“This Is My Last Day on Earth”

Craig R. Hildreth, MD

The past two and a half years have been such a bonfire of emotions for me. At the beginning, I never realized I would have to cope with such shifting and volatile contradictions: terror and courage, rage and tranquility, despair and hope. Thirty months ago, I was diagnosed with cancer. For 30 months, I have been living with cancer, but today I am dying of it. It has been an exhausting journey and now like a fire’s last embers, my spirit also dims. Before the day and I both go dark, however, I need closure on some things that have been on my mind. May I share them with you?

To my primary care physician: I know that it wouldn’t have made any difference in my case, but when patients come to you with complaints, and you attribute them to bronchitis or a muscle strain or some other common problem, make sure you follow up to see that they have recovered. Remember that cancer can be a great deceiver of doctors. Don’t assume that folks as healthy as me could never be stricken.

To my oncologist: You certainly were pleasant and compassionate. You also tended to minimize the gravity of the situation when my disease progressed. I know you’re not psychic, but when things are going badly, don’t be afraid to tell me you’re worried. You once said, “No one can tell you how long you have left to live,” but I know you could have ventured a fairly accurate guess. You chose to keep it to yourself, I guess to spare me the sorrow, but how do I prepare my family for my death if I’m not kept informed? Also, please don’t feel you have to keep offering treatment after treatment. It’s okay to say, “Enough.”

To my insurance company: Your medical reviewer told my doctor that you are not in the business of practicing medicine, but then you denied payment for my Avastin, stating it was given two days before your regulations allow. You don’t know how much this upset my father. It is this type of nitpicking and rigidity that builds your reputation as a champion of mediocrity. I will remember you as a paltry and apathetic advocate of cancer care.

To all the nurses who took care of me: In the office, you were efficient and cheerful-you calmed me down, gave me a boost, and almost made me forget why I was there. In the hospital, I could tell you were stressed, but you never failed to attend to me-and you were sweet about doing tasks that I sure as heck could never do. As for my hospice nurses-you were a true blessing to me and my family, for which we will always be grateful.

To my loved ones: I am so sorry you had to go through this. Although I haven’t mentioned it, I am heartsick with the realization that once I’m gone my misery ends, but like the ancient myths, your grief lives forever.

Finally, to myself: You were not as strong as you professed to be, or as understanding. You lost track of your values, exasperated your family, and turned your back on some old friends, all just to spite yourself. You made the mistake of surrendering to the great seducer of the doomed-nothingness. In this void, no love could reach you, and you suffered all the more because of it. May you now find eternal peace.