We learned about my husband’s inoperable brain tumor from a nurse who doled out the news as though providing his cholesterol count. Mark stood frozen. I clutched at him and wailed.
“Are you OK?” the nurse asked.
Was she insane? Which part of this could remotely be described as OK?
Mark worried about how we would tell the kids, three adult children from his first marriage and our 11-year-old daughter.
“We will tell them,” he said thoughtfully, “that we hit a rough patch.” Only Mark could refer to a widespread brain tumor as a “rough patch.”
My husband was a hardcore journalist, relentless in pursuit of a good story, no matter whose sacred cow he skewered. He was also a really smart guy, winning a scholarship to Harvard University from a San Bernardino public school. He began studying chess at age 15 and eventually became a ranked master. After leaving newspapers, he ran his own public relations firm. His greatest fear, he later told me, was that something might happen to his brain.
After diagnosis, we hit the ground running, signing on with a top doctor at UCLA. Quality of life, we told him, was our most important priority. But when he offered hope that Mark might be able to gain another five years of life, we leapt at the chance.
Still reeling from the diagnosis, we readily agreed to the arduous treatment course the specialist suggested: six weeks of chemotherapy and radiation conducted concurrently. This would be followed by five days of chemo every month. At 58, Mark was relatively young and strong, and a doctor told us that 50% of the UCLA patients with his kind of tumor were alive after five years.
We never thought about that other 50%, and when we discussed treatment options, no one proposed the most basic: Do nothing.
But amid the flurry of medical meetings, a friend introduced Mark to a doctor who had also been diagnosed with a brain tumor, though one considered less aggressive. Mark spoke with him. Oddly enough, this fellow had passed up certain treatments. Why, we wondered, would he do that?
Why? Because doctors don’t die like the rest of us.
Physicians often decline treatment in cases of terminal illness, wrote Dr. Ken Murray in “How Doctors Die,” an essay for the Zocalo Public Square website.
“What’s unusual about [doctors],” Murray wrote, “is not how much treatment they get compared to most Americans, but how little.”
Physicians are much more likely than the general public to sign a living will, specifying what, if any, treatments they want in the event of serious illness, according to a 2003 study.