The three kiss-offs: what happened

September 2009.  Because we lived more than an hour away from the hospital, Laura went to a local imaging facility to get her MRI.  We then brought the MRI on a disk for the doctors to review.  This MRI had been done to see whether stereotactic radiosurgery (SRS) had accomplished anything. After the team looked at the MRI, the surgeon came in.  He said that there had been localized tumor growth around the edges of the area he had resected in July, and also where the radiosurgery had not hit in August. (We were only too aware of who drew the lines to guide that radiosurgery, having waited a week extra for the SRS to begin because of his delay in doing so.)  He said the oncologist would be talking with Laura about chemotherapy. By then I’d learned that the surgeon’s style of communication was to convey even the worst news in precise, technical language and then move on to what would happen next. I was not surprised, therefore, when the radiation oncologist came in and said that it was “very bad news.” More radiation would not be a solution. It was what we had feared: the tumor continued to grow, despite all that Laura had been through this past year. Nothing seemed to have worked. She gave Laura a hug and wished the best for her. The oncologist, who was clearly upset, said that he was going to put Laura back on Avastin and Temodar, but we didn’t get the feeling that he thought it would make much difference.

Late on Sunday morning three days later, I came home from taiji class to find Anne Mei and Laura sitting on the bed in our room—crying.  Laura had called Anne Mei in to tell her that she was going to die soon.  We all cried together.

Seven weeks and three more Avastin infusions after that, the oncologist called it quits.  He said Laura could go on a standard chemotherapy or try to get on a clinical trial.  He gave me information on web sites that list clinical trials.  We should let him know.  When Laura went to the bathroom, I returned and asked the oncologist if Laura was going to have a painful death.  He said they had ways to keep the pain under control.

In her last two months when I was home with Laura, I heard her tell visitors about the “three kiss-offs” she had received—from the surgeon, the radiation oncologist, and the oncologist.  At the time I thought she was being too harsh on the doctors.  I was also concerned that Laura felt less worthy because of their failures.  I was dense on both counts.  In telling people about the three kiss-offs, Laura was not abandoning herself to her fate.  She was not expressing any sense of failure on her part.  Rather, in her usual pithy way, she was using sarcasm to counter the “against” closing in on her.

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