I Wish I Had Let My Mother Die Naturally

In the months before my mother, Dr.Rachel V. Holland, a well-known African American college professor  and social activist died of liver cancer in 1997, she and our entire family and social network were forced to face the inevitability of her death.  We were also compelled to make key medical decisions about how she would spend the last months of her life. 

Once the liver tumor was identified and the diagnosis of liver cancer was made, the treating oncologists told us that she would live six months without chemotherapy and nine months with chemotherapy.

That’s when I made one of the most uninformed and emotional rather than rational decisions of my life.  I urged and nearly compelled my mother to submit to the chemotherapy treatments, which turned out to be just like torture in terms of their effect on her, except with the intention of extending her    life just long enough for her to suffer this torture.   Every few days she was pushed to the verge of death by chemicals that poisoned the rest of her body as much as they poisoned the cancer from which she would die in any case. 

The doctors should have explained to us that my mother had six good months to live, whether she underwent chemotherapy or not.   Any added time chemotherapy gave her would be spent in horrible suffering, nausea, vomiting, sleeplessness, and other symptoms not unlike those suffered by prisoners at Guantanamo Bay.   She would be pushed to the brink of death by one set of poisons and the dragged back from the brink by other medicines.   The date of her death, I later realized, could be pushed three months further out, but the amount of her vital life could not be changed no matter what we did.

Ha d I understood this at the time of the decision regarding chemotherapy, I would have understood that my mother only had six good months to “live” no matter what we did.  The only question was how many months of suffering we wanted to add to her life with chemotherapy that we knew would be ultimately futile in any case.  We could not prolong her life; we could only prolong and exacerbate the physical pain of her death.

My mother immediately underwent chemotherapy and was barely even with us while the three months of torture continued.  It is a shame that such a creative and productive life had to be punctuated nine months before the end with three months of unremitting  physical misery.

After that experience, my mother arranged for hospice care and determined that she would die in her own home, on her town terms, with sufficient levels of medicine to diminish but never truly relieve her physical pain.  She told me once, matter-of-factly, “Frank, I’m going to die.”  I could only respond to her that, ‘We are going to die and none of us knows exactly when.’   It’s something we all have to accept about ourselves and about each other.

Today, in the New York Times, writer Anetola Hartocollis has published a profoundly well-written article addressing end of life “palliative” care -- the care that Sarah Palin has demagogically characterized as “death panels.”  Palin seems to believe that everyone will live indefinitely if doctors simply refrain from talking with patients and families about the prospect or certainty of death.   “Just say no!” 

The simplemindedness and callous posturing she brings to this issue should tell us how she would behave if she ever were in a position to affect these decisions nationally.

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We talked with my mother about death quite a lot in the last months of her life, after discussing her prognosis with doctors.   She determined that she would change her diet and asked me to drive her to the home of a relative, where she would eat only whole foods in a home-ready attempt to stave off the death that hospital doctors had promised.  When she called me to drive her home and asked that we stop at Popeye’s Fried Chicken on the way, I argued with her.  I knew that eating her favorite junk food meant that she had accepted the inevitability of her death, and so should we all.

I urge others to read the New York Times article of today entitled, “Months to Live:  At the End, Offering Not a Cure, but Comfort.”  The article addresses studies showing how difficult it is for doctors to discuss fatal prognosis with patients and families, and the difficult choices to be made when longer life means only longer suffering.

When my mother, who taught English literacy to the nuns of the Mother Teresa, had finally succumbed to cancer, we did what we and her friends knew she would have valued.  We started funding a scholarship in her name at Bristol Community College, where she was the first African American professor and where she spent most of her career.

Atty. Francis L. Holland is an international social and new media activist living in Brazil.