give hope, but prepare for death. part II

i'm trying to be a cheerful oncologist. really. but i just can't seem to get past the suffering. so i use this as an outlet. overall, i'm not a despondent person, but things like this make me wonder aloud about how we continue to live our lives as though nothing is wrong:

TM was one of my first cancer patients three months ago as i began my training. tough guy, leather jacket, tattoos, drives his motorcycle cross-coutry. he has the bad kind of lung cancer--not that there is a good kind. the first day i meet him, i have to tell him that his cancer has spread to his brain despite showing an initially good response.

"i don't want to hear about time, doc," he interrupts me. "i don't need to hear about how much time i have left. let's just do what needs to be done." later on that night, his wife calls me and asks for the gory details. so i tell her.

over the past three months, TM has taken a turn for the worst. he was at a motorcycle rally when he fell and didn't have the energy to get back up again. when i visit him in the hospital he looks tired, different somehow. i sit down next to him in silence.

"you're here to tell me that i'm too sick for more chemo," he sighs.
"yeah," i barely whisper. i find it very difficult to look at this man's man, with the tattoos and the motorbike and the tough build--i find it very difficult to look him in the eyes and tell him he is dying. but this time he wants to hear it.
"so tell me, doc. tell me how long i have." he wants to know the gory details. so i tell him.

he's at home now, under the care of home hospice. i called him expecting his wife to pick up. but he answered, his voice weak over the phone, tv in the background. he has not the strength to get off the couch. he knows his time is near, and i fear his spirit is broken. to die comfortably at home is one thing; to die with a broken spirit is another.

earlier on, when he still walked into my clinic with his chest out and his bald pate shining, he chortled at the comment of the resident who discharged him from the hospital stay: "can you believe this guy, doc? he told me i shouldn't be riding my motorbike? was he kidding me? that's all i got, doc. that's all there is left of me."

i took a deep breath before i said, "mr. M...you can't ride your motorbike anymore."


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thank you, Chixulub, for your comments. any and all comments are always appreciated.