By Gil Schamess

The evolution of my family's new life begins in earnest when the environment in which we live is dramatically altered. In a standard examining room are three doctors. My wife, my brother, and I are in the examining room, too, waiting to be told what these doctors know about my body that I cannot discover independently. The doctors are calm, accustomed. We--this subset of my family--are reaching out among ourselves for what comfort awkward touch can provide. We are struggling, too, to achieve an unwanted propriety--because to secure the best possible professional services from these doctors, we not only need the right insurance card, we also need to display the right behavior. We sense a certain standard of decorum is required.

First, a solemn pause, perhaps a minute long; but already the atmosphere is unfamiliar and adaptation a necessity. Then the doctors reveal the results of my biopsy and the ground drops away from beneath our feet: I have liver cancer. It has already spread to my lungs.

After another solemn pause, we move on to the possibilities for my treatment. This segment of the visit, too, is unmercifully short, its forward flow solidly dammed against any incursion into the territory of hope. A single abstract from the voluminous literature of cancer treatment is proffered: a chemotherapy protocol out of Japan that helped a few people live a few months longer than predicted.

The oncologist, a man we now refer to as "The Undertaker," has declined a chair while he speaks. Clearly he will be the first to leave. He answers some of our questions, vaguely. In demonstration of his highly developed medical skills, nothing he says resembles a promise or even a reassurance. He looks away as my wife begins to cry. He offers us this: "Come back when the cancer is making you very uncomfortable, and we'll try to improve your quality of life a little with this chemotherapy." He waves the badly photocopied abstract around like a discovery we should be excited about. "In cases like this," he wraps things up, "it's all about quality of life." Ultimately, because we have been courteous enough to thank him for his time and help, he offers us another tidbit of wisdom, a quote he thinks will help us more completely understand our gratitude for his care: "To heal sometimes, to comfort always," I believe it is. He tells us the source of this cold comfort, and it slips my mind as soon as it's been said.

The remaining two doctors--my primary care physician and my gastroenterologist--make a stronger attempt to offer genuine comfort. Each hugs me and then my wife and shakes hands with my brother, a doctor himself, who today cannot climb to any high and distant vantage point where tragedy disappears into the longer view of science.

The comfort we all desperately need, of course--now that medicine has shouted its shortcomings from its exclusive hilltop--cannot be found in a clinic examining room. We hope to find it at home, where my mother and my brother's girlfriend wait, able still to imagine comfort can be found in biopsy results.

Read the next installment of "A Diary of Living with Cancer," Spiraling Downward, or choose another column here:

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