THE LAST GOODBYE

Yesterday, I went to the funeral of a patient who recently lost his battle with prostate cancer. Surprisingly, it was the first time I had attended a patient's funeral. Mr J. was one of the first patients whom I met 3 years ago after starting at my current hospital, and he touched me in so many ways. He had metastatic prostate cancer when I first met him that had progressed despite having been treated with most of our approved therapies.

On that first meeting, he and his family were packed into a small examination room in the seventh floor oncology clinic when I entered. I explained to him that without treatment he had approximately 6 months to live, but that, for the average patient, the median survival with chemotherapy was 18 months. The family began crying. As I handed out Kleenexes all around, they smiled and said, "Don't mind us! We are an emotional group. We even cry at Safeway store grand openings." With that, gravity gave way to levity that day and in most of our other visits, which were always punctuated, however, by his and his family's tears when they thanked me for all I was doing for them.

Mr. J. enrolled in 3 clinical trials and constantly talked about how he wanted to give back to others. Even if these experimental treatments did not benefit him, he hoped the results of these studies would benefit others. Additionally, he requested information about donating his body to science through our medical school's cadaver program after he passed away. He signed up for this, too.

Approximately, 3 years after I first met him, it became clear that he was too sick for more treatments and that we had reached the limits of what medical science could do to make him feel better. I told him and his family, that he taught me a lot during our journey together: about selflessness, about hope, and about courage. He went on hospice in December and died last week.

At his funeral, the officiating pastor, his son, passed a microphone to anyone in the church who had something they needed to share. After reading the back of the funeral program that asked that the guests make donations to my research program in lieu of flowers or any other gifts, I was overcome by Mr. J's final act of altruism.

I recounted my first meeting with Mr. J and that first joke which I heard from him about Safeway. I shared my view (despite many of my non-oncologist friends' incredulity) that I had the best job in the world. Had it not been for cancer and had I not chosen to be an oncologist, I never would have met Mr. J. I never would have seen how much one could love one's family as he did. I never would save seen how brave and selfless one man could be. I never would have had the opportunity to come to the church today to see how much a man could be loved. I never would have imagined the doctor, the man, the husband, and the father I could strive to be... if I had not become an oncologist... and if I had not met Mr. J.

I felt a wave of emotion sweep over me, my eyes well up with tears, and my voice begin to crack. I finished my remarks and sat down knowing that I had sad a proper goodbye to a patient who had given me far more than I could have possibly given him.