“There are, as I endlessly repeat, essentially four ways to die: sudden death; the long, slow death of dementia; the up and down death of organ failure, where it’s hard to identify the final going down, tempting doctors to go on treating too long; and death from cancer, where you may bang along for a long time but go down usually in weeks. Suicide, assisted or otherwise, is a fifth, but I’m leaving that on one side for now.” – Dr. Richard Smith.
On Friday, I read an article with the introductory line, “Cancer is the best way to die and we should stop trying to cure it,” posted on the online magazine, The Telegraph. Dr. Smith is quoted in the article saying that cancer gave sufferers time to say goodbye and that pain could be endured through “love, morphine, and whiskey”. A provocative story even for The Telegraph. However, further review informs the reader of the original source of the article, The BMJ Blog.
The BMJ is an acronym for British Medical Journal, a weekly peer-reviewed medical journal, that’s been around since 1840. Dr. Richard Smith is also a former BMJ editor and an honorary professor at the University of Warwick in the UK. The doctor directs his views towards the aging population about saving billions of dollars by NOT trying to find a cure for cancer,
“The long, slow death from dementia may be the most awful as you are slowly erased, but then again when death comes it may be just a light kiss. Death from organ failure—respiratory, cardiac, or kidney—will have you far too much in hospital and in the hands of doctors. So death from cancer is the best.”
Reactions to his anesthetized words of wisdom were met with a wide range of response from both the civilian and medical populations.
Reading those painful words, like an unexpected slap across the face, left a hot red mark on my mind. I couldn’t stop mulling over Dr. Smith’s words which had provided fodder for rags like Daily Mail and Mirror, and had also made it onto more respectable sites like, International Business Times and the Australian news.com.au.
In the hours before Shabbat, I felt uneasy, blurry eyed with fever and symptoms of the common cold or flu (which should pass without fanfare within 10 days for the average person). Surviving cancer has branded me with a mild case of chronic paranoia that whatever ails me could be related to the cancer coming to finish me off. While I hate to be alarmist, a little voice in my heart sometimes taunts me. Post-chemotherapy, we continue to monitor low blood counts, and mild neutropenia. And, frankly, that so-called insanity has helped me in the past and impelled me to rediscover some very real metastatic cancer. Neutropenic fever can be a real threat post-chemo so I’m overflowing with gratitude that I can have the flu now and not fear for my life.
After Shabbat, in my benign, feverish, flu-like state, I went back to the article in The Telegraph and tracked down the original source at the BMJ Blog. Reading Dr. Richard Smith’s original words in the intended context momentarily soothed the slap mark on my soul:
“You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion.”
Nostalgic and comforting suggestions about how to spend one’s final months, weeks, or days: ‘This is, I recognise, a romantic view of dying, but it is achievable with love, morphine, and whiskey. But stay away from overambitious oncologists”.
All hope is dashed with a final nail-shaped dagger to the heart of a scholarly coffin, built by the esteemed physician: “…and let’s stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.”
The misery that Dr. Richard Smith speaks of is true and real, but I disagree with his conclusion. Sadly, I have seen the merciless and brutal way that cancer kills. I loosely quote a wise rabbi I had the honor of meeting recently, Rabbi David Aaron, who told me and an intimate group of Hevria writers a story about suffering: When Rabbi Aaron’s wife was in labor with their first child, he felt deep distress over what he perceived as her terrible suffering during labor pains. He reacted with immense stress, which greatly troubled his wife. She asked him to calm down and he confessed that he couldn’t bear to see his wife suffer. She responded that labor and birth cannot be considered suffering as suffering is pain and distress without meaning, but soon she would deliver their firstborn child and they would joyfully greet new life!
Suffering is pain without meaning, without outcome.
Suffering is pain with loss and nothing to gain, no fruit of your labor. Cancer treatments come with nasty side effects and sometimes death. Treatments aren’t always successful, but when they are, like my miraculous treatments were, success is like rebirth, a renewed chance at life. Reminiscent of the agonizing labor contractions, the pain of my cancer treatments are worth it when at the end of a course, I greet remission, rebirth, and extended life. I’ve witnessed the suffering of family members and loved ones that death by cancer brings when treatment stops working or fails. As Dr. Smith so correctly states, there are drugs like morphine for cancer sufferers in their final days. The ultimate suffering belongs to those that cancer leaves behind, and I wish more focus could be directed at how to better comfort and palliate the caregivers and the survivors of cancer when death takes a loved one away, however that’s a subject for another essay.
