The Last Walk (Part 5)
Cancer complicates life. Daily activities take longer. Every visit to the bath presents danger of falling. The caregiver wants to intervene, to protect against injury. But the patient needs to do as much for herself as she can, to maintain strength, balance, mental agility, etc. In addition to such little complications, there are some big ones. We have to adjust on the fly.
For example, on September 10 I drove Karen to visit Tim and Tia, our son and daughter-in-law, who live in Kennewick. Karen had been looking forward to this trip for weeks. The next day, Sunday, Karen felt sick, with flu symptoms. She didn’t want to expose Jakobi, our grandson, so she asked Tim to drive her home.
We suspect Karen’s symptoms came from having a flu shot. It’s wise, of course for her to have a flu shot; influenza can be fatal to people with weakened immune systems. The down side of inoculation is that people often get mild flu symptoms—but for cancer patients, mild symptoms aren’t so mild.
Karen called me when she and Tim set out. I drove east and met Tim and Karen in the tiny town of Rufus, and from there I brought her home. So the planned week with Tim and Tia amounted to one night. And for Karen the drive home was thoroughly unpleasant.
Another big adjustment: Janie, my sister-in-law, took Karen for her third chemo treatment yesterday. For a number of reasons Dr. G judged her too weak to receive it. Chemotherapy hits the body hard; the hope is that in doing so it hits the cancer harder. Given Karen’s lethargy, mental confusion, dehydration, and other factors, Dr. G said he would not administer the drugs. She was given I.V. hydration, which helped perk her up, and Dr. G recommended that we ask the home health service to move her to palliative care.
Palliative care, I’ve learned, is a more intense version of home health care. (As I type this, we’re waiting for the nurse’s visit.) According to Dr. G, patients under palliative care often improve. He’s counting on that, hoping that Karen will be stronger and more alert in two weeks so she can get chemo.
Now when I first heard “palliative care or maybe hospice care” (Janie’s phrase on the phone when she told me) my mind latched onto the word “hospice,” and I assumed the doctor’s advice meant Karen and Phil’s last walk would soon end. A later conversation with a home health care supervisor reassured me. It is not unreasonable to expect good results from palliative care. If Karen gets stronger, she may have more chemotherapy. If she gets chemotherapy, it may significantly extend her life.
So now we live in an uncertain space. Will Karen be ready for chemo in two weeks? Is the chemo actually working against the cancer? Tim and Tia plan to come to Newberg soon; will Karen be alert to enjoy their visit?
Cancer brings long term uncertainties too, some of which we can prepare for—reviewing and revising legal documents, buying a burial niche, arranging for cremation, etc. There’s a lot of detail work to get ready to die! Yet every conversation is peppered with “if” or “someday” or “eventually.” So much we don’t know; we don’t even know that Karen will die before me, and the documents must reflect that possibility.
When you think about it, cancer only reveals something that is true of every life. We all live in uncertain space. The vibrantly healthy college students in my classroom eagerly make plans for the weekend, the holidays, or their careers after graduation. God bless them—I hope their plans bear fruit as they expect. But the truth is that we do not know what tomorrow will bring. Three weeks, three months, or three years: cancer makes our uncertain space plain to Karen and me. What we can be sure of is how we face the uncertainty. I will love Karen to the end, no matter what. Because of the gospel of Christ, we hope for resurrection, no matter what.