I’d fight, but I would either know when to call it quits, or my family members would.
My mother died fourteen years ago, and we let her go. We told the doctors, “Stop the antibiotics, withdraw the respirator, leave her alone.” We probably should have done it sooner, because the care was just dragging out the inevitable. It was her fervent desire that heroic extremes NOT be used. If she had known what her final hospital bill was going to be, she would have pounded us all into the ground.
Ten years later, we had to make the same decision for Daddy. We told the doctors to stop the supportive drugs, and they assured us his death would be within a couple of hours.
Daddy, being Daddy, held on for over twelve hours. He had to go on HIS terms.
Being in a hospital, hooked up to machines and tubes and monitors is horrific. Being hooked up to all that when there is no chance of recovery is selfish, IMHO. Even though insurance covered everything, Daddy would have said the futility would have been “pissing away money.”
Fight, if there is reason to fight. Fight to kiss a baby, see another sunset, or to watch old TV shows, if that is your desire. But to fight only to be tethered to this world by drugs, machines, and miles of tubing is NOT living.
~VOW
While there is certainly truth to this in a grander social sense, “fighting” a given illness is in large part mental (and it can help with recovery). You can certainly choose other words to describe it, but any time I’ve had to describe the four people I’ve either personally or indirectly witnessed passing from a form of cancer, “fighting” was a figurative word used to consolidate many others. However, it certainly was a constant struggle, with the help of those close to them, to even make the attempt to persevere, so it would certainly qualify. One person opted to accept fate, and prior to her passing, wrote some beautiful words about what it means to just live and enjoy life; but even in that, the struggle was again mental and she found peace (which should be the point of “fighting”, IMO).
I don’t think there are any losers or winners (there is certainly a lot of fortune and luck), and it’s definitely not polarized as such in private; but there are definitely people who completely break mentally and are afraid, who are somewhat contrasted by those who try to stay strong/brave and enjoy aspects of their life in the face of enormous fatigue or pain, each day (though in all honesty, the same person can/does experience both sides). Neither is an unreasonable or unexpected response, since a lot of forced perspective and uncertainty takes place. But winning versus losing? I don’t think it’s a situation where the two ideas have much meaning, unless the individual sets those goal posts.
As far as extroverted social influences go, I think they may have some bearing (in the sense that many people perceive death to be bad, living is therefore good), but in the face of critical decisions, don’t weigh as heavily as suggested. Objectively speaking, and as you alluded to, it largely comes down to how/if any treatment is being financed and how good the support structure is around the person. Save for a few other influences and exceptions, the other issues just don’t matter.
I’ve watched cancer claim way too many of my relatives to be considered the statistical norm.
My mother submitted to lung cancer treatment beyond the point of futility, and I sure as hell do not want to go through what she endured. My dad had his bone marrow killed off twice in reboot his immune system as treatment for M2 leukemia.
Given that I am more or less the poster boy for medical treatments going right, my position is that given an objective chance of 1 in 3 of surviving 5 years with an arbitrary cancer, I’d fight like hell, otherwise send me home with palliative care and let nature take it’s course.
I’m not about to be like my mother, who had the towel thrown in for her by the doctor. I want to be the one calling the shots, and by definition it will be my call to stop the drips, reel in the tubes, and call it a life.
Yes indeed I have, more than once.
My previous wife developed a thymoma in 2000 and the Sloan Kettering mortality table gave her a 25% chance of living 5 years. She made it almost seven years to the end of 2006. In between, she had three thoracic and one abdominal surgery, six separate rounds of chemo, and enough rads to kill a cockroach in addition to all the other little things like massive doses of steroids and antibiotics with all of their little side effects. During the almost seven years that she lived with this, she never said no, never decided that something was too much trouble or that the side effects would be too severe. If it was a chance, she took it and dealt with whatever horrible side effects came along. During this time she went from being one step short of a tennis pro to being barely able to move, but she was alive and alert and kept trying to do what she perceived as her job.
I agree that everyone dies sooner or later but my previous wife was what I consider a fighter and I will do the same thanks to her example if I ever develop some dreadful malady.
