Quality versus Quantity

A wise man once said the best death is an unexpected death. On the other hand there are advantages to having some time to prepare, allowing all the loose ends we generate throughout our lives to be resolved. But I've run into an obstacle. Having been given some time prepare I have been slowly moving through my list, contacting friends, resolving old issues, and of course doing the paperwork.  When I was admitted to the hospital I made it clear to the colorectal surgeon that I was interested in quality not quantity, he disagreed, saying he wished I would do more. His opinion but not mine. The most telling sign that my position had validity was the diversional colostomy which did not touch the primary tumor except for biopsy. If it was so important to go full bore in treating this thing then why was the tumor left in place. Well it's simple, the tumor had spread to my liver, lungs, spine, and omentum so removing the primary tumor had little benefit and exposed me to a much longer surgical procedure. The next medical professional was the oncologist. Upon our initial meeting I also made it clear that my long term goals were quality not quantity. The 5 year survival stats are less than 10% and the survival curve, with treatment, was not encouraging with 50% survival after 1 year for stage 4 colon cancer. He made a strong argument for palliative chemotherapy. He gave 80% confidence that I would see some improvement and extend my life. What he neglected to mention was that after chemotherapy became ineffective I would still go through the possibly messy end stages. So really it is a choice about time (quantity and not quality). This confusion between quality and quantity in the minds of medical professionals is understandable, they mostly deal with families, with often differing and conflicting needs so quantity could easily be equated with quality in families seeking to extract the absolute maximum amount of time with a loved one. He made the same argument at our first office appointment, saying 59 was to young to die, but since all the possible medical intervention he can muster would not give me an average lifespan or even a median lifespan. When I pointed out that this was essentially a quantity argument he quite looking at me and physically turned to my sister and began addressing her as if she would convince me to follow his plan. But he did not know was that my sister has also walked the cancer path with leukemia. And in typical Thompson fashion she did not tell anyone until she well into chemotherapy. She completely supports my position having been down this road herself. Her only question was “would he (the oncologist) sign the death certificate so the corner would not have to do an autopsy”, to which he replied yes. I told the oncologist that I would consider his arguments again and let him know my decision by the end of the day. After stopping for some Chick-fil-A we headed back to the farm. I ate and then slept for several hours and upon rising from my nap was still comfortable with my decision and called his office and let one of nurses know my decision and asking for a belly line so I can drain acities from my belly. So, the next step is done. It is off to the lawyer tomorrow, then the local Episcopal Priest to get aquainted so the funeral, for the benefit of my mother, will have some substance. 

As  a final observation, I finally had a poo through the new colostomy, but you know it's just not the same feeling of goodness and relief.  A good poo, the old fashioned way, is orders of magnitude more satisfying.