Not A Pink Girl

Update on a friend | August 18, 2008

Spoke to my friend Nancy today. She somehow remembered my birthday. I have trouble understanding her on the phone. She’s so weak, it’s difficult for her to project her voice. She said she had her tubes removed. I think that refers to the tubes she had in her side to help with the disposal of bile & other excretions (she has little liver function, had her gall bladder removed, & has bile duct cancer). As I mentioned, I can’t quite understand what she’s saying when we speak on the phone. She had left me a message last week & I couldn’t decipher it. She lapsed into whispers & had the phone so close to her mouth that her voice was inaudible.

I asked her what was going to happen next. I want to somehow have the courage to ask her if she feels that she is going to die. I don’t know whether to ask her that or not. I know her mother (who is in her mid-70s) will not discuss her 56-year-old daughter’s imminent death. A nurse made the mistake of saying to Nancy in the spring (when she had her gall bladder out) that Nancy’s cancer was winning. This sent her into hysterics (crying, hyperventilating, refusing treatment) from which it was difficult to extricate her.

So I asked Nancy today, “What is going to happen next?” I want to open the door so that she can talk about maybe not making it through this. I know she can’t talk to her mother about dying. But it’s been a bit over one year since Nancy was diagnosed, & since then she has lost more than 50 pounds. She weighs under 100 pounds now & is skeletal. I just don’t want Nancy to be afraid. I know she’s in pain; she said she doesn’t take all the medication her hospice caretakers have prescribed for her. She “falls behind” the pain, & then it’s difficult for her to get ahead of it again.

When I asked her what would happen next, Nancy responded, “Heal, heal, heal, heal, heal.”

It’s difficult for Nancy because her parents & siblings are intellectuals. I think, when they found out Nancy had cancer in July 2007, they figured they’d research this thing into submission (or remission). They had always told Nancy what to do – in big & little ways – her whole adult life. Nothing changed when they found out she had cancer & a dim prognosis for recovery. If anything, that just made them more determined to throw all the initials after their names at this illness & bark, “Back! Back!” at the cancer cells eating away at her liver & other organs.

They’ve dictated the direction of her treatment, giving scant attention to her input. If one surgeon said she was inoperable, her mother just found another one (with more glittering credentials) that would do the surgery.

I guess I understand that. I would want to do everything in my power to save my child. But the thought that Nancy has been cut up, poked, stabbed, scanned, injected, shunted, stented, cathetered, medicated, & mishandled for over a year now just makes me literally tremble with fear & sadness on her behalf.

This whole thing has been doubly difficult for me as Nancy’s friend because I found it tough to understand her way of communicating when she was healthy. When she got sick, she spoke in ever-more cryptic language. She refused to say the word “cancer” or that she was terminal. She wouldn’t allow the doctors to put any labels on her illness. They tried to tell her it was inoperable, & she told the doctor never to say that word to her again.

Yes, I understand that, too. Nancy had read The Secret & watched the DVD. She was acutely aware of the power of positive thinking. Maybe that’s why she’s still alive today, who knows? But it’s difficult for a mere mortal like me to understand the big picture of my friend’s illness when she won’t come out & tell me what the doctors said.

I’ve had friends who died of cancer. There are marked similarities with their illnesses & Nancy’s. When Nancy first found out she had cancer, she pointedly & forcefully informed me that I was not to talk about my friends’ illnesses because all cancers are different. It didn’t matter that two of my friends who died had been heavy smokers (like Nancy) & that they’d been diagnosed with the same kind of cancer (bile duct) at about the same age as Nancy. Again, I am a lowly human being who can only use her past experiences as a frame of reference. So the past year of our friendship has been especially trying for me to navigate because I feel I can’t be the kind of good friend I could be if Nancy allowed there to be no holds barred on the discussion of her illness & its prognosis & progression.

I’m not chummy enough with her parents & siblings to get them to discuss Nancy’s illness with me honestly. Also, each family member is in a varying state of denial of the gravity of the prognosis. When I went to visit her a few weeks ago, I asked her mother & 50-year-old sister how she was doing before I went up to Nancy’s room. They both said, “Good! She’s getting better!” That was just not true. I steeled myself as I climbed the stairs to her room but still wasn’t prepared for the condition in which I found my friend.

The bottom line is that the thought of Nancy being in a trembling panic & a constant state of pain & fear just breaks my heart. She doesn’t sleep except for an hour here & there. I know how surreal everything seems to me – a healthy middle-aged woman – when I don’t get my full eight hours a night. To think that she is in this drugged state, in & out of pain & lucidity… Would it be better for her to go on to the next phase, death?

All I know for sure is, I don’t know anything at all.

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