It can, but doesn’t always, and that’s another thing people tend to forget. It’s hard to think of a better metaphor than “fighting” for dealing with a prolonged illness, but the metaphor is not always appropriate and it can be burdensome and annoying because it makes it sound like the patient is responsible for the results of the treatment. It seems sort of cruel to compare the whole situation to a fight when the most you can “win” is the health you already had in the first place and you’re often less healthy than you were at the beginning. Like casdave said, from that perspective you can’t really win- you just fight it to a draw and try to lose as little as you can. And I definitely think it sounds cruel when people say someone who dies of a long and difficult illness “lost their battle.”
**Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.**
Harold Pinter wrote this poem in response to his eventually fatal cancer:
“Cancer cells are those which have forgotten how
to die” - nurse, Royal Marsden hospital
They have forgotten how to die
And so extend their killing life.
I and my tumour dearly fight.
Let’s hope a double death is out.
I need to see my tumour dead
A tumour which forgets to die
But plans to murder me instead.
But I remember how to die
Though all my witnesses are dead.
But I remember what they said
Of tumours which would render them
As blind and dumb as they had been
Before the birth of that disease
Which brought the tumour into play.
The black cells will dry up and die
Or sing with joy and have their way.
They breed so quietly night and day,
You never know, they never say.
Note to mods I have posted the entire poem, as it was originally published in the Guardian and is available on their website.
I like Pinter’s attitude. Fight the disease, be aware it’s fighting back. I voted to fight, as long as death is not inevitable, as long as some useful ground could still be gained, I’ll throw the dice. This is not incompatible with a desire to have some say in the timing of my death, to choose my end if I am given that grace.
It also makes it sound like the alternative is “giving up” You are either a fighter and a winner, or a fighter and a loser, or a quitter. There is no acknowledgement in those words that acknowledges a choice to accept…that maybe your choice is not to play the game at some point.
And I think that those word choices discourage making peace. That at some point its time to talk about end of life plans, make a will, and decide what music you want played at your funeral. Time to tell friends “hey, I ain’t got much time left, its probably time to visit if you want.” Coming to terms with your own death can make it a lot easier for those close to you - nothing makes it easy . And that is hard work and its time consuming work for most people.
You know what has an absolutely 100% fatality rate? Life. No matter what you do, you’re not going to make it out of here alive. So if you haven’t given up yet, why now?
But I’m working on coming to terms with my mortality. I’m not fighting to live my life, I’m living it. And as I live it, I’m doing the work to face the fact that in the end, I’ll die.
One thing I heard from someone with terminal cancer…she was asked “what’s it like to wake up each day knowing you are dying.” And her answer was “what’s it like to pretend you aren’t.”
No one says, when you bury a 93 year old man “he put up a brave fight.” Because, at some point, you are tilting at windmills - we all die. Now, at what point that is is going to depend on the person - for someone 80 years old facing terminal cancer, it might be different than someone with two young kids at home. It may be different for someone in a lot of pain versus someone whose cancer is pain free and lets them live a full life. It shouldn’t, but often is, different for those that are wealthy than those who are poor and can’t afford decent care. But I don’t think there is any dishonor in “giving up.” And I do think the language implies that there is. And I think that we are REALLY BAD as a society at accepting death which adds to the suffering death brings - both for the dying and those left behind.
Ditto. My father-in-law had a DNR but apparently if 911 is called to your home and you are unconscious, once they have started treatment you are stuck with it. The doctors made my sisters-in-law fight to let their father die. It was horrible, and thruout it the doctors were just awful.
Because living in horrific pain, hooked up to machines, fading in and out of unconsciousness, looking a hot mess, and burdening family members indefinitely is NOT how I want to live.
Why would anyone demand a loved one go through that? Who in their right mind would call that “living”?
I hope that if any of my family members had to face a dilemma like the one in the OP, I’d be supportive and fully accepting of whatever decision they made. Doing so would require bravery and selflessness. I hope I have enough of both in me.
This is probably a bit much for a forum, but when I was sixteen my father (Stage IV liver cirrhosis) asked for permission to kill himself. I didn’t give it to him, and he lived another three years – in agony, on a laundry list of medications, but I wouldn’t have traded that time for anything. Knowing how valuable small moments can be to loved ones, I can’t imagine giving up if I were put in a similar situation.
I said “depends”. I lean towards “always fight for it,” but I can easily think of some circumstances I would give up… for example, if it’s to the point I’m not really “living” (i.e. hooked up to a machine all day where I can’t even read or talk to people), or if the treatment is so expensive it’s going to send my loved ones into crushing amounts of debt for a slim chance anyways.