WEBVTT - 2: It's Terminal

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<v Speaker 1>I'm just a fool, wait, fearing stranger. Welcome to death,

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<v Speaker 1>grief and other ship. We don't discuss. I'm Kyle McMahon,

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<v Speaker 1>m hm. Hello. Okay, what does that mean? Should I

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<v Speaker 1>come there now? Okay? Please please keep me updated? Okay,

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<v Speaker 1>all right, love you bye. Dad had called me to

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<v Speaker 1>tell me Mom was going into the emergency room. She

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<v Speaker 1>hadn't eaten in seven days. She was in pain all

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<v Speaker 1>the time. Through my mom's cancer journey. They had hired

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<v Speaker 1>an oncology nurse, Kim, to come and check on Mom

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<v Speaker 1>here and there, and it really helped to ease Mom's

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<v Speaker 1>anxiety from growing through all of the various treatments and appointments,

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<v Speaker 1>knowing that she had someone by her side at my

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<v Speaker 1>parents house to help guide her through. Kim had been

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<v Speaker 1>over the last few days since Mom had taken a

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<v Speaker 1>turn for the worse. My mom. Mom's mother had passed

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<v Speaker 1>away just a few weeks prior, and Mom had really

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<v Speaker 1>gone downhill since then. All of us really were just

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<v Speaker 1>trying to keep our heads above water. I was so

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<v Speaker 1>close with my mom. I'd visit her weekly and we'd

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<v Speaker 1>eat ice cream and watch horror movies or American Horror

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<v Speaker 1>story how awesome is it to say you watch American

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<v Speaker 1>horror Story with your eight year old grandmother. My mom's

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<v Speaker 1>death was truly tough on all of us, and the

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<v Speaker 1>aggressive chemo Mom had been getting had been taking its

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<v Speaker 1>toll too. She was weaker than she usually was that

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<v Speaker 1>mom Mom's funeral, Dad had pulled out a wheelchair for

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<v Speaker 1>Mom to get in when she was getting out of

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<v Speaker 1>the car. She had been having stomach problems and wasn't

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<v Speaker 1>eating like she normally does, which really had never been

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<v Speaker 1>much anyway. Seeing your mom in a wheelchair for the

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<v Speaker 1>first time in your life just hits different. She was

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<v Speaker 1>always superwoman to me, and now at my mom's funeral,

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<v Speaker 1>here she was being wheeled in a wheelchair by my dad.

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<v Speaker 1>Due to COVID, attendance at my mom's funeral was severely restricted.

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<v Speaker 1>Mom's care team had said that Mom and Dad had

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<v Speaker 1>to sit separately from everyone else because of her chemo

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<v Speaker 1>and the cancer. And since I didn't live with my parents,

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<v Speaker 1>I sat with my Aunt Kim and the rest of

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<v Speaker 1>my family while Mom and Dad sat across the aisle

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<v Speaker 1>from us. I had so many feelings just flowing through me.

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<v Speaker 1>At that point, I was sad for my mom, and

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<v Speaker 1>I was already missing her so much. I was worried

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<v Speaker 1>about Mom, I was concerned about Dad, and here my

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<v Speaker 1>parents were just ten feet away, and I couldn't even

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<v Speaker 1>sit with them at a time I really really needed them.

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<v Speaker 1>My family had asked me to give the eulogy for Mama,

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<v Speaker 1>and I had worked on it for hours the day before.

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<v Speaker 1>I looked over to Mom as I stood at the pulpit.

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<v Speaker 1>She was crying, and although she was wearing a mask

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<v Speaker 1>as we all were, I could see she was smiling

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<v Speaker 1>at me, and that gave me comfort, just that look.

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<v Speaker 1>And Mom always had that ability. She is safety, she

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<v Speaker 1>is home, she is love. When I finished the eulogy,

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<v Speaker 1>Mom motioned for me to come sit with them. I

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<v Speaker 1>quietly asked Dad if that's what she meant, and he

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<v Speaker 1>said yes. Mom kissed me on the head through her mask,

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<v Speaker 1>and I knew she was in so much pain, not

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<v Speaker 1>just physically from the cancer, but emotionally from losing her mom.

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<v Speaker 1>And here she was cancer and horrible pain, grieving, and

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<v Speaker 1>yet comforting me my safety, my home. Love. When we

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<v Speaker 1>went to the cemetery from my mom, that's when Mom

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<v Speaker 1>really broke down. She was sobbing, hysterically getting up from

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<v Speaker 1>her wheelchair and nearly laying herself on my mom's casket.

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<v Speaker 1>I could feel her pain. I missed Mom so much already,

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<v Speaker 1>but now I'm hyper focused on Mom and her health.

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<v Speaker 1>I just lost one of my two rocks, my two people,

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<v Speaker 1>so now I'm terrified of losing the other one. I

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<v Speaker 1>looked up at the wall that my mom would be

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<v Speaker 1>put in. She'd forever be with her husband Jim, my

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<v Speaker 1>beloved pop up Aunt Kim would eventually be cremated and

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<v Speaker 1>go in with them. Mom and Dad will be right

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<v Speaker 1>above them, and I'll be cremated and go in with them.

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<v Speaker 1>Aunt Kathie and Uncle Tom had their own place right

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<v Speaker 1>next to them, and hopefully their son t J and

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<v Speaker 1>his family would be there too, and my uncle Kevin

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<v Speaker 1>and Aunt Michelle and their kids Brian and Megan. We

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<v Speaker 1>could all be together forever. Mom collected herself and then

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<v Speaker 1>apologized for losing it. But who could blame her. My

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<v Speaker 1>mom was a special woman with a huge heart, and

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<v Speaker 1>that's a big reason why Mom was too Mom told

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<v Speaker 1>me later that day that she felt embarrassed about how

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<v Speaker 1>she acted. I said, Mom, you lost her mother. Nobody

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<v Speaker 1>is judging you at all for crying over losing your mom,

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<v Speaker 1>And I could tell Mom was a bit spacey, a

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<v Speaker 1>bit off. Ever, since my mom had passed the cracks

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<v Speaker 1>and the foundation started showing up on Mom's cancer journey,

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<v Speaker 1>it was almost like now that she was grieving momm

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<v Speaker 1>she couldn't fight her cancer with energy too. I mean,

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<v Speaker 1>it takes everything in you to fight a diagnosis like that.

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<v Speaker 1>How could you possibly have the mental or physical energy

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<v Speaker 1>to deal with the pain and grief and loss of

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<v Speaker 1>losing your mother on top of fighting for your own life.

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<v Speaker 1>And now here we are with Mom at the hospital

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<v Speaker 1>and my anxiety sky high. Dad had said I couldn't

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<v Speaker 1>go in because of the COVID restrictions at the hospital,

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<v Speaker 1>but he would update me just as soon as she

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<v Speaker 1>was seen. I retreated back to my bubble with blue

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<v Speaker 1>binging more unsolved mysteries, with my phone in hand, just

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<v Speaker 1>anxiously awaiting dad's call. He texted an update that they

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<v Speaker 1>were taking her in for some tests, and I begged

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<v Speaker 1>him please keep me updated. Then once again I began praying,

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<v Speaker 1>now more angry and desperate than ever. God, you can

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<v Speaker 1>change all this, so do it. Give us good news,

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<v Speaker 1>Give her good news. I was no longer gracefully and

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<v Speaker 1>humbly asking God to help Mom. That tactic clearly wasn't working.

