(siren wailing) NARRATOR: When serious illnesses
take us to hospitals, we look to doctors for answers. But what happens
when there are no more cures? - Do you want
to call her daughter? NARRATOR: Zara Cooper
is an emergency surgeon with palliative care training at Brigham and Women's Hospital
in Boston. She frequently must deal
with patients surprised that they're nearing
the end of life. - It's certain that
everybody's gonna die. There's no certainty as to when. It's not clear from the CT scan
what's going on... And frequently,
as an emergency surgeon, I'm meeting somebody
for the first time, and they have no idea that they
could die from their disease. Whether that's because nobody's
told them or they're in denial, I don't know,
but it's always a surprise. NARRATOR: Clyde Earle
has been undergoing treatment for advanced cancer for a year. He's now suffering
with intense pain. The prognosis is not good. - Well, you're in good hands
here with Dr. Cooper. - I know. NARRATOR: Dr. Cooper
wants to talk to Mr. Earle and his wife Audrey
about what comes next. - So the rumor has it you guys
are newlyweds, is that right? - Yeah, in March. - That's great. Now, what happened before you
came in to the hospital? - One morning, I had so much
pain, I could not take it. I was in deep trouble
with pain. - About 3:30 in the morning. - What I discovered was that
he and his wife had the expectation that
he had many more months. - So let me ask you, what do we expect to happen
after you leave the hospital? - We're going fishing. - Okay. - We're going up
to the house in Maine. And then after Maine, we'll go back
to the house in Florida. - Right. - Now, has anybody
talked to you about hospice or having hospice nurses
take care of you? Is that part of the plan? - When and if we need it,
I know the procedure. - Yeah. When I said "hospice," it was
as if I was talking to somebody who only thought that hospice
would be necessary when he was just about to die. My impression was that
that was the goal, was to get him to hospice. I think the lesson learned
is that you have to ask. You can't make those assumptions
because oftentimes, patients and their families aren't at all
where you think they are and aren't at all
where you think they should be. NARRATOR: But Zara Cooper had
at least started a conversation about the end of life. - We are here to take care
of you, okay? - Okay. - All right. NARRATOR: As Clyde Earle's
condition worsens, Dr. Cooper brought in
Kathy Selvaggi, a senior palliative care
physician whose expertise is
in end-of-life care. She would now take up
the hospice discussion. - She and I had a conversation
about goals of care, and... - When Dr. Selvaggi came down
to the ICU to meet them, I said, you know, "You've got
a lot of work to do." She said, "I know." - It was really important
to take his wife aside and talk about
what I was seeing. - Hi. - How are you, Audrey? - Let's not even ask questions
like that. - I know, I know. Clyde, good morning. - (moaning) - It's been... like this. (whispering) I don't like it. - I know you don't. - I don't like it at all. - It is a process, and I think, you know,
it is very hard to come to the realization
that you're dying. These are really important
conversations that should not be waiting
the last week of someone's life. I'm not sure I'm gonna
get him back to Maine. - We're not. Let's face the truth. - I don't think we are. - No. - I think he's gonna be here
with us. - Yeah, I know he is. I guess I was in my own world,
thinking if they could fix. In my heart, though,
I knew better. I knew what was ahead. And I didn't share it with him. - It's those moments
when people show that they want
to talk about it. Once somebody gives you
that kind of opening, in palliative care, we're
trained to take that opening and to identify that as a moment
where you can help somebody, whereas I think the natural
inclination is to say, "We're gonna get him better
and you're gonna get him home," because it makes you
feel better. - I love you. - I love you. - I love you, honey.
My first wife died of Stage 4 metastatic breast cancer at age 48. She’d been stage 3 for many years, and we had heard the Stage 4 diagnosis when it spread to her liver, bones and brain. She was a very brave woman through it all, fought till her last breath to stay alive. In the last 18 months of her life, we had to relocate to another city due to job changes. So we had our original oncologist (awesome, caring man) find us another oncologist, even though we all knew the fight wasn’t going to save her. He found us one, we went to meet the man, perfect fit for where we were in her late-stage cancer care.
He sat us down during the initial consult, and asked if I could trade chairs with him. I was sitting by my wife, we were both across from him. I did, and he sat next to her, held her hand between his and told her very gently that he was a skilled doctor, and had worked with many rare and exotic cancers over his years, but knew hers was one that was aggressive and that it was unlikely that he would be able to do anything to help save her. However, he knew some things that might prolong her life, and give her some quality of life, before her death. And in her case, there was no cure, just a chance to help her hang on a little longer to enjoying being alive, and making memories with her family, and sharing the love that only a mother can give to her husband and children. She hugged him so long and hard and I sat there and cried like a baby. I’ve never before, and never since, had a medical professional exhibit that kind of emotional power and authenticity in such a dire moment. As she went through her various blood work tests later that visit, he pulled me into his office and coached me about how to help take care of her needs and help him keep her as active as possible. And then he laid those same hands over mine and said “You’ll never realize what gift you’ll be giving her just knowing she’s dying while being loved by her husband.”
We knew she was dying. But this man...so much care in his voice and words of wisdom and comfort.
She entered hospice three months after that visit. And died just a few months after hospice. But he kept his promise and she was active until the day she fell into a coma, Valentines Day. He came to her funeral and afterwards introduced me to a grief therapist that helped me get through her loss. I still get the occasional letter from him checking on the family. He will go down in my life as the greatest hero I’ve ever met.
Those doctors are top notch humans. Every day, they're interacting with people who are in tremendous pain due to their illness or because they're losing someone close to them. It might be easier to deal with by disassociating and closing yourself off, but they instead show tremendous compassion, empathy and fully share in the emotions of the people they're helping. I can't imagine the strength needed to do this every day.
welp, that's enough internet for me for the rest of the week... fuck. I thought enough time had passed since cancer took my mom (about a year and a half), but nope, too soon to watch something like this.
The way he tries to say "I love you" when she says that to him rips my heart out. Goddamn.
Absolutely crushing. I'm 35 and when I was 29 I was diagnosed with glioblastoma (grade 4 brain cancer). I'm doing great, and because of the events of the weeks after diagnosis, followed by the years, I have such a better perspective about death than almost anyone I know.
With that being said. This video just crushed me really badly. I have so many questions, and more so, I have many, many conflicting opinions about how these doctors should be approaching these patients. We're all only human, and it seems like these doctors are trained to suppress their own humanness and emotion. At the same time, it's probably best to keep it cool, calm, and compassionate.
As my years have progressed, I've seen 3 friends and one friend's mother die of the same brain cancer (crazy coincidence, yes, also all much older), and to be honest, I handled it quite well. As I hit the five year mark, one of my doctors suggested I work in outreach to newly diagnosed, younger (better prognosis) brain cancer patients, to remind them that long term survivors do exist.
I'd love to do it, but losing my shit in situations like this video probably makes me a poor candidate.
tl;dms (didn't make sense);
Cancer fucking sucks and fucks with my head.
Damn.
I was expecting the Onion News Network. Instead I got chopped onions.
Dying is not popular subject in todays world.
Yet ... This is our most common subject. There is nothing more common, we will all die.
There's a full documentary about this topic done by frontline a few years ago. It really makes you stop and appreciate your loved ones and empathize with your parents who had to go through losing their parents. I would highly recommend watching it.