Oooh, or CIDM
then you can have a really touching scene where the pt is on a ventilator and decides she doesn’t want to be mechanically ventilated and the son has to turn it off and etc.
Actually I think there are many autoimmune diseases that could fit . . . vague symptoms, fast onset, potentially drastic consequences, and less cliched than cancers
Huh, I just reread your OP and now realize that the pt goes from “100% hale and hearty” to “dead” in about 6 weeks. In that case I think Guillian-Barre syndrome might be your best bet (like CIDM but more acute). I like the suggestion of cardiomyopathy too. Another thought is fulminant hepatic failure although I think 6 weeks might be a tad too long for that.
I think 6 weeks is generally a bit too short even for a virulent cancer. I think something autoimmune or infectious might be your best bet.
I’ll check that out. No touching scenes, though–like I said, the book is already written, and the mom’s disease is not a focal point of the story (except as it affects her son and his activities). The son is a main character but not the main protagonist.
I like this, and also the acute viral myocarditis/cardiomyopathy that DSeid recommended–I’d kind of like to stay away from cancer if possible, but I also don’t want something so strange or unusual that it’s going to end up being the focus of anything. Ideally I want something fairly “normal” so the reader will just go, “Oh, yeah, that’s sad. She’s got X and she’s probably going to die soon” rather than “Oh, she’s got <exotic X>–I wonder how that’s going to affect her, what her treatment will be, etc.”
I think GBS is probably a better fit than CIDM for the time frame you are suggesting. And it is something common enough that I would think almost every health care provider has seen at least a couple of cases, and neurologists or longer-practicing generalists have seen several, if not dozens.
It could be longer than 6 weeks if need be–when the story starts, Mom is already pretty sick but not so sick that she has to be hospitalized. So essentially she goes from “pretty sick” to dead in about 2-3 weeks, but there could have been some buildup to it ahead of time. The only catch is that the buildup can’t be more than “Not feeling well” for anything more than a month pre-story. In other words, she could have been feeling bad for a while, then finally decided to go to the doctor (or the doctor finally figured out what was wrong with her) about a month ago. Maybe it’s something that mimics something else (for example, maybe it’s something that a woman her age is unlikely to get, so the doc thinks it’s something else) and by the time they pin it down it’s very advanced)
This is all backstory–none of it will come out in the actual story except the name of the disease. It’ll literally be a version of:
“What’s wrong with his mum?”
“She has X–she’s pretty sick.”
“Oh–I’m very sorry to hear that.”
And then everybody will just move on and deal with her being unspecifically sick as the story progresses. She only appears in one scene, at the beginning–for the rest of the time she’s either referred to off-screen or else she’s in the hospital and sleeping/unconscious.
You could have her have a stroke that went undiagnosed for a long time, then a later stroke that puts her into the hospital and kills her.
Or you could even kill her off with a drug like Coumadin. Heart valve problem, finally diagnosed, heart surgery, treated with Coumadin, uncontrollable internal bleeding, hospitalization, death. One of my relatives nearly died after this sort of reaction to Coumadin, though I don’t know how common it is. (I just remember that the choice was either have a pig heart valve and have to have surgery again, or have a mechanical valve and have to take Coumadin forever. That choice freaks me out.)
ETA: Actually, you could have any surgery go bad and kill her. That would solve the problem of having to have a disease that people understand. She’s sick, has surgery to fix it, then dies from the surgery at some convenient point in the plot.
Doesn’t the paresthesia and paralysis move up the body in hours or days, though, not weeks? Seems like that one is too quick for the home care section, and not quite deadly enough. If I heard someone had GBS, I’d expect them to be very very sick, but if they were in the hospital under a doctor’s care, I wouldn’t expect them to die - it’s only got about a 4% mortality rate worldwide, and lower in places with modern medical care.
But I only know that one from school and working at flu vaccine clinics, not personal experience, so maybe I’m wrong.
Hmm, having a bit of trouble understanding this. So basically what is fixed is that in 2-3 wks pt goes from very sick to dead. And then one month before that pt goes from feeling mildly ill to very sick. The flexibility comes in with the fact that the patient could have been ill with little to no symptoms for some time before the month in which she goes from mildly ill to very sick?
Another (sort of cliched but still appropriate) idea is HIV/AIDS . . . very nonspecific prodrome, very variable length of latency, and then can be quite aggressive, and unlikely to be thought of in a 40 year old female. Syphilis is a bit like this too.
Really though I don’t think there are a ton of non-exotic diseases with a month-long prodrome which then kill in a few weeks (unless someone with more experience wants to jump in, as I have been a doctor for about two months).
Well, she could have some kind of viral illness for the month which is the trigger for the GBS, and then in two weeks she could have ascending paralysis which progresses to ventilator dependence. I have basically seen that happen during my rotations. And 4% is a fairly high mortality rate . . . and if she refuses mechanical ventilation, one could very well die from it. Yes, overall it’s not the most fatal disease ever, but I don’t think a lot of diseases really fit the picture the OP is looking for, and GBS is common enough that it’s not really exotic, nor is it cancer.
A friend of my dad’s went into the hospital for shoulder surgery, went home, went back feeling really bad, ended up with pneumonia, they transferred him to a different hospital with his wife screaming about malpractice, got worse, not a month after the surgery he died. Autopsied him for the malpractice suit, found out his lungs were eaten up with cancer.
ETA - which, having seen my aunt die of lung cancer, is the absolute best way to die of advanced lung cancer.
