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Safe and Close

By Michael Sharp, MD

Cancer and dying. As I write this I notice a tightening in my stomach and a tingling in my upper arms. I feel myself sensing a void that part of me knows is always there but I pretty successfully keep at bay most of the time. As I get older, random body pains (the ones we all have many days) seem to take on more of a frightening aspect. Again—I am pretty good at keeping frightening thoughts at bay but I felt less vulnerable 10 years ago. But even back then, the words could make my heart skip.

Michael Sharp, MD

If I link other “bad” diagnoses in my mind with the word death—I don’t trigger those feelings of losing contact. Alzheimer’s and death, heart attack and death, stroke and death. These are not pleasant thoughts but I don’t feel the fright I do with “those” two words. Cancer carries with it an ominous cloud and, unfortunately, the tactics currently used to treat cancer carry their own ominous and frightening aspects. I wonder to what extent the capacity of this diagnosis to elicit bad or dark feelings doesn’t come in part from the negative associations most of us have with chemo and radiation treatment. I know this is not the intent of those who administer these therapies but sure enough, they have those associations.

Having practiced medicine for over 40 years, I’ve had experience with death. I’ve watched it approach those I’ve cared for and those I’ve loved. As a pediatrician—for many years—I saw its effect on families and children. “Cancer and children” evokes a particularly frightening image. Friends would say they didn’t know if they could stand being a part of those stories. Implying I guess that they would retreat if they found themselves in my shoes.

As I look back I don’t find myself pushing those memories away. For the most part, these memories are gentle ones full of touching emotions and opportunities to connect at a level of intimacy and truth that seem special and precious. I have vivid, good memories of families I travelled this road with—because we could connect at a depth that is perhaps more difficult in less tragic scenarios.

So the idea of death and cancer provokes a fear that is really quite different from my actual experience.

I think my fear comes from fear of separation and loss of control. When I really try and tune into the bad feelings that are aroused when I put those two words together, I go back to the sense of a void opening between myself and everything I cherish. I sense a primal fear deep down of being left alone—abandoned really—and cold, and little. And yet one thing I know. If this were to happen to me (again) I would so reach out. And I realize how many beautiful people I would be able to reach out to. Wow. What an amazing and good feeling!

As Kathleen and I talked about this the other day, the topic of euthanasia arose. Intellectually I support this practice. I think this is something terminally ill people should have as an option. My goodbyes to Cully and Osa (two beloved dogs) are peaceful memories because we had that solution at hand and I think the path of dying can be made less frightening for some if it is an option. I don’t have any moral imperative about the sanctity of life in this setting.

But my experience with patients suggests that there is a rhythm to the path. I likened it to a piece of music. And my experience is the piece of music isn’t over until it’s over and that to end it prematurely is to possible miss some beautiful parts. Maybe that is why unexpected death is so difficult. Much more difficult in my observation than the piece of music played out with the possibility of intimacy and honesty and a complete absence of the void that tries to insert itself but that need not be there.

To your health.