Terry was a 24-year-old mother of a toddler when she was first admitted to the hospital five years ago to have a growth on her right kidney removed, a growth her doctor had assured her was benign. After the biopsy showed the tumor to be cancerous, her doctor told her that such a cancer at her age was very rare and added, "It's also difficult to cure." An oncologist subsequently told her that, even though the surgeon had removed all of the visible tumor, this type of cancer often reappears within a year. Terry and her husband rejected this gloomy prognosis and found an oncologist who talked about occasional complete remissions and recommended a course of chemotherapy. After the course of therapy was completed, he told the couple that they could now get on with their lives. This is what the couple did, having a second son shortly thereafter and very recently adopting a baby girl.
Weeks ago, Terry developed a raspy cough and occasionally spit up streaks of blood in her phlegm. At first her primary care physician thought she had a bad chest infection and gave her an antibiotic. But the condition continued. A chest X-ray showed multiple shadows in her lungs. The cancer had returned. A lymph node biopsy removed any doubt, and a three-week course of radiation therapy to her chest did not halt the progression of the disease. The cancer moved quickly, spreading to her sinuses. Soon thereafter painful spots appeared on her shoulder and hip.
One morning, on attempting to get out of bed, she felt something give way on the right side of her pelvis, and she collapsed in excruciating pain. At the ER, the admitting doctor wrote in her chart: "No fractures are evident today; however this patient obviously has very rapidly progressive renal cell carcinoma with several known foci of metastatic involvement to the skeletal areas and attendant secondary problems with extreme pain, malnutrition, weakness, fatigue, and severe depression. Unfortunately, her prognosis with all of this is quite horrible, and therapy is only palliative." The physician inserted a Portacath directly into Terry's bloodstream and ordered high doses of Decadron and a constant infusion of narcotic.
As a second physician is now explaining to Terry and her husband possible courses of treatment and palliative care, she turns to him and asks, "How can this be happening to me now? Why did God let us adopt Sally if he knew this was going to happen? Is she now going to lose two mothers? Why is God doing this to me? "(Adapted from Ira Byock's Dying Well).