THE AUDACITY OF HOPE

Today, I met with the wife of one of my late patients who died this summer after a very long battle with prostate cancer. The appointment was arranged by our social worker, who thought that bringing Mrs. __ back to meet with her husband's providers would be therapeutic for her. Mr. __ had been diagnosed with metastatic prostate cancer over 10 years ago and had responded very well to initial treatment until I met him a little over 2 years ago. Mind you, the average life expectancy for patients with cancers like his is about 3.5 years. During the course of his various treatments under my care, his wife always accompanied him to his appointments, and she kept him honest by not allowing him to downplay side effects and symptoms. I could tell that they had a very loving marriage by the fact that they seemed to "bicker" in a very endearing way during their visits.

For much of the visit today, we just sat back and listened to her recount the tale of Mr. __'s final days. She spoke freely and without prompting about the symptoms he experienced and about how he did not seem to be in pain at the end. She was tearful through much of the visit and became quite upset near the end of her account when she described how Mr. __ had stated that he had wanted to die at home but that he had become very short of breath before his passing, which prompted her to call 911. The paramedics arrived, and he was taken to the hospital, where he eventually passed away within several hours. She had been married to him for 40 years, had given him 3 children, had been with him for every step of his journey with cancer, had given him his medicines, advocated for him with his doctors, and served as his primary caregiver when he went on hospice, but she said she felt as though she had violated his dying wish to pass away at home and hence had let him down. She thanked us and said she felt blessed to have us care for Mr. __ and her, but I could sense that she felt as though he had died in vain.

I wanted Mrs. __ to know that her husband's life and his death had great meaning to all of us in the room. When I see patients like him, invariably they have read the statistics and know how grim their prognosis may be. They are looking for hope- not false hope, but the possibility that their cancer may not take them too soon, that they might make it to their 12 year-old son's high school graduation or their 21 year-old daughter's eventual wedding...someday. I always bring up the outliers, like Mr. __, with these patients, and I know it provides them some relief. Although he never knew it, Mr. __'s course has brought solace and hope to innumerable patients whom I have encountered since meeting him. I shared this with Mrs. __ today because I thought she needed to know what her husband's resolve, strength, and his story meant to me and to countless other patients today. I thought she deserved to know that today.

Afterwards, we hugged and held each other tight, with no attempt to fight back the tears, and no other words were necessary.