Recently I had the privilege of tending to a young mother whom I shall refer to as Molly. Molly had advanced cancer. The cancer caused blockage of her stomach and intestines. She couldn’t eat or drink anything because all foods and liquids would back up. Molly was painfully thin. Her face was gaunt with sunken cheeks. Molly was sustained nutritionally by IV fluid composed of dextrose and amino acids. The cancer had spread to the liver and caused fluid to build up in her belly. The fluid needed to be removed by a needle every 2–3 weeks, or she wouldn’t be able to breathe.
Most recently, the cancer caused an accumulation of fluid in her chest. I performed a procedure to remove the fluid in the chest compartment. It gave her some relief, but she was not well enough to go home.
I have seen this scenario play out before. Cancer marches on aggressively and seizes control of everything in its path. No matter how hard the patient fights back, no matter how brave and strong they are, the cancer eventually takes over, and the battle is lost.
Throughout Molly’s terrible journey, she took everything in stride. She remained pleasant and appreciative. Not an ounce of bitterness could be felt whenever I spent time with her.
The fluid I had removed from Molly’s chest was sent for analysis. When the result returned, it was confirmed that the cancer now involved her lungs. I went to visit her to discuss the result.
The room was dark. I asked if it was okay to turn on the light. Molly said yes.
After I flipped on the light switch, I asked her how she was feeling.
“I’m still here,” she said, squinting a bit to adjust to the light. Then she smiled like she always did.
I inquired about her two young children. She showed me their pictures and video clips. She told me the few activities they still were able to do together. Molly could no longer walk or drive. All she could do was read her children bedtime stories and kiss them before her husband ushered them to bed.
“I’m grateful to be able to do these things still,” she said.
Molly then asked if my visit was about the test result. With a heavy heart, I said to her,
“The cancer has gone to your chest and it’s making all these fluids build up. We can implant a tube so you can drain the fluid at home. It will give you some time, but it won’t stop the cancer.”
I paused. Molly sighed, but the smile did not leave her face entirely.
I went on,
“I feel like I wouldn’t be doing my job as your doctor if we weren’t talking about hospice.”
Molly told me other doctors had talked to her about hospice before. She was not naive. She knew what was to come. She and her husband had made arrangements.
“I know what I’m up against. I know I won’t be here for my girls’ next birthdays. But now is all I have and I just want to take in all I can when I can.”
She seemed so at peace with the statement, “Now is all I have.”
There is no truth more universal. The past cannot be undone. The future cannot be predicted. For Molly, it took staring Death square in the face to understand it and express it with conviction.
There’s finitude in human life. We know this intellectually, yet we live our lives as if we have eternity to spare.
We do not.
With each breath, we are moving closer to death.
The darkening sky has a way to magnify the glory of the sunset. Likewise, the mindful recognition of death highlights the beauty of the present.