It would also help to know how old this woman is. Elderly patients are more likely to have something creep up and then race to the finish line. I know we’re bored with cancer, but my mother-in-law was feeling “off”, had a chest x-ray that was clear. At home, she slowly got worse, and became homebound because she needed oxygen all the time. (This is the point at which she would have qualified for a home nurse under Medicare guidelines.) Soon she developed low oxygen levels despite the oxygen and her implanted pacemaker/defibrillator went off several times in one weekend, which triggered an emergency room visit. A new x-ray found a small cell cancer on the surface of her lung - review of the then three month old x-ray confirmed it wasn’t visible then. She had them turn off the pacemaker/defibrillator and three days later her heart stopped in her sleep. So within three months she went from pretty much okay if a little run down to dead. I believe she was 87 at the time of her death.
Okay, sorry, maybe I’m too vague here. Let me clarify a bit more.
Mom has an 18-year-old son who was scheduled for quite some time to go off to another country to study magic with a master who’s a long time friend of the family when he turns 18. However, right around this period (so like a month before he’s scheduled to leave) Mom gets sick. Son refuses to go because he doesn’t want to be that far away from his mother, so alternate arrangements have to be made. The master in the other country contacts a friend of his (the book’s protagonist) who lives near the boy, and asks him to take over the boy’s training. The protag agrees. Throughout the story, Mom’s failing health serves as a constant distraction to the boy, and causes his training to hit various snags and delays.
So essentially at the time when the story begins, Mom has to be sick enough that the son isn’t willing to leave her and go so far away, but well enough that she’s still being cared for at home. Shortly after that she’ll take a turn for the worse and have to be hospitalized. She never comes home after that point, and dies a couple of weeks later.
I wouldn’t go with either of these–she’s not sexually active, and she’s your basic middle class suburban mom who hasn’t had any medical procedures that might cause AIDS/HIV.
I hadn’t thought about it, but jsgoddess’s suggestion of a stroke in the hospital might be a possibility too. Maybe she could die of something only tangentially related to what she has–a complication, maybe, or an event that occurs in conjunction with whatever she’s got.
Mom is in her early to mid 40s.
Oh, that is a lot harder! Then yeah, GBS with a viral antecedent might be a good choice.
Or uterine cysts with a hysterectomy that doesn’t heal right, leading to sepsis, maybe? That would give him as much or as little fretting time as you need, and it’s more likely than cancer at age 40.
That could bring lupus or RA into it. She’s sick, has a bad flare up of an autoimmune disorder and finds it hard to cope, son feels all sorts of guilt, and she can be better then worse then better, then have a stroke or something and die.
I know that lupus can cause strokes (or maybe cause isn’t the right word. Maybe it’s facilitate or something).
Lupus is useful because she could have been sick for a long time without being diagnosed. My father had lupus and it took a LONG time to diagnose. And a woman in her 40s is prime lupus and RA territory.
I think if overall you want a diagnosis which doesn’t detract from the story with its oddity, by far the best choice is as jsgoddess suggested, something routine, like maybe a gallbladder surgery, with really bad complications, like the gallbladder perforates during surgery and causes peritonitis and sepsis and death. Maybe at some point the complications seem to be resolved enough for the pt to go home with home health, but then they flare back up, like she spikes another temperature and has to go back to the hospital and dies.
If we are going with operative complications, I think infection is a good idea, as that can be prolonged enough for what you need. Something like massive blood loss happens a lot quicker.
Too much exposition for what seem to be our op’s purposes. (IMHO, as if anyone’s HO other than the author’s and the potential readers’ matter.)
40 year old previously healthy woman who gets a bit sickish. Diagnosed with bad prognosis albeit not always fatal disease. Suddenly sicker. No shock gets sicker yet and dies. All over two to three months. Minimal exposition desired. Not a cliche but but so unheard of that it will detract from the plot line. Can mention she is seriously ill, that she has X, and later that she worsened and died, all with not much more said than that and without inducing eyerolling from either those who know what X is or from those who have read lots of books with Love Story illnesses.
GBS causing death and over that time course would be eyeroll inducing for me anyway. Sorry. It usually gets its worst within two to three weeks not months, and if in a modern hospital rarely kills.
Yeah, that’s the tough part. I really don’t want the illness to be center stage. The purpose of it is that it has to compel the son not to leave her, necessitating a change in his magic teacher from the family friend in England to the local mage. That’s why it has to come on fairly quick or else be something that doesn’t appear to be terribly serious for quite a while and then suddenly take a bad turn right before he’s ready to leave: because otherwise they’d have made arrangements with the local mage much earlier, and it’s supposed to be a fairly sudden thing requiring him to make a fast decision.
Hmm…ya know–there’s no reason it needs to be a disease. Could I do it with an accident? Like she gets hit by a car shortly before the kid is ready to go, and then some complication ends up killing her? A blood clot or something, maybe? I recently heard of a local case of a guy getting hit on his bike, seeming fine, and then dropping dead of a blood clot a couple of weeks later.
Yeah, maybe something with a blow to the head. I think I just read a story about a guy who was not a native English speaker, had a blow to the head, went to the emergency room and was treated and released, then died a couple of weeks later of some sort of brain hemorrhage. (The article pointed to the language issue as a potential complicating factor, which is why I pointed it out.)
I don’t want you to have to rewrite anything, but would it be possible that the kid didn’t really think much of the illness until the time got closer to leave? There are times when I don’t think of obstacles until it’s too late, or they become magnified at the end.
It’s possible, but he and his mom are pretty close so I think he’d notice if she was sick, and be concerned about it. He’s a pretty sensitive kid–a bit of a geeky mama’s boy since the two of them are all each other’s had for many years (his father died when he was 5 and she never remarried).
Ideally, whatever’s wrong with her, I’d like it to be something that’s not immediately fatal (so it’s not like “she’s got a terminal disease,” but rather “something bad is wrong with her but we expect her to recover from it” only she doesn’t). Whether that’s an accident or an illness isn’t really relevant. It just has to fit the parameters.