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<v Speaker 1>Now I was demanding it. I went over to watch

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<v Speaker 1>a movie with my godson Aidan and his godmother, Michelle

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<v Speaker 1>Shell had lost her father to cancer, and I was

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<v Speaker 1>there with them through it all. She knew what I

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<v Speaker 1>was going through, so I'd go over there a few

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<v Speaker 1>times a week just to watch a movie and forget

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<v Speaker 1>about everything as best as I could. Tonight, though, I

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<v Speaker 1>was having a really difficult time, not concentrating on anything

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<v Speaker 1>else but waiting for Mom's test results. Since my mom

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<v Speaker 1>had passed, it had really become this vicious cycle of

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<v Speaker 1>Mom taking medicine to help her stomach so she could eat,

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<v Speaker 1>but then not being able to keep the medicine down,

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<v Speaker 1>which only made her stomach work, which meant that she

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<v Speaker 1>couldn't eat, and then the cycle would start over again.

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<v Speaker 1>Dad called, and I immediately hopped up and answered, they're

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<v Speaker 1>going to admit her. He said, They're gonna give her

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<v Speaker 1>fluids through an ivy and put the medicine through that

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<v Speaker 1>to help calm or stomach. Then they can work on

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<v Speaker 1>getting real food in her and get her strength back

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<v Speaker 1>up and get her home. Then Dad said something that

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<v Speaker 1>made me wonder if maybe God did intervene. He said,

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<v Speaker 1>I'm allowed to stay with her until the morning, and

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<v Speaker 1>then they're kicking me out, and Kim is going to

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<v Speaker 1>be working tomorrow and the section Mom will be in,

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<v Speaker 1>so she'll be there with her all day. This was

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<v Speaker 1>a lifeline in an otherwise shitty situation. Mom's own dear

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<v Speaker 1>friend and oncology nurse would be working in Mom's section.

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<v Speaker 1>That would help her mentally for sure, which is such

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<v Speaker 1>a huge part of this battle. For the next few days,

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<v Speaker 1>they did tests and determined that in addition to IBS,

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<v Speaker 1>which is a completely common g I issue, the tumor

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<v Speaker 1>had grown slightly and it was pushing up against part

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<v Speaker 1>of her stomach. The plan was to put a stent

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<v Speaker 1>in to push it away. That next day. The surgery

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<v Speaker 1>was successful, but I could tell Mom was scared. She

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<v Speaker 1>had texted me before that and said that she heard

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<v Speaker 1>it was cold outside. I couldn't help but laugh of

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<v Speaker 1>all the things going on with her, and she texted

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<v Speaker 1>me my hair, it's cold outside. Eventually she texted that

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<v Speaker 1>the situation wasn't good, but it's in God's hands now,

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<v Speaker 1>And when she said that, it really really hit me.

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<v Speaker 1>The same God I've been praying to for years, begging,

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<v Speaker 1>pleading with to help Mom, and we're just leaving this

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<v Speaker 1>in his hands now. I tried to steer the conversation elsewhere,

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<v Speaker 1>but she wanted me to know how much she loved

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<v Speaker 1>me and always has and always will. Of course I

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<v Speaker 1>felt the same, and I let her know that. She

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<v Speaker 1>said she had to go for an X ray and

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<v Speaker 1>she texts me later. Once again, I just broke down

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<v Speaker 1>in tears. Over the next few days, this roller coaster

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<v Speaker 1>called cancer journey continued up and down and sideways and

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<v Speaker 1>upside down. As it was getting closer to Christmas, it

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<v Speaker 1>was becoming clear that the chances of her being home

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<v Speaker 1>before then we're getting smaller. You wouldn't do that, right,

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<v Speaker 1>God right, Mom needs to be home for Christmas. You

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<v Speaker 1>wouldn't do that. God right. My entire life, I had

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<v Speaker 1>been with my mom on Christmas. It didn't matter how

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<v Speaker 1>old I was. Mom always made Christmas special. It didn't

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<v Speaker 1>matter if I was eight or eight. She had a

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<v Speaker 1>way of going overboard in the best way, always knowing

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<v Speaker 1>what you'd love while also covering what you wanted. And

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<v Speaker 1>probably most important, getting you what you needed to And

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<v Speaker 1>it wasn't just like that with presents. She was like

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<v Speaker 1>that with everything having to do with Christmas and all

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<v Speaker 1>year really, but Christmas was just special with Mom. Mom

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<v Speaker 1>and Dad always had Christmas at their house. It was tradition.

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<v Speaker 1>The whole family would come over and we'd have dinner

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<v Speaker 1>and laughing and presents and love. Christmas and Easter were

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<v Speaker 1>Mom's holidays and it always showed. Now, with Christmas Eve

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<v Speaker 1>being just a couple of days away, my heart sank

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<v Speaker 1>realizing that she probably wasn't going to be home this year.

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<v Speaker 1>She'd be in a hospital bed and none of us

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<v Speaker 1>would even be able to go in and see her

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<v Speaker 1>because of COVID. That thought scared me so much. Mom's

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<v Speaker 1>favorite holiday, and she'd have to spend it alone in

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<v Speaker 1>a hospital bed, with no visitors and in pain. This

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<v Speaker 1>just wasn't fair. None of this was right, None of

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<v Speaker 1>it is just I brainstormed with my family to see

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<v Speaker 1>what we could do. We found out from her nurse Kim,

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<v Speaker 1>that Mom could see out the window to the top

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<v Speaker 1>floor of the hospital garage, so we planned a many

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<v Speaker 1>surprise pop up party on the top floor of that garage.

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<v Speaker 1>I would have sat out there all day if I

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<v Speaker 1>was allowed. After all, what's Christmas without Mom? Christmas Eve

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<v Speaker 1>came and I decided that I was going to do

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<v Speaker 1>something with that energy, that anxiousness, that the nervousness and

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<v Speaker 1>anxiety that I was having. I was going to use

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<v Speaker 1>that energy and do something good for the situation. So

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<v Speaker 1>I wanted to bring dinner to the staff working on

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<v Speaker 1>Mom's floor at the hospital. I went to Costco and

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<v Speaker 1>bought a bunch of desserts, and then went to Boston

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<v Speaker 1>Market and got a big turkey in a bunch of sides.

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<v Speaker 1>They were away from their families at Christmas, making sure

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<v Speaker 1>that mine was okay. It was the least I could

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<v Speaker 1>do for them, and once again it was one of

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<v Speaker 1>the things I was able to control and an otherwise

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<v Speaker 1>uncontrollable situation. I drove to the hospital and and let

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<v Speaker 1>the guard know that I had food for them on

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<v Speaker 1>Mom's floor, and he looked so happy and thankful. He

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<v Speaker 1>called somebody from the floor and they came down and

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<v Speaker 1>got it and brought it all up. Of course, a

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<v Speaker 1>few hours later, Christmas morning came and it was just

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<v Speaker 1>another morning for me. There'd be no joyous Christmas morning

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<v Speaker 1>with my parents, like there had been every year my

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<v Speaker 1>entire life. I had bought presents for people, but couldn't

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<v Speaker 1>even gather the emotional strength to wrap them. I retreated

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<v Speaker 1>to my bubble with Blue, just counting down the hours

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<v Speaker 1>until we could surprise Mom. And when that time finally came,

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<v Speaker 1>I gathered up the poster boards I had decorated to

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<v Speaker 1>make signs telling her how much we love her, and

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<v Speaker 1>I met my family and some of her close friends

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<v Speaker 1>on the top floor of the hospital garage. We called

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<v Speaker 1>Mom's nurse, Kim, who was working that day, and she

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<v Speaker 1>wheeled Mom over to the window and we all screamed

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<v Speaker 1>and hooped and hollered and told her how much we

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<v Speaker 1>love her. This was Christmas with pancreatic cancer. It was

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<v Speaker 1>yet another thing that it was robbing us up. Shortly

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<v Speaker 1>after that, Dad and I met at my parents house

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<v Speaker 1>and went over to Aunt Cathy's. She was having Christmas

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<v Speaker 1>dinner at her house in place of Mom's usual get together,

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<v Speaker 1>and Dad and I really didn't feel in the Christmas mood,

