There but for the Grace of God......

September is often an emotionally difficult month for me. The 26th will mark 17 years since my father passed. In ways it feels like it's been forever; other times, it seems like it was only yesterday. This morning, something Pop said to me in the weeks before he died, came home to roost. While he was in his dying process from leukemia, he remained amazingly mobile; on several occasions I escorted him down the hallway from his hospital room, to the shower where I helped him bathe. It was something I was grateful to be able to help with, something he would permit neither of my sisters to do for him. That act transported me some 35 years earlier, when I was the five-year-old being bathed, after he plucked me from the hole in the ice where I had fallen through, though this time I was the surrogate parent. One afternoon, as I toweled him dry, he turned and said, "there is a lot to be said for simply having a stroke and going out." I responded, "you know Pop, there's no guarantee that the stroke would take you." He became pensive and a few minutes later continued, "you're right, of course. Still there is much to be said for it."

This morning while I rounded on my one inpatient, I saw several people I knew pass me on their way into another patient room; they were somber, and some were in tears. I diagnosed a man in my practice with breast cancer a year and a half ago. He was 2 1/2 years my junior. Despite his cancer being metastatic to several of his lymph nodes, he had done well and finished his course of chemotherapy in June. He was hospitalized six weeks ago to remove the subcutaneous port through which he had taken his chemotherapy. Apparently, Sunday he suffered a massive stroke to his brainstem. They transferred him out of the intensive care unit to palliative care just last night, and he expired this morning before the palliative care physician did rounds. I walked into the room to find his grieving widow, his stoic son, and a bevy of friends and relatives, many of them my patients. I put my arms around his widow and allowed her to weep on my shoulder. "Era mui rapido," I said, " menos tiempo para sufrir." She nodded and wiped away her tears. She shook her head, the irony that he was cancer free, yet now gone, lost on neither of us. Pop's words echoed in my brain and my heart, as I felt a lone tear trace its way down my face.

I pray she can take some modicum of solace that his suffering was so short. That, and I'm grateful she was not there for a discussion I had with him right after I diagnosed his breast cancer. I was fussing at the time over his blood pressure, which he'd had for a long time and had never treated appropriately. He asked me why BP was so important, in the face of his breast cancer, to which I told him that his un-managed hypertension, "could kill him just as dead." He laughed at that, and acknowledged I had my point. "I hate having to comfort grieving widows," I told him with a smile, and with an amused smirk, he promised to do his best not to put me in that position.

"I'll hold you to that," I said, not really expecting this would be how it would all play out.