January 6, 2015

"Dying from Cancer is the Best Death" WHAT??? REALLY???

It has taken me several days to write a response to Dr. Richard Smith's post entitled "Dying from Cancer is the Best Death". The reason it took me so long is that I wanted to try to understand where Dr. Smith was coming from instead of viscerally reacting to his piece with incredulous disbelief.  I am not sure that I have fully sorted out my feelings, but I will attempt to add my two cents to the discussion which has exploded in the online space of social media since his piece was published last week.

First, I commend Dr. Smith for putting his ideas in writing, because I suspect he is not alone with his romanticized version of "death by cancer". I have no idea of his personal or professional story, the deaths he has witnessed, the road he has traveled with loved ones, but I can speak to my own experience and the cancers that were not "gentle" to my family members.  I return again and again to Dr. Smith's romanticized belief that once one has been diagnosed with cancer, you will have a period of time when you can revisit your life, repair relationships, travel, and reconnect with those things that gave you meaning, put your financial house in order and somehow when you have completed these tasks to your satisfaction, rest and call it a life. This may be true for some, but many who receive a diagnosis of cancer are not afforded this gentle trajectory.  

What Dr. Smith fails to acknowledge is the suffering that often accompanies a death from cancer. I am not simply speaking of adequate pain management for physical pain, but the existential suffering that often occurs with a death from cancer and other life-limiting illnesses. This cannot be palliated by a good dose of morphine and a shot of whiskey as Dr. Smith suggests.  I have witnessed my dad, an esteemed educator and academic, lose what he loved passionately-- the ability to speak, write,  read, and communicate with others as a malignant brain tumor robbed him, piece by piece,  of that which gave his life meaning. This is suffering.  I have witnessed my 14 year old son, diagnosed with an aggressive bile duct cancer, lose the things that gave his life purpose and meaning-- friends, playing the guitar, athletics, piece by piece as his life contracted, smaller and smaller, until his death.  This is suffering.  

Dr. Smith opines that cancer is the best way to die.  I hope each of us will use Dr. Smith's essay as a rallying cry, a wake-up call, to the fact that perhaps there is no "best way to die" but maybe a "best way to live"... by attending mindfully to those things that give our lives meaning and hope, in the present moment.  It is only then that we can let go of striving for "the best way to die".


Michelle W said...

Smith's reasoning breaks down for me right at the start, where he breaks down 'ways to die' into 4 neat categories. There are many, many, many ways to die of cancer and it's utterly unfair to lump them all into one group. How one dies of cancer depends on a number of things: what type of cancer, stage at diagnosis, treatments options, the treatments chosen, what support and treatment you can afford or access, mental state, how ready a person is to face death, support from family and friends, etc. If I accept Smith's notion of a romanticized cancer death, then perhaps it is one of the better ways to die. But as he admits himself, it is a romanticized version of reality, and reality is usually quite a bit messier.

Meredith Gould said...

Smith's essay is stunningly inane on oh-so-many levels that I heaved a deep sigh and dismissed it after my first reading. Thanks, Pam, for making me re-read it. Really. Not being sarcastic!

I re-read it wondering if there was any value to this piece. All I can conjure up is that it reveals what others might be reluctant to put in writing, thus providing a glimpse of...what? Wishful thinking? Delusional systems? Magical thinking? Copping to his being a romanticized view hardly offsets his blithe perspective about dying with cancer.

If there's anything to be salvaged from his piece, it's that conversations about how we wish to die, including but not limited to conversations about treatment (or not), ought to happen long before a diagnosis forces the issue. If possible. And, as you point out, the real conversation with self, if not others, is how we intend to live.

Relative to our ongoing discussions about self-disclosure, I suppose we must allow that to include disclosing insensitivity and flat-out ignorance.

Beth Gainer said...

Pam, I'm so sorry for your heartbreaking losses. I agree that Smith seems to have no idea of the type of suffering this illness causes. I also wrote a post refuting what Smith claims at http://bethgainer.com/cancer-the-best-way-to-die/