(Previous) 04-01-2001 (Next)

The doctors said esophageal cancer is an uncommon type. It is usually untreatable because it's very aggressive. By the time Dad went to the hospital it had spread to most major organs in his body.

I wasn't really shocked. He smoked heavily his entire adult life. He had every single risk factor there is. He drank regularly. He ate very poorly and exercised very little. His mother had two major bouts with cancer and his father died from it.

When he was in high school and watched his father waste away over seven years, I think he resigned himself to this fate. That's the way he's lived his life.

You wouldn't know it from his attitude now. He's concerned about his health and treatment. It's his physical appearance that has deteriorated. He's aged thirty years in the past two months. The shape of his skull is clearly visible and his eyes are sunken. His skin, accustomed to wrapping a plump man, is a loose mottled bag around his skeleton. He looks nothing like what you see on TV. They can't show you how dramatic the change is. I have to remind my eyes that he's my father.

The cancer is growing without bounds. It's using up all the energy he has. His organs are all failing. It has partially blocked his esophagus and entirely blocked his intestines. His stomach is a dead end, so they inserted a naso-gastric ("N-G") tube to drain his stomach. Even if he could keep food down, it would only help nourish the cancer. Without his oxygen mask he pants and his speech is slurred.

He likes popsicles. He enjoys the flavor and the cold sensation. They don't make him nauseous. The doctors say he can eat whatever he wants.

There's no reason to deny anything he wants. He's "actively dying". His care is entirely focused on making him comfortable. This has a horrible trade-off: His comfort comes primarily from morphine. As his pain increases, so does his dosage. We needn't worry about addiction, so his dosage can be very high and frequent. High doses of morphine, however, suppress one's breathing. His breathing is already difficult. The cost of his comfort is a shortened life.

The popcicles are a comfort...perhaps more for us than for him. We like to be able to give him some small amount of enjoyment. All the candies and food-related gifts (that we sent him before we knew how serious his condidion is) are just sitting around the room because he can't eat them.

Mom, Rick, Kappi and I are keeping him company. We don't really talk about the inevitable. We seem to hide behind the biology of the situation, discussing the flow rate of the N-G tube, the time of his last morphine shot and how his pressure sores are doing. We don't dare say that he's about to die.

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