still, I’d love the time to do even more.

Unwanted silver linings. I’m not going to claim there’s an upside to dying. If I had my druthers, I’d much rather be doing something else with my time.

Still, when folks learn that I’m dying, their behavior changes. They suddenly become awfully nice, they start calling out of the blue and they might even try to visit. This includes people I haven’t seen or heard from in ages.

Got something you don’t want to do? As I’ve discovered, you can tell folks you’re dying and you’re immediately off the hook. This includes dinner invitations, jury duty and visits from old colleagues you never liked.

Every so often, I’ll even “play the C card.” I’ve done so perhaps a dozen times, including with customer service reps who were being unhelpful and with contractors who were dragging their feet. I’m not saying I’m proud of this. But it sure is effective.