Cancer and Its Aftermath

Cancer changes everything.  Its aftermath is different for every one.  I share two examples; I would be happy to share yours as well.

Brian had been coming into the urgent care frequently for quite some time; his visits always coincided with the completion of a round of chemotherapy.  He was so sick when he arrived:  pale, dehydrated, feverish.  Often he was transferred to the hospital for further care and more time away from his family and home.

Brian was a sweet, soft-spoken young man in his mid-30s, married with 2 preschool-aged children.  When I met him he was almost done with the chemotherapy treatments for testicular cancer.  Once he would begin to feel better we would have time to chat for awhile, he told me that the doctors had already told him he would survive the cancer but the chemo was needed to catch any random cancer cells that may be left.  He felt that the surgery to remove his testicle was nothing compared to the agony of post-op chemo.  He always was so exhausted, he was depressed by watching his wife carry so much of the load; and his children’s energy wore him out and sometimes his tone was sharp with them, which only made him sadder. 

I also had the opportunity to meet Brian’s wife and two children.  Carol was quiet, worried and exhausted.  This battle was wearing her spirits down, too.  The little ones were precious, they stood near their father’s bed asking with their ‘inside’ voices if their daddy was going to get better and come home soon. 

When Brian successfully completed his chemo, his doctors had told him “the cancer was gone, the battle was won,” and he would regain his strength over time; he just had to be patient.  Yet Brian continued to have more complications.  One return visit was due to the development of a clot in his port, and another time he had an infection caused by the port.  They finally removed the offending port.  It was evident that he was slowly regaining strength, but he was still having side effects from the chemotherapy.  On one visit several weeks later he was wearing a baseball cap and refused to take it off; he had lost all his hair many weeks after the final treatment – the one loss he thought he had avoided.

I had the opportunity to see Brian and his family again several months later; they were bringing his son into the urgent care for an ear ache.  I would not have recognized him except for his shy smile. He looked good; he had gained some weight and was able to carry his little one, consoling him gently.  It was difficult for him to come back to the same building that held bad memories from the difficult days of chemo.  Yet he and Carol were quietly grateful and hopeful.  They shared their plans to take some time for a short family vacation before Brian returned to his work as a school teacher.

                                                           

Kelly and I had been coworkers and friends for several years.  She was a fun-loving woman with a wild head of short curly red hair and a mischievous yet caring nature.  Her cynical sense of humor and wicked laugh were a striking contrast to her gentle approach to our patients and her own four children.  Because she was such a fair-skinned redhead, she avoided the sun by wearing layers of sun block and large hats.  So she was very surprised when she finally went to see a doctor (at the nagging push of a nurse practitioner at the clinic) and learned that the pinpoint spot on her cheek was malignant melanoma, the deadliest form of skin cancer.

Surgeons operated immediately and believed they had removed all the cancer, but Kelly insisted on chemotherapy just to be sure.  She continued to work throughout her therapy, the infusion pump hidden under her scrubs discreetly infusing the medication, unbeknownst to those in her care.  Her spirits stayed remarkably strong.

A year later, still cancer-free, she celebrated with friends, but those closest to her noticed grave changes in her personality.  It was as if a meanness had crept into her spirit.  She was openly critical of friends and coworkers who had helped her during her cancer battle, complaining even about those who prepared meals for her family or those who had looked after her children while she had been so sick.  True or not, her words were very hurtful and bad feelings grew.   

Her anger mounted towards her family, too; it was as if she was on a mission to destroy those closest to her that had not also directly experienced the cancer.  She began to spend money wildly, choosing to refurnish the house rather than pay the mortgage owed.  She separated from her husband of 20 years, certain that he had been unfaithful to her during her cancer, despite having no proof.  She forbid him contact with the children, yet she herself was at odds with her children, complaining that they had emotional disorders. She tried to have the two oldest removed from the family home.  Despite concerns from many, she refused to seek any intervention for herself and her family, and she would end relationships with who voiced concern.  It was a nightmare to observe what was happening and to be helpless to intervene.  

Several years later, Kelly lost her life after a reoccurrence of melanoma.  During this last battle, her circle of caregivers was much smaller.  She had chosen to allow cancer to redefine her relationships, thereby surrendering the essence of her life well before her death.