Advances in medicine are prolonging life, valuable lives like this married mother of five. When I was diagnosed, I reached out to my family, friends, and community and was answered in an outpouring of kindness, love, and support. Those surgeries were painful, treatment has weakened me physically and given me nausea, aches, and distress, yet I continue to survive and live a life worth fighting for. I feel happy and loved like I have never felt before.
My life was perfectly interesting and meaningful from 1975 through 2012 without this life threatening demon called cancer. Had the medical gods of science and cure-chasers saved their money and abandoned hope for curing this disease, I might have died shortly after July 2012 or December 2013 when the cancer reappeared. My life with reportedly incurable metastatic ovarian cancer, not without discomfort and affliction, continues to be a bright and hopeful journey. I responded to treatment and scored a coveted position in a clinical trial. Now that I live with a cancer diagnosis and feel my mortality, I feel more awake.
Perhaps Dr. Smith is correct about cancer giving us the gift of being able to reflect on life, visit special places, listen to favorite music and prepare for The End… and maybe he misses a step and comes crashing down on his backside because he fails to see the potential that every added day of living offers. Everything happens for a reason. We can live life with the focus on the inevitablity of death, or we can live life with hope and appreciation.
From the beginning, I vowed to greet cancer as a turning point. As I experience a new life living in spite of cancer, a lot of things have become clearer. I was a very happy person before my diagnosis, yet I feel life’s happiness redefined. It’s about accepting and appreciating what you have, enjoying every drop you can squeeze out of it, and not looking left or right at anything else. I love and appreciate myself, especially my children, my family, my friends, and genuinely love the creations that God put on this earth, and I am happy. When acceptance and love fill my life to the brim, there’s a lot less room for anger, sadness, envy, or regret. I’ve already lived through some very painful and difficult things and I’m willing and prepared to endure far worse if that means I get to continue to be alive!
According to worldwide cancer statistics, 14.1 million adults in the world were diagnosed with cancer in 2012 and in that same year, 8.2 million people died of cancer worldwide. I worry. I’ve had down days spent in bed, yet I’m still breathing, still pumping blood with my heart, and still living life. I have some sleepless nights, yet the sun always rises and so I continue to smile and enjoy. I accept cancer as part of my journey, which was given to me along with many beautiful gifts and people who depend on me. Cancer is not something I would choose to deal with, and yet cancer inspires my enthusiasm for life. I’m terrified about my limited future, yet I have every reason to be optimistic. I have hope that the three white pills I take daily will prolong my respite from that deadly threat of cancer. There’s a 1/3 chance that I’m swallowing 3 capsules of powdered sugar everyday but I simply don’t have time to spend on anything besides hope and the day-to-day business of being alive. My life still has meaning, perhaps with enhanced appreciation and gratitude, and that’s why living with cancer is the best life that there is.
In fact it’s been scientifically proven that appreciation and gratitude both seem to be strongly connected to happiness and satisfaction from life. A 2012 study at Rutgers University, suggests that the significance of appreciation is twofold when compared to gratitude in demonstrating overall satisfaction with life. I can’t prove that there’s a science to practicing appreciation on a routine basis, however I’d be willing to suggest that stopping to smell the roses is more than a cliche and should be elaborated on by each individual, cultivated, and mastered. Daily. I would then take it one step further, the step that Dr. Richard Smith tragically misses, and say that life is precious and relevant, beyond our physical boundaries, as long as we are able to hope and breathe, love and appreciate.
I understand the risks of dying from cancer are high. Death isn’t something I ignore or pretend about. I’ve said this so many times: the only thing that we are absolutely guaranteed in this life is death. I will die. You will die. We all die in the end, and that is why cancer is the best way to live.
That is why we should spend billions of dollars trying to cure cancer because every year that passes exposes more choices, more treatments, better options for prolonging life, better drugs for controlling side effects, and brings us closer to a cure. Those billions of dollars provide physical and medical answers to pain and suffering, but not just that; they provide hope. Perhaps Anne Frank said it best when she wrote in her famous diary, ‘Where there’s hope there’s life. It fills us with fresh courage and makes us strong again.’.