Up and Coming Weekly is a weekly publication in Fayetteville, NC and Fort Bragg, NC area offering local news, views, arts, entertainment and community event and business information.
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THIS WEEK WITH MARGARET by MARGARET DICKSON Your mother probably cautioned you not to talk about some topics in casual or social settings, because not everyone is comfortable with them. These might include politics, religion and the ever interesting and ever unnerving subject of sex. Better, your mother might have said, to discuss such matters only with your nearest and dearest, if at all. I bet she did not mention death or the process of dying at all. Talking about them is just too scary for words. Congratulations to Dr. Larry Kilgore Beginning Teacher of the Month for Cumberland County Schools Dr. Larry Kilgore is a dedicated, hard- working teacher. He left the medical fi eld and pursued a new career in education. Prior to being hired he substituted full- time. Dr. K, as the students call him, is passionate about making learning fun and meaningful. He often dresses in at- tire that represents the time period of discovery or cre- ator of a scientifi c element to enhance the learning of students. Dr. K also tutors/mentors students every Sat- urday at the local library, so that parents and students can have contact with him. Dr. Kilgore is well-deserving of the beginning teacher of the month award. The American Society of Clinical Oncology has screwed up its courage, though, to say that we must talk about these issues with each other and with our health care professionals, and now rather than later. The Society has even developed a booklet to help us do just that and to explain the choices individuals and families face when terminal illnesses strike. It is also working on focused guidelines to help doctors have these tough end-of-life conversations with patients and families, especially when they may not comprehend the gravity of the situation. Delivering such news must be almost as diffi cult as receiving it, so docs need some tips on how to do it as well. What the society is saying, as reported by Lauran Neergaard for the Associated Press, strikes a fresh and painful chord with me. This time last year, a lifelong and dear friend was diagnosed with several advanced and terminal cancers. He and his family were naturally stunned, deeply sad and fi ghting mad. Doctors said there was no conventional treatment, so they quickly began investigating “alternative” treatments, each expensive, far away and with no proven record of effectiveness. As it turned out, there was no time for anything. My friend died a month after his diagnosis in the gentle and caring cocoon of hospice care, warm and in no obvious pain or distress. He quite literally, as we say to cushion the blow, “passed away.” Everyone who loved him was saddened but also relieved that he did not suffer from sickening, debilitating and ultimately futile medical treatments and that he did go gently into the night. Like birth, death is a process, and his appeared to be a peaceful one. The society, made up of members whose jobs and passions are to battle cancer and win, wants people to understand when it is time to quit that particular battlefi eld and to simply make the patient feel comfortable and surrounded by love and when it is appropriate not to begin that battle at all. Translated, this means helping people, both patients and those who love them, know that sometimes, as in my friend’s case, no treatment can change the course of the illness and that they can cause suffering themselves. It also means that when treatment is begun, honesty about its effectiveness is critical. If treatment is not working, patients and those who love them should know that in order to decide whether to continue or not. If the answer to that most basic medical question is no, then honesty about how much time may be left and how to be comfortable during that time is absolutely necessary. The Society’s CEO, Dr. Allen Lichter, minces no words about tackling this most terrifying of issues, not when the time has come but before then when we are healthy and not burdened with the stress of serious illness. Says Dr. Lichter, “This is not a 15 minute conversation, and it should not happen in the back of the ambulance on the way to the ICU at 3 in the morning. When everyone is well and has their wits about them, it’s time to start the process.” That conversation should also include more mundane matters like wills and living wills stashed in known places as well as special directions for funerals and memorial services. Taking those steps, hard and frightening as they may be, is a special gift of love to the people who love you. Trust me. If you have not been in such a situation yet, chances are you will be at some point — with a parent, some other relative, a friend or maybe even yourself. Dr. Lichter and his Society of Clinical Oncologists are the people on the front lines, and they acknowledge that having what they call a “realistic conversation” is tough for everyone involved, including them. Taking that step, though, can mean the difference between honesty and delusion, suffering and comfort, and expensive and unnecessary treatment. You can get the society’s booklet at www.cancer.net. Your mother might have been right when she cautioned you about discussing Sponsored by: Federal Transition to Teaching and politics, religion and sex because not everyone is interested or participates in those fi elds — well, religion and politics at least. But we are all going to face death one way or another, and for one, I would like to do so with honesty among those I love and in comfort as I take my departure. 6 UCW FEBRUARY 16-22, 2011 THIS WEEK WITH MARGARET A Good Death MARGARET DICKSON,Contributing Writer. COMMENTS? editor@upandcomingweekly.com WWW.UPANDCOMINGWEEKLY.COM