A dear friend was in palliative care, dying from a second recurrence of uterine cancer. It was a few days away from her care team finally finding the right cocktail of medications to keep her pain-free, alert, and not wracked with nausea. 1/x
She was restricting visitors. She no longer ate. I was taking dictation for what she intended as a final publication, an overview of her life's work. Her family was gathering for what all assumed would be a last farewell. Into this situation one day popped her oncologist. 2/x
He was no longer involved in her care. I had the impression they had not seen each other for some time. He was full of cheer and promise, and the rhetoric of how they were still going to "beat this thing." No. Nobody was going to beat this thing. 3/x
My friend responded with blank civility, and made no further comment after his quick exit. She had cooperated in the prior rounds of treatment with hope and cheerfulness, and had even herself used the rhetoric of having "beaten" the first occurrence. 4/x
It was clear that at this juncture that the rhetoric of combat was not simply an annoyance and an imposition, it was a hollow, even grotesque, lie. It served no interest of the patient. 5/x
A longtime atheist, my friend had announced early after beginning treatment that she welcomed all good wishes, whether couched as prayers, healing thoughts, or good vibrations. 6/x
As a career activist and fighter, she often used the language of struggle and battle; it was part of her, and at one point offered comfort and hope. When her son was diagnosed with a terminal cancer, he rejected all militant language, which for him was rife with bitter irony. 7/x
As patients, we get to choose how to describe our responsive strategy. Healers would do well to follow their patients' lead, choose appropriately supportive language, and adapt to the realities of a terminal state. 8/9
As colleagues, friends, family, and intimates, let us hope for and wish the best, listen for what those who need us say they need, and not presume. 9/9
#LanguageMatters
#LanguageMatters
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