My mother has been tentatively diagnosed with lung cancer. It’s tentative because she is stubbornly refusing any more tests, at this point – as is her right and as is in line with her long-declared philosophy about this type of thing. She’s also had a coronary occlusion, which is a kind of proto heart attack, as I understand it. My speculation is that the occlusion was brought on by the severity of her coughing fits. Information is scarce and third-hand, so I say none of this with any confidence. [UPDATE: This paragraph’s last sentence is proving appropriate. The current, revised diagnosis has taken lung cancer off the table. The conditions are still serious – the heart occlusion, lung problem (emphysema, now). But the “end-of-life” tone of what follows is now seeming a bit premature. None of that negates the emotional turmoil discussed below. And the frustrating interactions I’ve had with others are if anything made more frustrating by having been, to some degree, a “false alarm.” I’m feeling now not just humbled but vaguely ridiculous, and even more inclined to just go into hiding for a good, long while. I am tempted to simply delete this whole blog post as over-the-top and embarrassing, but I believe in transparency, and admitting error and letting mistakes stand is a part of that. So all that follows is to be taken with the understanding that it was an early reaction to a situation still in flux.]
There’s nothing in my mother’s medical history, nor in the last several years of described symptoms of various kinds, that makes the idea of lung cancer at all surprising. She’s been struggling for years with a steadily declining weight, with a persistent cough, with phlegm and chest pains – not to mention she was a smoker for 45 years. So there’s nothing shocking at all in this. Given our family’s characteristic stoicism, she’s probably allowed it to get pretty far along – just as I did, in 2012-2013, with my mouth cancer.
My mother and I have actually gotten along really well, this last decade or so. I speak to her on the phone weekly, and we have exchanged emails two or three times a week for many years. She is this blog’s most “loyal” reader – and she provides me with meaningful reactions, thoughts, and much-needed copyediting. She is possibly one of only two people about whom I can say, with confidence, that she has read every single thing I’ve published on this blog over the last 17 years – 8455 articles and counting!
My mother is an Australian citizen, and I actually have a lot of faith in the Australian healthcare system (socialized medicine!) to do the right thing – both with respect to her needs but also respecting her oft-expressed wishes regarding such things as healthcare directives, living wills, and the like. She was, if anything, quite over-thorough and obsessive about end-of-life planning. I sometimes found it morbid and frustrating, in talking to her, with how often it came up. In this moment, however, I’m deeply grateful for it. Because of it, I have a high degree of clarity about her expectations, her desires, and I feel I could easily answer the question, “What would she want?” in almost any possible circumstance.
There are lots of people in her life, there in Australia, who are equally well-informed: friends, neighbors, etc. Because of this, I personally have utter confidence that, left to their own devices, the Australians would solve things and would do so entirely respecting Ann’s wishes, within the bounds of what the law and local healthcare practice demands.
What has left me frustrated, confused, even bewildered, is that I failed to mentally prepare myself for interacting with all the other people in her life. Different people have different perspectives, and they see different priorities, and I’m left confused and feeling helpless because, despite being psychologically prepared for what is happening to my mother, I am unprepared for how other people will handle it and react – to me, to my thoughts, to my desire to step in and “manage” things in some moments, or to my reluctance to do the same, in some other moments. I can manage my feelings, I can predict my mother’s feelings, but all these other people are muddling the picture.
So I’m not handling this as well as I could be. If these other people weren’t in the picture, I could feel utterly at ease with my mother’s situation and with the choices she’s made and where that puts us, now. But… with these other people, suddenly I feel very anxious, unable to cope with balancing different points of view, more than once on the verge of a frustrated retreat into non-communication.
I know this sounds terrible, but I’m actually grateful that, due to Covid, no one in North America will be going over there. Australia remains completely locked down – an island continent is easy to do that for. I feel like if one or more of us family members showed up, it would leave the Australians worried about offending someone, and they’d retreat and wait for one of her family to act, and then things might get messed up, because the North Americans would be unfamiliar with the legal environment and Australian healthcare system.
I am at peace with the interactions I’ve had with my mother. Hopefully, if things go according to her plan, she’ll be allowed to go back home to “die in peace”, with minimal palliative and/or support care of some kind. Her home is in an isolated location, but there do exist agencies in Australia that will take on that role, if asked. Her friends and neighbors, there, are well-informed as to her wishes and competent to make these things happen. And hopefully I’ll get to interact with her some more, once she’s out of the hospital, via phone or skype or email. We’ll see.