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The Down Side

Posted 4/7/2015

Posted in

  I love my work. I love my work because of my colleagues and, most of all, because of my patients. Through the years, I have been blessed and honored and delighted to know so many wonderful women. We have intense, close, but unusual relationships. I often know intimate details of their lives, current and past, and many stories about their families and friends. I may know about the last moment's of their mothers' lives and why they fell in love with their husband and what scares them most about cancer. What I don't know is what their apartment or house looks like or what kind of tea they prefer or where they get their hair cut--all things that we surely know about our close friends.

  I feel especially tender about my relationships with women who attend my group for women with advanced cancer. It is remarkable to watch them care for each other and teach how to live in the looming presence of death. The cliche about "living well is the best revenge" surely applies here--except that revenge seems like the wrong word. They are trying, and usually managing, to live well in spite of the face of death; if revenge can be directed there, the word is right.

  Today, however, I am painfully experiencing the very down side of my work. Two women from that group have died in the last few days. When one dies, it is barely manageable. This is devastating. Both women had lung cancer and both knew this was inevitable; they lived gracefully and courageously in quite different ways. Both were wonderful role models for those of us who will follow them.

  Amy was an accomplished attorney. By the time that I met her, she had made the reluctant decision to retire from her work because she felt unable to keep up with the intense work and travel demands. She lived alone in a beautiful condo in Boston and had a well-connected group of friends from many parts of her life. She was divorced and had a son, also an attorney, whom she adored. During the final year or so of her life, he stayed with her during the week, ostensibly to shorten his commute, and went home to his own family on week-ends. He made it possible for her to live the last months of her life exactly as she chose. Amy was dignified, self-contained, seemingly (almost) always in control of her emotions. She spoke thoughtfully and eloquently, but calmly about her death. She said, over and over, that she was not afraid.

  Susanne was younger by more than a decade and had been married, for the first time, only a couple of years before her diagnosis. She was appropriately enraged by the question from others:" Did you smoke?" (she didn't), and loved the response suggested by another group member: "Only after sex." She kept working until very close to the end of her life, determined to keep the fact of her illness private from most of her colleagues and her clients. It was a testament to her strength and determination that she pulled this off.  She and her husband own a vacation home on Nantucket, and last summer she talked a number of times in Group about her struggle about how much to use it. Unable to admit, although surely knowing, that it might be her last summer, she wanted to be there in the place that was her haven. Going for longer than the usual weekends and two weeks in August would be, she thought, an admission of her illness. It was easy for the rest of us to work hard to persuade her to think otherwise, and we had an eventual compromise: she went for the whole month of August and several other long stretches. She was glad, and we were delighted. She died in her husband's arms, the very spot where she was most loved and most secure.

  Today I mourn, and I remember all the others whom I have loved, learned from, respected, admired, enjoyed and lost. This is the very big down side of my work. And it is always worth it.



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