In Memory of My Father
One year ago, my father, a celebrated physician and medical researcher, died an ugly, ugly death from metastatic melanoma.
I wish like hell that I could recognize something in his passing that resembles “How Doctors Die,” Ken Murray’s moving post at Zocalo Public Square.
Doctors know too well the violence and violations of extreme measures, writes Murray. Thus, they opt to forgo what so many people, less schooled in death, choose or are forced to endure.
“For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves,” he observes. “They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.”
It is a reassuring view. It is an important message. But I am here to tell you that it is not always the truth.
Ever the academic, my father retained his faith in the capabilities of modern medicine long after it had nothing more to offer. He himself had wrought near miracles for his critically ill patients, many of whom genuinely owed productive lives to his groundbreaking research and meticulous care. It embittered him greatly to have no miracle of his own.
My father did not accept his death. He was terrified of it, and he denied it as long as possible, placing unreturned calls to his oncologist and always insisting to his generalist that he was feeling “better today, a little better.”
No doctor that we know of found a way to speak truth to him, to trespass on the aura of his prestige and certainty, to offer any alternative to denial. He did not go gently. He raged, raged, without a glimmer of the serenity that Murray describes.
Had extreme measures been available in his situation, I have no doubt he would have availed himself of them. “As long as I can recognize people, or have any hope of recognizing people, then I want to live,” he told us a month or so before his final decline.
A crisis in the ICU would have been far preferable to him than the unrelenting wasting away that he endured at home. At least then, medicine could have DONE something.
Until hours before his death, when his resolutely unmanaged pain became unbearable, he refused hospice care. To a physician of his generation, hospice still was nothing more than a sanitized way of saying, “We give up on you.”
I do not know if this is the tale of a medico-generational mindset, of a massive system failure, or simply of my father in all his complexity.
A year on, my heart still aches for him, and for the peace that I wish he—and we—could have had.