0:14:40.880 --> 0:14:44.120
<v Speaker 1>and with COVID it was probably just as well. We

0:14:44.200 --> 0:14:46.560
<v Speaker 1>took our plates back to my parents house and just

0:14:46.640 --> 0:14:53.680
<v Speaker 1>had a quiet meal together. Mom's presence was felt, but

0:14:53.760 --> 0:15:02.440
<v Speaker 1>her absence was felt more. See that's the thing about cancer,

0:15:02.640 --> 0:15:07.200
<v Speaker 1>or any kind of terminal diagnosis. It doesn't just eventually

0:15:07.400 --> 0:15:10.080
<v Speaker 1>rob you of your loved ones. It robs you of

0:15:10.120 --> 0:15:13.720
<v Speaker 1>those moments along the way. Can rob you of Christmas

0:15:13.800 --> 0:15:18.520
<v Speaker 1>morning laughing and enjoying each other's company. Can rob you

0:15:18.600 --> 0:15:21.320
<v Speaker 1>of your mom's cooking, which you never realized just how

0:15:21.400 --> 0:15:25.880
<v Speaker 1>much you'd miss. It. Can rob you of that hug

0:15:25.960 --> 0:15:29.280
<v Speaker 1>you look forward to every time you see your loved one,

0:15:29.920 --> 0:15:34.680
<v Speaker 1>that shoulder when you need it. Pancreatic cancer was robbing

0:15:34.720 --> 0:15:37.560
<v Speaker 1>Mom of her life, and it was robbing me of

0:15:37.680 --> 0:15:40.480
<v Speaker 1>my mom, And it was robbing the world of a

0:15:40.600 --> 0:15:47.320
<v Speaker 1>really damn good person. What cancer doesn't care. Cancer doesn't

0:15:47.360 --> 0:15:49.720
<v Speaker 1>care that Mom had built her whole life around being

0:15:49.760 --> 0:15:54.440
<v Speaker 1>a good person, doing for others, making people happy. But

0:15:54.600 --> 0:16:00.840
<v Speaker 1>I do care, and I'm powerless as it steals her away.

0:16:06.040 --> 0:16:09.200
<v Speaker 1>By New Year's Mom was well enough to go home.

0:16:10.440 --> 0:16:12.400
<v Speaker 1>That had called me to tell me that hospice was

0:16:12.440 --> 0:16:15.480
<v Speaker 1>going to come in, and immediately I began having a

0:16:15.600 --> 0:16:20.080
<v Speaker 1>full blown anxiety attack. He explained that it was actually

0:16:20.080 --> 0:16:22.760
<v Speaker 1>the palliative care part of hospice that was coming in

0:16:23.200 --> 0:16:25.720
<v Speaker 1>and the plan was to help Mom regain her strength

0:16:26.080 --> 0:16:28.920
<v Speaker 1>so she could begin chemo treatment again and then be

0:16:29.000 --> 0:16:32.080
<v Speaker 1>back on the road that we were on. I heard

0:16:32.120 --> 0:16:34.640
<v Speaker 1>what he was saying, and I held onto that hope.

0:16:35.120 --> 0:16:37.560
<v Speaker 1>But something in the back of my mind just knew

0:16:37.840 --> 0:16:45.760
<v Speaker 1>this was bad. This was really, really bad. The palliative

0:16:45.880 --> 0:16:49.400
<v Speaker 1>nurses of hospice were amazing, and they'd come about twice

0:16:49.400 --> 0:16:51.560
<v Speaker 1>a day to check Mom's fluids and make sure she

0:16:51.680 --> 0:16:56.120
<v Speaker 1>was eating and moving around. Ultimately, they never did get

0:16:56.160 --> 0:17:00.000
<v Speaker 1>to that rehabilitation stage, as Mom was simply fighting every

0:17:00.000 --> 0:17:03.440
<v Speaker 1>every day to stay alive. Ever since she had gotten

0:17:03.440 --> 0:17:08.160
<v Speaker 1>home from the hospital, she was simply existing. The good

0:17:08.240 --> 0:17:12.960
<v Speaker 1>days had turned into good afternoons, and soon those turned

0:17:12.960 --> 0:17:17.760
<v Speaker 1>into good moments, and eventually those good moments were less

0:17:18.080 --> 0:17:22.600
<v Speaker 1>and less. I was watching the person I love the

0:17:22.720 --> 0:17:27.720
<v Speaker 1>most in this world fade away before my eyes. I

0:17:27.880 --> 0:17:31.000
<v Speaker 1>cherished every moment that I could with Mom. It was

0:17:31.040 --> 0:17:32.800
<v Speaker 1>so hard to see her in pain, but it was

0:17:32.920 --> 0:17:37.159
<v Speaker 1>apparent that time was running out, and I was numb.

0:17:37.800 --> 0:17:40.639
<v Speaker 1>It was almost as if my brain shut down everything

0:17:40.680 --> 0:17:43.480
<v Speaker 1>and I was just going through the motions. Except when

0:17:43.560 --> 0:17:46.720
<v Speaker 1>I went to see Mom. And when I got too

0:17:46.720 --> 0:17:48.879
<v Speaker 1>emotional to see her in the states she was in,

0:17:49.400 --> 0:17:51.760
<v Speaker 1>I tell her how much I love her, give her

0:17:51.800 --> 0:17:54.280
<v Speaker 1>a big hug and kiss, and I'd run to my

0:17:54.359 --> 0:17:58.240
<v Speaker 1>car to cry it out. Almost every night, I'd leave

0:17:58.320 --> 0:18:03.119
<v Speaker 1>my parents house and drive around crying, screaming about how

0:18:03.200 --> 0:18:07.240
<v Speaker 1>unfair this is. Somebody that may have seen me driving

0:18:07.280 --> 0:18:10.399
<v Speaker 1>down the road probably think I'm some kind of whack job.

0:18:11.000 --> 0:18:14.640
<v Speaker 1>Seeing this random dude driving down the road screaming and

0:18:14.680 --> 0:18:17.879
<v Speaker 1>crying alone in his car with his hands waving everywhere.

0:18:18.600 --> 0:18:21.280
<v Speaker 1>I'm sure it was a sight to see. And I

0:18:21.320 --> 0:18:24.480
<v Speaker 1>did that every night that I would leave my parents

0:18:24.520 --> 0:18:33.080
<v Speaker 1>house until one day it was different. One day I

0:18:33.160 --> 0:18:38.560
<v Speaker 1>asked God to take her. Don't let her be in

0:18:38.640 --> 0:18:46.400
<v Speaker 1>this pain anymore. Stop making her suffer. It's cruel, it's inhumane.

0:18:47.520 --> 0:18:50.280
<v Speaker 1>How can you possibly allow her to live like this?

0:18:51.560 --> 0:18:58.320
<v Speaker 1>Take her? God, take her. The guilt from saying that

0:18:58.440 --> 0:19:02.439
<v Speaker 1>hit me immediately. I had uttered the most reprehensible words

0:19:02.480 --> 0:19:06.000
<v Speaker 1>I could imagine, but that's how I felt. I couldn't

0:19:06.040 --> 0:19:10.119
<v Speaker 1>see her suffer anymore. Since the day she was diagnosed,

0:19:10.160 --> 0:19:13.160
<v Speaker 1>I was always so positive and optimistic, and I would

0:19:13.160 --> 0:19:16.080
<v Speaker 1>get angry at her when she wasn't matching my good vibes.

