It was nearly midnight when the call came. Spencer was in pain and the hospice nurse was over an hour away. Could I come and give him a dose of morphine? They knew the answer before the question was asked. Of course I would come. I had made that promise the moment Spencer enrolled in hospice with incurable brain cancer. I could not save him, but I knew I could keep him from suffering.
I rolled out of bed, threw on some clothes and headed out the door. My heart was heavy as I drove the few miles to Spencer’s house. It was a rainy night, which seemed strangely appropriate. I pulled into the driveway, exited my car and walked, slowly, to the door. I was somberly welcomed into the home, the wave of a hand directing me to where Spencer lay in bed.
I had not seem him in a while, and was shaken by his appearance. It had been a year since the day the neurosurgeon had called me with the diagnosis of inoperable brain cancer. They were going to do all they could to prolong his life, but another year was all they could hope for. “All they could do” included high dose steroids, which caused Spencer to gain considerable weight. His face was so puffy he was nearly unrecognizable. He was no longer able to speak and I could not tell from his eyes if he was even able to recognize me.
Quietly I reached for the vial of morphine on the table to his side. I drew up the dose into a syringe, rolled down the top of his pants to access his muscle, and gave him the injection. I set the empty syringe down on the table and sat, looking at him, wondering what to do or say. I fought back tears. I lost that battle and teary-eyed, took his hand. I asked if I could say a prayer. I asked God for comfort and peace, said, “amen”, then leaned over and kissed him on the forehead. “I love you Spencer,” I said, and quietly left. That was the last I saw him. He died a few days later.
He was 5 years old.
I thought of Spencer yesterday as I was driving away from the home of another hospice patient, a woman just 2 weeks older than my wife who was dying from uterine cancer. Although the original diagnosis was made years ago, until February of this year she had considered herself cured, attending to her life with no thought of the cancer growing within. It was then that she came into the office for two red lumps that had appeared on her abdomen. They had grown rapidly and were quite tender. She thought they were skin abscesses. They weren’t. A CT scan brought the worst possible news. They were metastases. The cancer was back, and it was every where. In addition to the lumps on her skin it filled 90% of the space where her liver should have been. The hope the initial oncologist gave, of perhaps another year of life, proved to be false and a second opinion from the City of Hope quickly took it away. There was nothing anyone could do. We enrolled her in hospice, committed to making sure her few remaining days would not be days of suffering. That was just a few weeks ago.
Her husband called me late Saturday morning to tell me she was emotionally done, too tired to fight any longer. She wanted to go to sleep and not wake up. He wondered if there was anything I could do. I was at my son’s house only 5 minutes away from her home when I got the call. Something in the tone of his voice told me I needed to be there. I left my son’s and went straight to her home.
Her husband met at the door, his gesture toward his wife similar to the one Spencer’s mom had given me so many years ago. She was in a hospital bed near the door. An empty chair was pulled close to her, near enough to hold her hand or caress her face. It was her husband’s chair. I sat down and looked at her.
She was clearly uncomfortable. Her speech was clear but slow, every few words followed by a long pause, as if she was gathering the strength to continue each sentence. Her eyes were tinged with yellow, a sign that her liver had succumbed to the cancer and begun to fail. I knew she did not have much time left, days at the most.
With her husband listening on I developed a plan. I put in a call to the hospice nurse instructing her to begin giving morphine around the clock, a dose every few hours. I added a sedative to help her rest. She was not going to suffer, not if I could help it. I finished my explanation, took her hand and asked if I could pray for her.
She and her husband responded in unison, “Please!” Unsure what to say, I prayed as I did with Spencer, asking God to give her comfort and peace. I asked God to welcome her into the home which He had prepared for her. There were six wet eyes as I said, “Amen.” I let myself out, wondering if I would ever see her again.
I won’t. The hospice agency called me just 5 hours later. She was gone.
Both patients remind me of a lesson I learned a long time ago. Even when there is “nothing” more I can do, there is often still something I can do. I can love, I can give comfort, and I can pray. I can shed some tears, hug my wife, and thank God for the gift of life with which I am still blessed. And I can press on, willing to accept the pain and sorrow, committed to sit at the next bedside, take the next hand, and say the next prayer, knowing that as a Family Doctor this is my calling.