For many years Norma and Leo would listen to Paul Harvey's "The Rest of the Story" at lunch time in their humble home in northern Michigan. Now, this is the rest of her story . . .
During the same two-week period her husband, Leo, was dying, Norma was traveling through her own medical maze.
After having some blood detected in her urine during a routine exam she was sent for an ultrasound, and then another. The day after Leo was admitted to Hospice we learned that she had a large, likely cancerous mass on her uterus.
Two days after Leo died we found ourselves sitting in an OB/GYN office talking about treatment options.
You know the drill: surgery, then radiation and chemotherapy in some order. When the doctor was finished, and giving her no other options to consider, he asked her how she would like to proceed.
A tiny woman at 101 pounds and under five-feet tall, an exhausted Norma looked the young doctor dead in the eye and with the strongest voice she could muster, said, “I’m 90-years-old, I’m hitting the road.”
The doctor and the confused first-day medical student who was shadowing him looked at Tim (her son) and me (her daughter-in-law, Ramie) for some clarification.
We had had time to talk to Norma beforehand about the likelihood that there would be some bad news coming from the doctor. She made it VERY clear to us that she had no interest in any treatment. We “got it” and were in complete support of her decision.
But what next? We couldn’t imagine leaving her in a nursing home, especially after walking down the long halls of the local Tender Care to visit Leo in the last room on the right, reserved by Hospice for the dying. No way.
There is also no way she could live at home alone without Leo. They were truly a well-oiled team of 67 years.
Having recently read Being Mortal: Medicine and What Matters in the End by Atul Gawande (please put this on your reading list), our best idea was to take her on the road with us. Norma was not in pain, her mind was sharp, she loved to travel, and she was remarkably easy to be around.
We explained to the well-meaning doctor and his student that we lived in an RV and that we would be taking her wherever she wanted to go. He didn’t hesitate to say, “RIGHT ON!” We asked if he thought us irresponsible for this approach. His reply was telling.
“As doctors,” he said, “we see what cancer treatment looks like every day: ICU, nursing homes, awful side effects. Honestly, there is no guarantee she will survive the initial surgery to remove the mass. You are doing exactly what I would want to do in this situation. I'd want to be in that motorhome. Have a fantastic trip!”
Meanwhile, the medical student stood discreetly by the exam room door taking it all in. Until that point she had spent her first day working with pregnant women (the waiting room was filled with them) all of them just thinking about the beginning of life, not the end. The look on her face during our conversation indicated she had just received the education of a lifetime.
So this is what they don’t teach you in medical school...