Sometimes you say goodbye. Not often, just sometimes. If the diagnosis is plain, the prognosis clear and the choices limited, there might be a time in to say goodbye. It has to be a particular patient with whom you share a bond and then, maybe, there is a precious moment. Then, sometimes you say goodbye.
He has been my patient for many years. During that time I saw him monthly, or perhaps not for a half a year. We fought off one cancer, and the complications which followed. Drove it into remission, and added a decade to his life. He enjoyed books, grandchildren, laughter, sunrises, and great meals. Terrible golfer.
I love him. The love of soldiers that have shared battle. The love of travelers who see the same world. Patient and doctor, who rejoice in life, expect and mourn suffering, would lose all for family, and believe in building on frank words. Two people who cope with a wry smile, a bad joke, the occasional tear and the sweat of the brow. We hold, as with Woody Allen, that “Life is full of misery, loneliness, and suffering – and it’s all over much too soon.”
Now, a second cancer ravages his body and he will soon die. Because he is the type of man who knows that life will pass and can speak of a world thereafter, because I believe dying is a part of life and we can talk of it without folding, and because we are close, it is time to say goodbye. Thank him for wonderful years together and the wisdom he has shared. Thank him for his teachings and support. Make sure he knows I am sorry to see him go.
Except, I cannot say goodbye. I do not lack words, desire, or courage. I know exactly what to say. I cannot say goodbye because the illness, the malady, has taken his mind. In its first rapid attack, the new cancer has poisoned thought, and while he is still my friend, and perhaps recognizes who I am, he is already drifting away. No precious special time, he is almost gone.
I sit at his side, hold his hand, and look into his gentle round face. Expression slack, baffled scowl, eyes adrift, he focuses on blank space. It is a shared moment, without sharing. Does he understand my love, my loss, my pain? Perhaps he is already too far. The burden is on me to remember, to touch, to feel.
We sit quietly, his breathing shallow disturbed by an occasional cough, my breaths deep, disturbed by tightness in my throat. We do not talk of family, sunrise or sunset. No travel plans or food. No smiles or joy. No hope or dreams. Two friends, share not goodbye, but silent moments at the end of life.