0:19:16.520 --> 0:19:20.399
<v Speaker 1>But now I was raising the white flag. It was

0:19:20.440 --> 0:19:23.280
<v Speaker 1>selfish of me to want her to stay here, not

0:19:23.520 --> 0:19:27.920
<v Speaker 1>like this. She didn't deserve this, She didn't deserve any

0:19:28.000 --> 0:19:31.040
<v Speaker 1>of this. The right thing to do is to want

0:19:31.040 --> 0:19:47.000
<v Speaker 1>her suffering to stop. Right right up next, I speak

0:19:47.040 --> 0:19:51.560
<v Speaker 1>with a highly published oncology expert, Dr Gregory Masters, and

0:19:51.800 --> 0:19:54.440
<v Speaker 1>we talked about the other side of a terminal diagnosis,

0:19:54.560 --> 0:19:57.719
<v Speaker 1>which is the doctors who must give them when we

0:19:57.760 --> 0:20:07.199
<v Speaker 1>come back. When we think of our own grief journey,

0:20:07.240 --> 0:20:09.199
<v Speaker 1>do we really ever think of the people on the

0:20:09.240 --> 0:20:12.800
<v Speaker 1>other side of it. On a cancer journey, were often

0:20:13.000 --> 0:20:16.280
<v Speaker 1>intimately involved with an oncologist to help guide our loved

0:20:16.320 --> 0:20:19.159
<v Speaker 1>one on the right course of treatment for them. I

0:20:19.280 --> 0:20:21.520
<v Speaker 1>was interested in how a doctor is able to give

0:20:21.520 --> 0:20:25.439
<v Speaker 1>such devastating news and all the time, regularly throughout their

0:20:25.600 --> 0:20:29.520
<v Speaker 1>entire career. I sat down with lung cancer specialist Dr

0:20:29.560 --> 0:20:33.240
<v Speaker 1>Gregory Masters, an oncologist at the Helen F. Graham Cancer

0:20:33.320 --> 0:20:37.240
<v Speaker 1>Center and Research Institute who also serves as an associate

0:20:37.280 --> 0:20:42.840
<v Speaker 1>professor at Thomas Jefferson University Medical School in Philadelphia. Dr

0:20:42.960 --> 0:20:46.520
<v Speaker 1>Masters is one of the world's foremost experts on lung cancer,

0:20:46.760 --> 0:20:50.680
<v Speaker 1>and he's published numerous papers on his studies. I wanted

0:20:50.720 --> 0:20:53.480
<v Speaker 1>to know about that other side of the cancer journey.

0:20:53.880 --> 0:20:57.520
<v Speaker 1>Mom's oncologists seemed to always be rooting for her, even

0:20:57.640 --> 0:21:02.919
<v Speaker 1>when she disappointed him. Why is this do they give up? Dr?

0:21:03.040 --> 0:21:09.439
<v Speaker 1>Masters lays it all out. I go into see a

0:21:09.480 --> 0:21:12.919
<v Speaker 1>new patient with either suspected cancer or with cancer. I

0:21:12.960 --> 0:21:16.760
<v Speaker 1>want to get all the information I can that's available

0:21:16.800 --> 0:21:20.199
<v Speaker 1>at that time, and sometimes it's incomplete. Sometimes that's one

0:21:20.200 --> 0:21:22.399
<v Speaker 1>of the hardest things, is going in and not having

0:21:22.440 --> 0:21:25.960
<v Speaker 1>all the information, because people want to know everything that's

0:21:25.960 --> 0:21:28.840
<v Speaker 1>going to happen right away and that that's totally understandable.

0:21:28.840 --> 0:21:31.280
<v Speaker 1>They want to know what's next and you know what's

0:21:31.320 --> 0:21:34.520
<v Speaker 1>happening now. So I try and gather as much information

0:21:34.760 --> 0:21:37.320
<v Speaker 1>as is available before I go in to see a patient.

0:21:37.359 --> 0:21:41.920
<v Speaker 1>I may look at other UH specialists records from their

0:21:41.960 --> 0:21:44.919
<v Speaker 1>interviews and their encounters with the patient. I'll look at

0:21:44.960 --> 0:21:48.520
<v Speaker 1>any radiology testing or X rays or CAT scans or

0:21:48.640 --> 0:21:51.560
<v Speaker 1>m r I scans. I may look at any biopsies

0:21:51.680 --> 0:21:54.639
<v Speaker 1>to see what the pathology is and if we know exactly,

0:21:54.880 --> 0:21:57.240
<v Speaker 1>you know what the cancer is, where the cancer is.

0:21:57.800 --> 0:22:00.080
<v Speaker 1>And then I have to, you know, prepare myself to

0:22:00.160 --> 0:22:04.879
<v Speaker 1>go in and talk about something that's not really ever easy.

0:22:05.200 --> 0:22:07.280
<v Speaker 1>My intent is to go in and learn as much

0:22:07.320 --> 0:22:10.400
<v Speaker 1>as I can about the patient. Once I know as

0:22:10.480 --> 0:22:13.320
<v Speaker 1>much as I can about the medical situation, and I

0:22:13.400 --> 0:22:16.240
<v Speaker 1>try and get to know that patient. You know, it's

0:22:16.240 --> 0:22:18.520
<v Speaker 1>in a short period of time. But I try and

0:22:18.560 --> 0:22:20.600
<v Speaker 1>get as much as I can from the patient and

0:22:20.640 --> 0:22:24.480
<v Speaker 1>from the family because almost always when someone comes with

0:22:24.800 --> 0:22:28.040
<v Speaker 1>you know, a family member or a friend, that person

0:22:28.160 --> 0:22:31.040
<v Speaker 1>is there to help provide as much support as possible.

0:22:31.080 --> 0:22:34.760
<v Speaker 1>So I really think it's important to include that. But

0:22:34.760 --> 0:22:36.560
<v Speaker 1>but I try and get as much as I can

0:22:36.680 --> 0:22:41.080
<v Speaker 1>about you know, what the patient knows, what they fear, um,

0:22:41.080 --> 0:22:43.560
<v Speaker 1>what they think is going to happen, and then to

0:22:43.600 --> 0:22:46.480
<v Speaker 1>try and get to their questions about what might happen

0:22:46.520 --> 0:22:51.480
<v Speaker 1>and what we're gonna do next. Is there ever resistance

0:22:51.600 --> 0:22:55.720
<v Speaker 1>from the patient, and what I mean is culturally religiously,

0:22:56.600 --> 0:22:59.400
<v Speaker 1>where there might you know, you might have to take

0:22:59.400 --> 0:23:02.320
<v Speaker 1>those kinds of things into consideration. Is that a thing

0:23:02.680 --> 0:23:06.639
<v Speaker 1>or oh it's totally a thing. Yeah, So there's there's

0:23:06.680 --> 0:23:09.399
<v Speaker 1>I guess to me, that's all part of my job

0:23:09.520 --> 0:23:13.399
<v Speaker 1>that makes it interesting and challenging. Sometimes it can be

0:23:13.480 --> 0:23:17.280
<v Speaker 1>a barrier to getting you know, good communication, But again

0:23:17.320 --> 0:23:19.440
<v Speaker 1>I sort of feel like that's part of my job

0:23:19.560 --> 0:23:23.400
<v Speaker 1>is to understand the patient and their family and their circumstances.

0:23:23.480 --> 0:23:27.240
<v Speaker 1>And it can go anywhere from some families who don't

0:23:27.280 --> 0:23:31.040
<v Speaker 1>want the patient to even know the diagnosis um or

0:23:31.119 --> 0:23:33.320
<v Speaker 1>don't want the patient to know that they're going to die,

0:23:33.520 --> 0:23:36.280
<v Speaker 1>or don't want the patient to know that, you know,

0:23:36.480 --> 0:23:39.560
<v Speaker 1>they may not be a candidate for some treatment that

0:23:39.600 --> 0:23:44.600
<v Speaker 1>they're really depending on whether it's surgery or radiation. Sometimes

0:23:44.600 --> 0:23:47.720
<v Speaker 1>it's there's a lot of fear to thinking about chemotherapy,

0:23:47.800 --> 0:23:51.680
<v Speaker 1>maybe based on experiences they've had, or their friends or

0:23:51.720 --> 0:23:55.560
<v Speaker 1>their family has had. Sometimes those experiences are you know,

0:23:55.600 --> 0:23:58.240
<v Speaker 1>a long time ago where we weren't as good. But

0:23:58.320 --> 0:24:00.200
<v Speaker 1>what I try and do is to help, you know,

0:24:00.240 --> 0:24:03.640
<v Speaker 1>as to understand people and try and understand their situation.

