Death Comes Stalking

August 30th, 2009 by Harrumpher Leave a reply »

In what passes for wit, we are wont to speak of our mortality drolly. “We are all terminal patients here” is one example.

Yet, in the past year of Ted Kennedy’s brain cancer, it seems odd that such privileged folk haven’t earned a long-term pass. The flare of irony there, of course, is that he worked so long and with such enthusiasm to have health care more widely available and more equitable. Yet with his huge resources and access to the best of care did not add even a decade to his span.grieving family tombstone

For cancer and dying too soon, I tend to recall my dear friend Paula Delancey. She was a far less famous version. She died at 33 in 1981.

Paula and I, as Southerners might say, kept company in high school. We got our physical and emotional stuff out of the way at 15. We were then clear and clean to become great friends as young adults.

She was the first woman to head her class at the Culinary Institute of America and became a skilled, reviewed and well paid chef in Manhattan. During her time in chef school, she shared my apartment and life on weekends. Years later when she was just in the swing of the city, she got a rare cancer — of the spine.

Like Kennedy’s, it took about a year to kill her once discovered. She had money and insurance. She had the very best oncologists and their care in New York’s greatest hospitals. She put great faith in their chemo and radiation, and surgeries. None of it ultimately worked.

In Ted and Paula’s cases, money and top medical care was not enough to cure them or even prolong their lives substantially. While we likely all know people who have beaten cancer, mere access to care doesn’t make the the difference in many cases. It gives us better odds, but guarantees nothing.

Many of us would like to think that doctors are magic and that medical science is key to everything that primary-care physicians and specialists do.

A distant Star Trek-style future may bring diagnostic wands or the like. How grand if doctors then could diagnose anomalies  with the waving of devices. Then, of course, some laser or other beam could isolate and eliminate bad cells or bulging blood vessels inside the skull or elsewhere. Mirabile dictu!

Meanwhile, we have fallible tests and even more fallible doctors. Short of obvious and acute conditions, meaningful diagnoses and treatment result from luck and perhaps the art of a particular doc.

As a child, I viewed doctors as pretty magical. I had no chronic or difficult problems. Typically, I’d get inflamed tonsils and drop my pants for a magic penicillin shot. I went from febrile and in pain to hale. Magic.

As an adult though, I’ve more often found bumbling. Doctors are happy to take credit for the body’s natural healing and blame patients for problems they can’t cure. More often than not, I’ve been subject to shotgun medicine, that is, treating a symptom with a drug that may or more not help, may or may not have bad side-effects, but certainly does not relate to the undiagnosed underlying problem or its cause. Not magic.

Ted might have had a decade or so and Paula perhaps five decades, if only there had been reason to examine where their fatal conditions were festering. While awaiting those future diagnostic wands, we really can’t expect and won’t have pan-diagnostic sweeps of our bodies.

We have a pretty good idea of how Ted would have built on his long record of legislative successes.  For her part, Paula brought pleasure to strangers and regulars alike in her restaurants. She was also a delightful friend who was looking forward to being an Auntie Mame character to her brother’s children. She anticipated a life as an eccentric old woman and we who knew her figured she’d become a classic.

Part of me and perhaps of you would like to think one could buy perfect preventative and curative medicine. That is not yet the normal way of things. That is a great shame and also a great leveler.

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