In a recent talk by a local palliative care doctor, it was discussed how cancer is a necessary evil. Everything comes at a cost. In order for us to adapt to constant changes in our environment, our DNA must be adaptable. Because of this plasticity, our DNA makes itself changeable and because of this changeability, we open ourselves up to wrong mutations and are susceptible to cancer. The reason we get fat is because of a deep rooted ability of the body to hang onto fat in case the next famine arrives. In his words, the ability to get cancer is what prevents us from being “protoplasmic slime”. Without this ability we would certainly be worse off, or even extinct. With the change in our diets in the last three generations, we see an artificial example of this. Our genes simply cannot keep up with how quick we change our environments.
It is incredible how different individuals perceive the same problem. Quadratic equations teach us that different problems can have more than one result that is correct. This is the case in treating palliative care patients. We have the right to make a decision, even if it is the wrong one. Several sons and daughters can be around the same table with the palliative care doctor, even their cancer afflicted mother can be present, and each can have a different right answer in how to proceed with their mother’s health.
It is human nature to wonder if we had only done something different What the outcome would have been. What if I had quit smoking? What if I had exercised more? The truth is we only know what happened, not what could have happened. True, we know the gym membership might have prolonged his life, but maybe he would have been hit by a bus and died on his way to the gym one day. The best way is to decide the best solution and live with it. Wasting time on wether or not it was the best answer is pointless. The best reflection is that death is an inevitable part of being born and that most of us don’t really consider the fact that we are immortal .
One important lesson I learned is in the area of euthanasia. It not only involves the wishes of the patient, but the wishes of the caregiver. In an oath to do no harm, what of the feelings of the physician who does not want to be responsible for the death of the patient. Also, the patient should have the trust of their caregiver that this won’t be done in an effort to ease their suffering. This Doctor reflected on patients that finally found their own peace eventually, even if their family did not. He remembered patients that had a laugh with their family even in their last hour of life. It was postulated that we could cram all of our best memories into a very short period of time. Any time given to his patients was valuable.
I have worked with this doctor for years in ways to help improve the quality of life and dignity of his palliative care patents in the areas of pain control but I now understand the role I was providing – a very small role. As he said, everyone perceives things differently and “everything is in our head”.
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