0:24:04.320 --> 0:24:07.240
<v Speaker 1>And I don't try and treat every situation the same

0:24:07.280 --> 0:24:10.240
<v Speaker 1>because I don't think that fits. At the same time,

0:24:10.280 --> 0:24:13.280
<v Speaker 1>I do have as part of my job the role

0:24:13.480 --> 0:24:16.879
<v Speaker 1>of telling them what's going on and helping them understand

0:24:17.000 --> 0:24:22.160
<v Speaker 1>as much as they're ready. For my mom, there were times,

0:24:22.560 --> 0:24:25.400
<v Speaker 1>especially early on, she got better as it went on,

0:24:25.680 --> 0:24:28.800
<v Speaker 1>but there were times where she was like, tell him

0:24:28.880 --> 0:24:30.959
<v Speaker 1>to my dad and then he can he knows how

0:24:31.040 --> 0:24:35.840
<v Speaker 1>to filter the information back because a big challenge for

0:24:36.200 --> 0:24:39.200
<v Speaker 1>her doctor, which was my mom's and he was amazing.

0:24:39.920 --> 0:24:42.960
<v Speaker 1>He had a handful to deal with with my mom

0:24:43.040 --> 0:24:47.439
<v Speaker 1>because she had had anxiety and she was generally pretty

0:24:47.440 --> 0:24:50.560
<v Speaker 1>good about dealing with it in normal day to day life,

0:24:50.840 --> 0:24:54.040
<v Speaker 1>but when it came to this, it was like it

0:24:54.160 --> 0:24:58.680
<v Speaker 1>just opened up the floodgates, and so he had that

0:24:58.880 --> 0:25:01.800
<v Speaker 1>doctor had his ends full with my mom and how

0:25:01.880 --> 0:25:06.640
<v Speaker 1>to handle this, you know, delicately, and I'm sure, um,

0:25:06.680 --> 0:25:10.160
<v Speaker 1>it's got to be tough, you know, in your situation,

0:25:10.840 --> 0:25:14.880
<v Speaker 1>how do you handle somebody like that where you're not

0:25:14.960 --> 0:25:18.040
<v Speaker 1>just dealing with the physical part of it, you're dealing

0:25:18.080 --> 0:25:22.280
<v Speaker 1>with the mental part of it as well well. I

0:25:22.280 --> 0:25:24.919
<v Speaker 1>I think what you're describing as something that's common to

0:25:25.240 --> 0:25:29.120
<v Speaker 1>all patients and all families in different levels. Um So,

0:25:30.040 --> 0:25:32.720
<v Speaker 1>I do think it's important to to sort of get

0:25:32.760 --> 0:25:35.679
<v Speaker 1>in there with the patient and their family and understand

0:25:35.720 --> 0:25:39.120
<v Speaker 1>that and figure out where they're coming from. Sometimes that

0:25:39.280 --> 0:25:42.760
<v Speaker 1>comes out right away, and sometimes people are very reserved

0:25:42.760 --> 0:25:44.880
<v Speaker 1>in the beginning, and it takes a little bit of

0:25:45.400 --> 0:25:48.040
<v Speaker 1>getting to know them, you know, maybe talking about what

0:25:48.080 --> 0:25:51.640
<v Speaker 1>their outside interests are, talking more about their family, talking

0:25:51.640 --> 0:25:55.240
<v Speaker 1>more about where they've lived and what they've done. That

0:25:55.280 --> 0:25:58.960
<v Speaker 1>helps me to understand a little better when they tell

0:25:59.000 --> 0:26:02.760
<v Speaker 1>me something, you know, if there's maybe some other hidden

0:26:03.160 --> 0:26:06.439
<v Speaker 1>meaning behind that. So it's a really important part of

0:26:06.480 --> 0:26:08.000
<v Speaker 1>my job, and I don't think I could do it

0:26:08.040 --> 0:26:11.639
<v Speaker 1>well if I didn't listen carefully to what they're saying

0:26:11.840 --> 0:26:16.359
<v Speaker 1>and figure out what their family dynamics are. It is

0:26:16.359 --> 0:26:20.800
<v Speaker 1>hard having these conversations, but it's also a tremendous privilege

0:26:20.880 --> 0:26:24.359
<v Speaker 1>to be part of that. We have a job as

0:26:24.440 --> 0:26:29.320
<v Speaker 1>medical oncologist that's a combination of giving bad news, helping

0:26:29.359 --> 0:26:32.800
<v Speaker 1>people understand bad news and deal with bad news, and

0:26:32.960 --> 0:26:36.240
<v Speaker 1>also giving hope about what we might be able to

0:26:36.280 --> 0:26:40.919
<v Speaker 1>do to help them through it. So I try not

0:26:41.040 --> 0:26:44.359
<v Speaker 1>to focus on, you know, how it's affecting me, But

0:26:44.760 --> 0:26:48.080
<v Speaker 1>I can tell you in reality, each patient is affecting me,

0:26:48.440 --> 0:26:51.959
<v Speaker 1>and each encounter is affecting me. And if I can

0:26:52.160 --> 0:26:55.000
<v Speaker 1>learn from that and be a little bit better the

0:26:55.080 --> 0:26:59.199
<v Speaker 1>next time, or the next time I'm surprised by a

0:26:59.240 --> 0:27:05.040
<v Speaker 1>discussion or surprised by an emotion. You know. Then then

0:27:05.080 --> 0:27:08.280
<v Speaker 1>that allows me to enjoy my job more and be

0:27:08.359 --> 0:27:12.800
<v Speaker 1>a better doctor. So it's an ongoing experience, like anything

0:27:12.800 --> 0:27:16.320
<v Speaker 1>in life. I think we all learn that over time

0:27:16.720 --> 0:27:22.440
<v Speaker 1>we're better at our job and never perfect. How do

0:27:22.600 --> 0:27:28.080
<v Speaker 1>you give a diagnosis that I would think nobody wants

0:27:28.119 --> 0:27:33.200
<v Speaker 1>to hear? Is that something you have to prepare yourself for. Yeah,

0:27:33.240 --> 0:27:36.320
<v Speaker 1>it's totally something you have to prepare for. It's interesting.

0:27:36.320 --> 0:27:38.880
<v Speaker 1>There's a lot of discussion about how we should give

0:27:38.960 --> 0:27:42.320
<v Speaker 1>bad news, you know, and sort of academic discussions about that.

