Palliative Medicine for Serious Illness:
Life Is Good
Dr. Ira Mandel MD, MPH, is Medical Director of Pen Bay Healthcare’s Hospice and Palliative Care program
Jim and Linda are like two peas in a pod. After meeting in college, where they both majored in accounting, love blossomed and they married. They both took jobs working for a large accounting company in Connecticut after graduation, enjoying the corporate “perks” of excellent pay, rich benefits and job security. Life for them was good.
Jim and Linda planned to have a family, but were never blessed with children. However, life did not fail them. They made many friends, enjoyed hosting dinners and going out. Over the years, they rescued many loving dogs that were like children to them. Life for them was good.
Jim especially enjoyed Saturday mornings at the local diner with his “brunch bunch” buddies. Years ago, Jim stopped going for a few months after developing “Bell’s Palsy,” a mysterious nerve condition that often leaves one side of the face paralyzed from weeks to months. Jim was too embarrassed to show his face in public, worried others would feel uncomfortable with his “disfigurement.” His buddies finally coaxed him back to the diner even before he was able to drink his coffee without using a straw. They awaited his arrival with drinking straws in their coffee cups to make him feel at home. Jim had a good laugh and felt grateful to have such loyal friends.
The years passed. Jim and Linda took early retirement and moved to Maine where they spent many wonderful summers. They looked forward to slowing down and enjoying the views they could see from their windows and back porch. They discovered new haunts and favorite restaurants where they became regulars. Life for them was good.
A few months after Jim turned 73, he reluctantly admitted to abdominal discomfort that was causing him to lose his appetite and some weight. His family doctor, suspicious of something serious, ordered a CT scan. The bad news came. He had colon cancer that already spread to his liver. More tests showed that his intestines would soon become blocked unless he had surgery. Linda stood by Jim supporting him through all the tests and treatments and kept him strong through the hospitalization, followed by a full month of rehabilitation before he could return home again. Arriving home, both Jim and Linda were happy. Life for them was good.
Jim met with the oncologist. She offered treatment but was honest that she could not cure him of the cancer. After he thought about the side effects of treatment, he decided to return to his routines and to enjoy life. His oncologist suggested he consider hospice, adding that hospice would focus on his living well. Jim and Linda liked the idea of resuming their lives and living well. He soon met his hospice doctor who made Jim laugh and who helped him gain back his appetite. Life for them was good.
Four months later, Jim was still enjoying life. He was weaker but could get around with a wheeled walker without a problem. Hospice had controlled his pain and he enjoyed visits from his hospice nurse and his certified nursing assistant (CNA) who made sure he ate well and got a good cleaning. Jim really enjoyed the attention and gentle fun his CNA had with him.
Seeing Jim now, I notice he has become thinner but is comfortable, even though he is limited to home and needs his CNA to help him bathe. Jim still laughs and is grateful for his friends, his dog and hospice to make his days happy. He knows he will not live much longer and is comforted knowing that hospice will be there to make sure he does not suffer. He also knows he can stay home through to the very end and hospice will help his wife cope with his loss.
After Jim’s surgery, Jim and Linda opted to avoid the revolving door of doctor’s visits, repeated blood tests, x-rays and treatments that would make him feel sick. He could not understand how other people could go through all that when the outcome was not going to be good. He felt the better option was to live as fully as he could. Life was going to be good for Jim and Linda until the end. For that they give many, many thanks to hospice.
Ira Mandel, M.D., MPH is a Palliative Medicine physician and is medical director of Pen Bay Healthcare’s Hospice and Palliative Care program. He provides compassionate care with a team of health professionals who honor the wishes of patients with serious illnesses. His monthly column seeks to inform the public about choices they may wish to consider. Disclaimer: All people described in this column are not actual patients but are derived from many hundreds of patients Dr. Mandel has treated over many years.