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raised and then furrowed as he paused over a light green page. He turned it and glanced at the notes on the next page. With a sigh, he studied the remaining sheets and closed the book. I averted my gaze as he put it on the counter and stepped toward the cubicle.
"Mr. Pilet?" He thrust out his hand. "I'm Dr. Jacobs, the pulmonary specialist. I don't know if you remember me, but we met when your father was diagnosed with the lung cancer."
I nodded as we shook hands, and he continued, "Can we step out into the hall? I'd like to talk with you for a moment."
He led me around the corner to a small waiting area. I began to ask whether I needed to find my mother, but then I saw that she was already there. The doctor motioned us to sit down, and we took our seats.
Dr. Jacobs coughed and then began, leaning slightly forward and speaking quietly. "I've reviewed Pete's chart, and things don't look good. He has received the best possible care, but it hasn't helped. The tumor in his lung has grown despite the chemotherapy, and there's nothing left we can do." He paused and glanced down at his hands. "I also noticed in the chart that you want him resuscitated if he codes. And I…" Another hesitation. "…and I… would like to encourage you not to do that." He glanced up, as if expecting a reply. Receiving none, he continued. "I need to say - and I know you have already heard this - that Pete's situation is medically hopeless. There is nothing more we can do. Even if he is resuscitated, he will not, can not, get better."
Our family had long before discussed this, and Dad had made his wishes clear. "We know the situation," I said, "but Mom and Dad decided a while ago that they wanted done everything possible to sustain life. It was Dad's wish then, and we intend to abide by it still."
The doctor dropped his head and gave it a discouraged shake. "Again, let me say," he said, "that I really believe that is the wrong thing to do. I believe it is medically and ethically wrong." He raised his eyes and moved forward slightly. "I believe medicine is about prolonging life. And this will not prolong life. This is merely a prolonging of death, and there is a great difference between prolonging life and prolonging death. When our actions are simply prolonging death, I believe it is wrong."
"But doctor," I asked, "Isn't all medicine simply a prolonging of death? The death of each person is certain from the moment of birth. No medicine can give a lasting life."
He nodded. "Yes, that's true, in a sense. But we're talking here about quality of life and about avoiding unnecessary discomfort for your Dad." He softened his tone and looked at Mom. "We don't want Pete to suffer more than he needs to. Our goal at this point should be to make him as comfortable as possible."
"Doctor," I ventured, "with all due respect, there are matters of greater importance than comfort. I believe that Dad's choice in this matter was not a desperate attempt to gain another hour or day. Neither was it a grasping hope that he would somehow survive. I believe he wanted to give Mom, by doing this, the absolute and lasting knowledge that she had done everything, attempted everything. He wanted her to be able to continue her life without any lingering doubts. And he was determined to do that despite any discomforts he might encounter." I caught my breath and added, "And, it seems to me, no one lives a day in complete comfort or without the approach of death. So, though it may be only for a day..."
The doctor shook his head again and put his hands on his knees. "Well, I can see you and your family have thought through this. I don't agree with your decision, but I respect that you have made your decision and will continue with it." He rose to his feet, and we shook hands. "I'm sorry about this," he added, "I really wish Pete's condition was better."
And that's where we are at as I write this letter. Dad's condition has deteriorated. The nurse just informed us that his kidneys have now failed and the potassium levels in his blood have risen. She says this makes it simply a matter of time before his heart fails. When it does fail, the doctors will attempt to resuscitate him. If it is successful, he will be kept alive through mechanical means until even those means are unable to sustain him.
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(My notes from March 31 ended there. The following is part of my journal entry
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