0:27:42.920 --> 0:27:45.000
<v Speaker 1>And yet when you get down to it and you're

0:27:45.080 --> 0:27:48.439
<v Speaker 1>getting ready to go into see a new patient and

0:27:48.480 --> 0:27:52.760
<v Speaker 1>their family and you may have bad news, you're not

0:27:52.920 --> 0:27:56.040
<v Speaker 1>fully prepared because you don't know exactly how that's going

0:27:56.080 --> 0:27:58.959
<v Speaker 1>to play out. So again, what I try and do

0:27:59.080 --> 0:28:01.879
<v Speaker 1>is to help he's into it by getting to know

0:28:02.000 --> 0:28:04.240
<v Speaker 1>the patient a little bit, by getting to know the

0:28:04.280 --> 0:28:08.880
<v Speaker 1>family a little bit, by being ready for what might

0:28:09.000 --> 0:28:14.080
<v Speaker 1>come in that conversation, by knowing everything I can about

0:28:14.119 --> 0:28:16.320
<v Speaker 1>you know, what we're going to discuss that day, So

0:28:16.480 --> 0:28:19.240
<v Speaker 1>knowing their medical history, you know that sort of at

0:28:19.240 --> 0:28:22.320
<v Speaker 1>a minimum, and then you know, trying to figure out

0:28:22.400 --> 0:28:23.919
<v Speaker 1>how are they going to be able to hear this

0:28:24.080 --> 0:28:30.479
<v Speaker 1>news and continue on. So usually I'll talk about the

0:28:30.560 --> 0:28:35.080
<v Speaker 1>medical facts of the diagnosis and figure out if they

0:28:35.160 --> 0:28:37.880
<v Speaker 1>understand that part of it, and then talk a little

0:28:37.880 --> 0:28:41.960
<v Speaker 1>bit about what that means, because for each patient, with

0:28:42.000 --> 0:28:47.400
<v Speaker 1>each diagnosis, there's uncertainty. And even if I'm completely prepared,

0:28:47.960 --> 0:28:51.280
<v Speaker 1>it's not like TV where they say there's three months

0:28:51.320 --> 0:28:54.720
<v Speaker 1>to live or six months to live, and that's how

0:28:54.720 --> 0:28:58.800
<v Speaker 1>it is, and I think people sometimes are surprised by that,

0:28:58.880 --> 0:29:02.080
<v Speaker 1>even though in all trually we know that everyone's different.

0:29:02.880 --> 0:29:04.880
<v Speaker 1>So I try and help them understand that there's a

0:29:04.960 --> 0:29:08.360
<v Speaker 1>range of things that might happen, and then try and

0:29:08.480 --> 0:29:11.800
<v Speaker 1>think through how we're gonna get prepared to deal with

0:29:11.800 --> 0:29:14.640
<v Speaker 1>that and what are the best tools we have to

0:29:14.760 --> 0:29:18.320
<v Speaker 1>try and fight that um And many people come in

0:29:18.440 --> 0:29:21.800
<v Speaker 1>ready to fight, but some people aren't ready to fight,

0:29:22.760 --> 0:29:25.240
<v Speaker 1>and I have to figure that out and figure out

0:29:25.480 --> 0:29:29.040
<v Speaker 1>where they are in terms of their goals. Some people

0:29:29.040 --> 0:29:31.760
<v Speaker 1>haven't even thought about it at all because they might

0:29:31.800 --> 0:29:34.600
<v Speaker 1>be too scared to think about it, or maybe you know,

0:29:34.680 --> 0:29:38.000
<v Speaker 1>in their culture it's not something you talk about. Maybe

0:29:38.000 --> 0:29:41.280
<v Speaker 1>your podcast will change that, I hope, so, but I

0:29:41.560 --> 0:29:43.800
<v Speaker 1>try and figure out where I can go and how

0:29:43.840 --> 0:29:46.680
<v Speaker 1>far I can go in that conversation, but at the

0:29:46.720 --> 0:29:50.280
<v Speaker 1>same time and hopefully all the time being truthful and

0:29:50.360 --> 0:29:53.680
<v Speaker 1>being honest with what I know, because I don't think

0:29:53.720 --> 0:29:56.239
<v Speaker 1>it's my job to hold back information that I know,

0:29:57.040 --> 0:29:59.160
<v Speaker 1>but I think there are different ways to deliver it,

0:29:59.440 --> 0:30:03.239
<v Speaker 1>and sometimes is easing into it helping them understand, you know,

0:30:03.560 --> 0:30:06.640
<v Speaker 1>what the tools are we have available, and that can

0:30:06.680 --> 0:30:11.120
<v Speaker 1>help prepare for a discussion about a limited survival or

0:30:11.160 --> 0:30:13.640
<v Speaker 1>a limited time to live, even if I don't know

0:30:13.680 --> 0:30:18.320
<v Speaker 1>exactly what that is. Wow, it's got to be important

0:30:18.360 --> 0:30:23.120
<v Speaker 1>for you as a human too. Um have positive outlets,

0:30:23.320 --> 0:30:27.160
<v Speaker 1>I assume, right, Like whatever that is for you going

0:30:27.200 --> 0:30:29.760
<v Speaker 1>to the movies or golfing or whatever, is that kind

0:30:29.760 --> 0:30:35.880
<v Speaker 1>of how it works, or like how do you decompress? Yeah,

0:30:36.720 --> 0:30:40.000
<v Speaker 1>And I think that's important to think about because sometimes

0:30:40.720 --> 0:30:45.280
<v Speaker 1>with whatever work we do, we have trouble separating what

0:30:45.520 --> 0:30:49.360
<v Speaker 1>happens at work and what happens outside of work. But

0:30:49.600 --> 0:30:52.760
<v Speaker 1>just like many people, I go home to a family

0:30:52.960 --> 0:30:56.600
<v Speaker 1>and I have a job with my family too, I

0:30:56.880 --> 0:31:00.120
<v Speaker 1>try not to forget everything that happened during the day.

0:31:00.920 --> 0:31:04.200
<v Speaker 1>But I also don't think that it's you know, part

0:31:04.240 --> 0:31:06.400
<v Speaker 1>of what I need to do to go through every

0:31:06.400 --> 0:31:09.960
<v Speaker 1>detail because sometimes I do need to compartmentalize that and

0:31:10.000 --> 0:31:12.720
<v Speaker 1>I think we all do that with a stressful day

0:31:12.720 --> 0:31:15.800
<v Speaker 1>at work. I really think it's important to be able to,

0:31:16.000 --> 0:31:19.280
<v Speaker 1>you know, separate my time at home. Um So, even

0:31:19.320 --> 0:31:22.600
<v Speaker 1>though you know my wife is a nurse and spends

0:31:22.640 --> 0:31:25.240
<v Speaker 1>a lot of time dealing with helping our kids through

0:31:25.240 --> 0:31:29.160
<v Speaker 1>difficult times and dealing with all those kind of situations

0:31:29.200 --> 0:31:32.920
<v Speaker 1>that that occur in the family life, I don't think

0:31:32.960 --> 0:31:36.160
<v Speaker 1>I want to take home all the details of work

0:31:36.560 --> 0:31:39.760
<v Speaker 1>because there's enough going on at home to deal with.

0:31:40.440 --> 0:31:43.760
<v Speaker 1>So I like to you know, read, I like to exercise,

0:31:44.040 --> 0:31:45.800
<v Speaker 1>a golf a little bit, but not as much as

0:31:45.840 --> 0:31:49.840
<v Speaker 1>you think. Um. I like to sail, and I like

0:31:49.960 --> 0:31:53.120
<v Speaker 1>to spend time with other people and you know, figure

0:31:53.120 --> 0:31:57.000
<v Speaker 1>out what they're doing. So you know, I I try

0:31:57.040 --> 0:32:02.160
<v Speaker 1>and remember everything that's happening, but bring home all of

0:32:02.160 --> 0:32:05.200
<v Speaker 1>that stress at least not all at once, and probably

0:32:05.240 --> 0:32:07.040
<v Speaker 1>if you ask my wife, I bring home some of it.

