Random and not so random musings from a 5th generation NE Missourian who became a 1st generation Episcopalian. Let the good times roll!

Nothing, I've decided, beats lameness and the ability to trivialize like the news media. The news of Sen. Edward Kennedy's malignant brain tumor set the talking heads on TV going like there was no tomorrow, already eulogizing the man before he's yet to receive one radiation or chemo treatment. But the phrase that so often pops up in these yammerfests is one that drives me nuts when we are talking about the seriously ill or dying..."He's a fighter."

I think it's harmful to set our stock in measuring the journey of a loved one's illness in terms of "whether they fought or not," or "how hard they fought." It's based on the presumption that overcoming illness is always "winnable." This presumption, in fact, has the ability to tear families asunder. We are obsessed with colored ribbons these days. There seems to be this pervasive mindset that if we only buy enough t-shirts and golf balls with pink ribbons on them, somehow Mom or Sis or Aunt Boo will not die of breast cancer. We say people have "beaten" cancer. In reality we have only postponed our inevitable deaths. In all of us, "The grass withers, the flower fades," eventually, to borrow from Isaiah 40:8.

I recall in my own family when "fighting cancer" became a family fight. When my grandmother was diagnosed with small cell lung cancer, she decided to undergo palliative treatment rather than potentially curative treatment. She was 83 years old, and the chemo was a fairly brutal chemo regimen. In her frail health, the treatment was not an attractive option and could actually reduce her overall quality of life. Small cell lung cancer is associated with a worse prognosis overall than other types of lung cancer, across the board. Palliative radiation seemed to be a better option in terms of quality time in an otherwise dismal diagnosis. She chose palliation over a remote shot at "cure."

My mom, a breast cancer survivor, was horribly upset that "Mom doesn't want to fight her cancer." I was upset with her for upsetting Granny. I remember one heated interchange where I finally blurted out, "Mom, over 90% of people with this are dead in two years. Half of them are dead in one year. Barring a miracle, it ain't gonna happen, and if a miracle DOES happen, whether she fights it or not ain't got shit to do with it!"

So many times, the issue of someone "fighting" or being a fighter seems to have more to do with the survivors than it does the sufferer. For that matter, it also seems to obscure the fact that other people have chronic and serious illnesses that are just as devastating as cancer, and their sufferers are as much "fighters" as anyone else, but there are no ribbons or rallies for chronic renal disease, emphysema, or just plain "getting old and feeble."

So many people walk through the shadow of death daily, dancing between the life they used to have and the life they now have. Each is an individual footprint of the strength of the human condition, and deserves dignity. Somewhere along the road in each, the fight is to "accept the reality of death." I am reminded of this collect in the BCP:

This is another day, O Lord. I know not what it will bring

forth, but make me ready, Lord, for whatever it may be. If I

am to stand up, help me to stand bravely. If I am to sit still,

help me to sit quietly. If I am to lie low, help me to do it

patiently. And if I am to do nothing, let me do it gallantly.

Make these words more than words, and give me the Spirit

of Jesus. Amen.


I "fought" breast cancer 22 years ago, and I "won" that battle as did your mom. My sister died two years ago of pancreatic cancer. She had every treatment that was possible, although the prognosis for that cancer, when it has spread to the liver, is very bad. I didn't see the point, and she died within four months of being diagnosed anyway, probably more immediately from her treatment than from the disease.

Your grandmother made the right choice, IMHO. Folks can't seem to accept that the death rate really is 100%, no matter how much one fights.

The prognosis for Ted Kennedy's type of cancer is grim. My beloved neighbor-doctor had it, so I researched it some and know a bit about it. He lived for nearly three years, but that is quite unusual.

You are exactly right, Mimi. I really do think a person has to "know when to hold 'em and know when to fold 'em." You are right about your sister. She probably had less than a year no matter how you slice it.

I know my grandmother made the right choice b/c the palliative treatment got rid of a lot her more debilitating symptoms and allowed her a more peaceful death 10 months later. The "cure" would have been worse than that, and in her frail health she may not have lasted those 10 months!

As for Ted Kennedy's tumor, it's only the very low stage glial malignancies or the "variants" (like one called pilocytic astrocytoma) that have any hope of long term remission. Two years is often attainable; three, your friend was quite lucky indeed.

I think of one old boy I got to know quite well (because he came in for outpatient transfusions) who had a blood disorder called myelodysplastic syndrome. Not quite leukemia but not benign, either. He had to come in for more and more frequent transfusions for the anemia this causes. He probably went two more months that way because "his kids will be upset that he's not fighting this." He and I talked at length one day, and I realized he was ready to go but his kids were not, so he was doing it for them. One day he came in and announced that "This is my last one, doc, I'm not comin' back. I'm too tired to go through all this for someone else." I wished him well and told him he certainly had the right to take control of what time he had left.

It's a personal decision. I agree that the language we use may be demeaning to those who choose to live well for awhile rather than to fight till the end.


Thanks for this, Kirk.

Folks can't seem to accept that the death rate really is 100%, no matter how much one fights.

I really don't "get" that. I'm really not afraid of death---I'm much more afraid of pain or losing my independence. What I am *most* afraid of is losing those I love...

So, of course, I understand why family members want the one they love to "fight." But, given my own antipathy to the idea of breathing at all costs, I can't ask them to do something I wouldn't want to do myself.



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I'm a longtime area resident of that quirky and wonderful place called Kirksville, MO and am wondering what God has hiding round the next corner in my life.

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