On Endings and Beginnings

On Endings and Beginnings

Don S. Dizon, MD, FACP, FASCO

Dec 31, 2013

As I sit at my desk with the end of the year rapidly approaching, I am thinking about endings and new beginnings. I’ve just seen a pictorial about a dad and his three-year-old daughter. These were not family pictures per se. The father and daughter (Ben and Olivia) were preparing to move out of their home two years after Ben’s wife, Ali, had died of lung cancer. Before leaving, Ben recreated the wedding photos he and Ali had taken years earlier, only with Olivia instead. In the photos (set side by side), the house is empty- in one set, it is a home full of promise; in the other, it is a home full of memories.

These were pictures of an ending, shepherded a new beginning. They were also pictures of survivors; a dad and his daughter, re-creating a life without his wife, her mom; yet in those pictures, a tribute and a vow to never forget her.

I did not know them, yet the story resonated with me. It reminded me yet again of my friend, Kristina, and how she was no longer here, no longer a part of the lives of her husband, John, and two sons, all of whom she loved so dearly. I thought about John after seeing these pictures and reached out to him. I presumed that the first holiday season after Kris died would be difficult for them; but I had hoped that they would find solace and strength in each other.

In his own words:

It’s no fun wrapping Christmas presents on your own. Even making stockings for the hamsters doesn’t have the same sense of fulfillment. But as another year draws to a close, maybe the next one will be better. How many times have we said that before?

We all know Christmas is a memorable time of year. For our family, with our “unwelcome guest”, the memories are particularly raw.

Christmas 2010: Chemo done. Tick. Preparing for surgery. Tick. Everything going to plan. All will be OK, right? Yes- it will be OK.

Christmas 2011: Cancer is back. High dose dexamethasone resulting in manic behavior. Forgetting where the kids’ Christmas presents were hidden, reordering them online. Returning them later. A thousand texts and emails sent-- of goodwill to all men. And women.

Christmas 2012: Novel therapies. “Thank you for trying,” we say to the doctors, and “Merry Christmas”. We have fingers in the holes in the dam. Yet, water is leaking. A sense of dread, but still impossible to get the “perfect” family photo.

This Christmas is different.

The photos are different.

She’s not there.

She did leave us a Christmas card, buried deep in a box of festive decorations, which we found unexpectedly when we were putting up the tree. We opened it on Christmas morning along with our presents so she could be there. It read: "I love you and miss you, I am always with you, always deep in your hearts".

It’s not really the emptiness, or quiet moments that hurt. There are not many of those when life kicks in again and the kids have kids’ things to do, and I have the weekly sanctuary of counseling for reflection anyway. It’s not really the fear of lost memories or isolation or forfeited career opportunities or financial repercussions or sympathetic looks from people who know (but who don’t really know). No, what hurts is lying in bed at night, holding my boys’ hands as they breath quietly and dream and all I can think is what could have been. What should have been. Like a spoilt toddler I’m screaming silently “It’s so unfair”.

I’m not a jealous person. I’m not an angry person. And it’s not in my nature to feel morose. But when I see couples walking hand in hand, elderly couples walking hand in hand, retired, and in love, and together, all I can think is what could have been. What should have been. It’s so unfair.

So Merry Christmas and good will to all men. And thank you to everyone who has shared this rollercoaster ride with us. Goodbye Kristina, and Goodbye to Cancer and Goodbye to that most unusual way of life. It’s all my little one has ever known. And as another year draws to a close maybe, just maybe, the next one will be better.

As oncologists, we have the privilege of caring for our patients and their families at a harrowing time, and because of cancer, we become a part of their lives. Although we will say goodbye to many of them- whether at the end of curative intent therapy, after they reach that magical number of five years without evidence of disease, or sadly, after they have passed away- the impact of cancer lingers for them all.

And so, let us join our patients, their loved ones, caregivers, and advocates, and those preparing to move on, people like John and his sons, and Ben and Olivia, in hoping that yes indeed, may this year be better.

Happy new year, to all.

*My deepest gratitude to John for sharing his experience.

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