0:32:08.560 --> 0:32:11.160
<v Speaker 1>And so it's those things that are able to recharge

0:32:11.160 --> 0:32:14.320
<v Speaker 1>you too when you go back to work, to be

0:32:14.400 --> 0:32:18.600
<v Speaker 1>able to do it again. And you know, each day

0:32:19.080 --> 0:32:22.480
<v Speaker 1>and each patient is a little bit different. But every day,

0:32:23.160 --> 0:32:26.360
<v Speaker 1>you know, there are situations that are joyful and hopeful,

0:32:26.640 --> 0:32:29.360
<v Speaker 1>and every day there are some that are less joyful

0:32:29.400 --> 0:32:32.480
<v Speaker 1>and less hopeful, and you know, discussions about things that

0:32:32.760 --> 0:32:36.080
<v Speaker 1>it's hard to discuss, and so I try and get

0:32:36.120 --> 0:32:39.760
<v Speaker 1>ready for each encounter. And you know, again that's that's

0:32:39.800 --> 0:32:43.000
<v Speaker 1>my job, is to help people understand and work through

0:32:43.280 --> 0:32:48.160
<v Speaker 1>their difficult times, and sometimes to give them chemotherapy when

0:32:48.160 --> 0:32:51.000
<v Speaker 1>I think that's the best way to help them. Because

0:32:52.080 --> 0:32:54.160
<v Speaker 1>the medical part is is a big part. I don't

0:32:54.280 --> 0:32:57.320
<v Speaker 1>mean to minimize that, but there's so many more things

0:32:57.440 --> 0:33:00.280
<v Speaker 1>we can do now than we could even five years ago.

0:33:00.680 --> 0:33:03.080
<v Speaker 1>And my hope is that five years from now there

0:33:03.080 --> 0:33:05.160
<v Speaker 1>will be even more things we can do to help

0:33:05.200 --> 0:33:09.240
<v Speaker 1>families like yours. Until really, right now, I didn't realize,

0:33:09.680 --> 0:33:13.920
<v Speaker 1>you know, how much of a balance it is for you,

0:33:14.560 --> 0:33:16.720
<v Speaker 1>that it's not just the medical part of it when

0:33:16.720 --> 0:33:20.280
<v Speaker 1>you're dealing with patients and families. You know, a huge

0:33:20.400 --> 0:33:22.760
<v Speaker 1>part of it is is the mental part of it,

0:33:22.840 --> 0:33:26.080
<v Speaker 1>to the psychological part of it as well. From my

0:33:26.160 --> 0:33:28.120
<v Speaker 1>understanding of what you're saying, it's got to be a

0:33:28.200 --> 0:33:33.120
<v Speaker 1>balance between those two because you can't really separate them,

0:33:33.160 --> 0:33:35.960
<v Speaker 1>you know what I mean exactly. Yeah, I don't think

0:33:35.960 --> 0:33:38.520
<v Speaker 1>you can separate those and I don't think I can

0:33:38.560 --> 0:33:41.960
<v Speaker 1>communicate with the patient if I don't understand where they're

0:33:42.000 --> 0:33:45.920
<v Speaker 1>coming from. And I think that's also stresses the importance

0:33:45.960 --> 0:33:49.959
<v Speaker 1>of that multidisciplinary approach, and you know, having a social

0:33:49.960 --> 0:33:53.760
<v Speaker 1>worker help out, having a psychologist help out, having other

0:33:53.840 --> 0:33:57.960
<v Speaker 1>people that can support the family, sometimes having the hospice

0:33:58.000 --> 0:34:00.560
<v Speaker 1>team help out, when you know when that's a appropriate

0:34:00.680 --> 0:34:05.560
<v Speaker 1>Because what I've learned over my time, you know, nearly

0:34:05.600 --> 0:34:09.600
<v Speaker 1>thirty years same cancer patients, is that you really need

0:34:09.640 --> 0:34:13.799
<v Speaker 1>all that help. No one person can do that by themselves.

0:34:14.040 --> 0:34:18.279
<v Speaker 1>And so if you use those resources and and help

0:34:18.320 --> 0:34:21.759
<v Speaker 1>your patients understand the resources that are there, I think

0:34:21.840 --> 0:34:27.400
<v Speaker 1>that helps ease that communication and helps improve the understanding.

0:34:29.080 --> 0:34:32.560
<v Speaker 1>Coming up next, I asked Dr Masters how he handles

0:34:32.600 --> 0:34:35.280
<v Speaker 1>issues when the family wants one thing and the patient

0:34:35.400 --> 0:34:39.040
<v Speaker 1>wants something else. And do oncologists ever give up on

0:34:39.160 --> 0:34:52.920
<v Speaker 1>a patient and truly say it's over. On Mom's cancer journey,

0:34:53.160 --> 0:34:55.960
<v Speaker 1>there were times I became so frustrated by some of

0:34:56.000 --> 0:34:59.359
<v Speaker 1>the choices she made. How does an oncologist handle that?

0:34:59.680 --> 0:35:02.480
<v Speaker 1>Do they yell do they give up? Do they run

0:35:02.480 --> 0:35:06.360
<v Speaker 1>to their office and cry? Clearly oncology isn't the profession

0:35:06.440 --> 0:35:12.320
<v Speaker 1>for me? But Dr Masters gives us the truth you mentioned,

0:35:12.360 --> 0:35:15.680
<v Speaker 1>like a patient's family might say, you know, we don't

0:35:15.680 --> 0:35:18.440
<v Speaker 1>want them to know, we wanna handle it or whatever.

0:35:18.920 --> 0:35:22.000
<v Speaker 1>How do you deal with decisions like that where the

0:35:22.080 --> 0:35:25.520
<v Speaker 1>family wants something and the patient wants another. I mean,

0:35:25.520 --> 0:35:27.799
<v Speaker 1>that's got to be Is there a rule book for that?

0:35:27.960 --> 0:35:32.160
<v Speaker 1>Is it a decision by the doctor? How does that work? No?

0:35:32.320 --> 0:35:35.600
<v Speaker 1>And it's an interesting question because over time, I think

0:35:35.640 --> 0:35:38.719
<v Speaker 1>that's evolved. And you know, if you go back to

0:35:38.800 --> 0:35:41.920
<v Speaker 1>the times of Hippocrates, he didn't you know, he wrote

0:35:41.960 --> 0:35:46.000
<v Speaker 1>about not telling any bad news because that would hurt

0:35:46.040 --> 0:35:48.960
<v Speaker 1>the patient or that would decrease their chance of getting

0:35:48.960 --> 0:35:52.640
<v Speaker 1>through an illness. And it's taken a long time to understand.

0:35:53.200 --> 0:35:55.759
<v Speaker 1>And what I believe is that the patient has to

0:35:55.840 --> 0:35:58.920
<v Speaker 1>be part of these decisions, and to be part of

0:35:58.920 --> 0:36:02.400
<v Speaker 1>the decision, you have to have an understanding. Now saying that,

0:36:02.480 --> 0:36:06.680
<v Speaker 1>I also think it's important to recognize cultural differences and

0:36:06.760 --> 0:36:10.279
<v Speaker 1>individual preferences. So part of what I try and do

0:36:10.400 --> 0:36:13.160
<v Speaker 1>is to figure out what does the patient want and

0:36:13.200 --> 0:36:16.440
<v Speaker 1>if the patient doesn't want to know pieces of information

0:36:16.719 --> 0:36:19.600
<v Speaker 1>like a specific prognosis. I don't feel like I have

0:36:19.760 --> 0:36:23.080
<v Speaker 1>to force that on them. Again, I think communication and

0:36:23.200 --> 0:36:26.720
<v Speaker 1>listening is is so critical to me doing my job.

