June 7 was no ordinary Friday; it was my daughter’s last day in high school. Remember that day in your life? Endings are important, aren’t they? As a sports fan, endings are part of some famous quotes such as Yogi Berra’s quip, “It ain’t over ’til it’s over,” or Dick Motta’s inspiring quote for the 1977-78 Washington Bullets, “The opera ain’t over until the fat lady sings.” This flight of ideas from family to sports is leading straight to where my mind tends to flow . . . back to oncology. This undertow takes me to this question: when is the ASCO Annual Meeting really over?
Is the Annual Meeting over when I head back to the airport? Or, is it when my online evaluation is filled out? How about when the #ASCO13 hashtag traffic tapers off, or when I’m done sifting through the various notes I took about stuff that I should follow-up on or watch on Virtual Meeting. I suppose you can guess where this line of reasoning is headed . . . the Meeting is never really over. The ideas and connections created in Chicago ripple on and on.
One specific topic from the Annual Meeting that ripples through my mind connects with the idea of endings—attendance at funerals. Dr. Don Dizon mentioned this topic during a marvelous session, The Power of Words. He recalled that he went to nearly every funeral for patients he lost during the first year of his faculty career. He shared that this burned him out, and that he now does not generally attend funerals for his patients. I struggled with funerals early in my career, too, but I had the opposite problem. I decided not to attend funerals because it seemed inequitable to attend some funerals but not others. Whether it might be true or not, I didn’t want to think that some patients mattered to me more than others. This pattern was broken, however, when a colleague who was my patient died. Along with other colleagues, I attended this person’s funeral. It was an emotional experience that I didn’t expect, for I felt grief for all of my patients who died. It was a composite grieving experience. This broke the spell, and now I attend some funerals (for whatever reason), and when grieving, I am very inclusive about the target of my grief.
I discussed this funeral issue with some ASCO colleagues during a reception in Chicago, and it is remarkable how we all seem to have evolved some sort of strategy for dealing with this question of funeral attendance. Few others in medicine or otherwise face this kind of death density and have this particular dilemma to sort through. With progress in cancer care, we all hope that this density will change and future oncologists will focus on other sorts of endings to reflect upon (like transitions to survivorship clinics).