0:36:27.280 --> 0:36:29.319
<v Speaker 1>And I suppose if you you know, if you talk

0:36:29.400 --> 0:36:32.200
<v Speaker 1>to all the family when there are big differences, that

0:36:32.719 --> 0:36:35.680
<v Speaker 1>there isn't always complete agreement, and so part of it is,

0:36:36.000 --> 0:36:38.120
<v Speaker 1>you know, being a little bit of a referee in

0:36:38.120 --> 0:36:41.560
<v Speaker 1>in deciding, you know, who gets what information and how

0:36:42.000 --> 0:36:45.280
<v Speaker 1>with the understanding that that are in our current culture,

0:36:45.719 --> 0:36:49.440
<v Speaker 1>the patient has a right to their autonomy and that

0:36:49.640 --> 0:36:55.080
<v Speaker 1>sometimes means the independence to know, and sometimes it isn't

0:36:55.200 --> 0:36:58.719
<v Speaker 1>an independence or an autonomy to not have to know

0:36:58.880 --> 0:37:01.879
<v Speaker 1>every bit. That's a hard part of the job as

0:37:01.920 --> 0:37:05.000
<v Speaker 1>figuring out how you balance those and what does the

0:37:05.000 --> 0:37:09.080
<v Speaker 1>patient really want? Because I do want to help the

0:37:09.160 --> 0:37:13.080
<v Speaker 1>family understand and and I want to honor their wishes too,

0:37:13.880 --> 0:37:18.919
<v Speaker 1>But ultimately, I think my my principal obligation is to

0:37:18.920 --> 0:37:21.440
<v Speaker 1>to work with the patient and what he or she

0:37:22.000 --> 0:37:25.120
<v Speaker 1>tells me is most important, and sometimes they don't say

0:37:25.200 --> 0:37:29.680
<v Speaker 1>too much, so it's it's communicating and listening and trying.

0:37:30.760 --> 0:37:35.040
<v Speaker 1>I love that the the oncologists that had my mom. Uh,

0:37:35.200 --> 0:37:39.319
<v Speaker 1>you know, I had he bless him, he had his

0:37:39.400 --> 0:37:42.719
<v Speaker 1>hands full. You know. I had a real problem with

0:37:42.760 --> 0:37:47.880
<v Speaker 1>her some of her decisions. There was a treatment um

0:37:48.200 --> 0:37:51.880
<v Speaker 1>cyber knife, and she was going back and forth on

0:37:52.000 --> 0:37:54.640
<v Speaker 1>if she should do this, and it was a lot

0:37:54.640 --> 0:37:57.799
<v Speaker 1>of it was anxiety driven, and I had I'm like,

0:37:57.920 --> 0:38:00.160
<v Speaker 1>what are you doing? You're going to do it? And

0:38:00.400 --> 0:38:02.480
<v Speaker 1>I'm like telling my dad, I'm like, we can give

0:38:02.480 --> 0:38:05.040
<v Speaker 1>her zannex put it in her drink. And this is

0:38:05.080 --> 0:38:08.439
<v Speaker 1>like crazy now thinking about it that I like having

0:38:08.480 --> 0:38:10.839
<v Speaker 1>this discussion. My dad's like, Kyle, what are you talking about.

0:38:10.880 --> 0:38:12.759
<v Speaker 1>I'm like, we can put zanex in her drink and

0:38:12.760 --> 0:38:15.279
<v Speaker 1>then we can take her to the hospital and then

0:38:15.320 --> 0:38:17.279
<v Speaker 1>she can get cyber And he's like, but she doesn't

0:38:17.280 --> 0:38:19.040
<v Speaker 1>want to do it, you know, or she's not sure

0:38:19.160 --> 0:38:20.880
<v Speaker 1>she wants to do it yet, and blah blah blah.

0:38:21.160 --> 0:38:22.880
<v Speaker 1>And I'm like, well, she doesn't get the choice, Like

0:38:22.920 --> 0:38:26.000
<v Speaker 1>we're gonna get this for her because in my mind,

0:38:26.400 --> 0:38:32.920
<v Speaker 1>you're gonna do any possible thing to survive. And in reality,

0:38:33.320 --> 0:38:35.480
<v Speaker 1>it's not my choice, you know what I mean. And

0:38:35.880 --> 0:38:37.879
<v Speaker 1>it's not that she wanted to give up, but there

0:38:37.880 --> 0:38:40.719
<v Speaker 1>were some some things that she did not want to

0:38:40.719 --> 0:38:45.879
<v Speaker 1>do and um, and no amount of getting angry at

0:38:45.880 --> 0:38:50.520
<v Speaker 1>her or reasoning with her or whatever could change that.

0:38:51.040 --> 0:38:54.560
<v Speaker 1>And I had to learn eventually after she passed that

0:38:54.760 --> 0:38:57.279
<v Speaker 1>I should have respected that journey a little bit more

0:38:57.760 --> 0:39:01.279
<v Speaker 1>because it is her journey, you know, and she had

0:39:01.640 --> 0:39:06.000
<v Speaker 1>valid reasons for not wanting to do certain treatments and overall,

0:39:06.040 --> 0:39:09.000
<v Speaker 1>you know, she'd put her body through so much on

0:39:09.320 --> 0:39:13.000
<v Speaker 1>the journey of trying to get better that she earned

0:39:13.040 --> 0:39:15.040
<v Speaker 1>that right to say, you know what, I don't want

0:39:15.080 --> 0:39:17.400
<v Speaker 1>to do this, and that I think it was radiation

0:39:17.520 --> 0:39:20.799
<v Speaker 1>or something I've done, you know, six different types of

0:39:20.880 --> 0:39:24.160
<v Speaker 1>chemos over it was like two years of chemo treatments.

0:39:24.640 --> 0:39:28.520
<v Speaker 1>I'm kind of tired, you know, of trying all of

0:39:28.560 --> 0:39:32.480
<v Speaker 1>these things. And in my mind, that's totally unacceptable, you know.

0:39:32.480 --> 0:39:35.120
<v Speaker 1>And so I like, I'm not joking when I say

0:39:35.200 --> 0:39:38.160
<v Speaker 1>I had this conversation with my dad where I'm like, Dad,

0:39:38.440 --> 0:39:40.319
<v Speaker 1>she doesn't get a choice, Like she's gonna wake up

0:39:40.360 --> 0:39:42.160
<v Speaker 1>and she's gonna be there and she's gonna get it.

0:39:42.600 --> 0:39:44.520
<v Speaker 1>And you know, my dad's like, well, why don't you

0:39:44.600 --> 0:39:47.839
<v Speaker 1>think about this? You're talking about drugging your mom. And

0:39:47.880 --> 0:39:50.640
<v Speaker 1>then her waking up in a hospital like none of

0:39:50.680 --> 0:39:54.440
<v Speaker 1>this is okay. And of course that's in my grief

0:39:54.640 --> 0:39:58.400
<v Speaker 1>that or shock or whatever that that I want her

0:39:58.440 --> 0:40:01.480
<v Speaker 1>to get better at any cost, and that's not taking

0:40:01.520 --> 0:40:05.840
<v Speaker 1>into consideration, Well, who am I to say that she

0:40:05.920 --> 0:40:07.839
<v Speaker 1>should be doing this? Who am I to say that

0:40:08.200 --> 0:40:12.040
<v Speaker 1>she needs to go through radiation? It's not my decision.

0:40:12.920 --> 0:40:16.359
<v Speaker 1>So my all of that to say, I'm assuming there

0:40:16.400 --> 0:40:19.480
<v Speaker 1>are at least a few people like my mom that

0:40:19.600 --> 0:40:22.760
<v Speaker 1>when they're talking to their oncologists and their oncology team

0:40:23.120 --> 0:40:26.919
<v Speaker 1>that there are limits to what the things that they're

0:40:26.920 --> 0:40:29.200
<v Speaker 1>willing to do and things that they're not willing to do.

0:40:29.680 --> 0:40:33.439
<v Speaker 1>Is that hard for you as a doctor if you

0:40:33.560 --> 0:40:38.800
<v Speaker 1>are hopeful in certain treatments or are you more patient

0:40:38.920 --> 0:40:41.480
<v Speaker 1>focused where you're like, hey, this really could help you,

0:40:41.520 --> 0:40:44.040
<v Speaker 1>but it's about you and your journey, Like what how

0:40:44.040 --> 0:40:46.919
<v Speaker 1>do you balance that? And what is it? Like? I'll

0:40:46.960 --> 0:40:51.360
<v Speaker 1>tell you, um, the things that you're describing are present

0:40:51.400 --> 0:40:55.160
<v Speaker 1>and almost every family that I deal with, where you know,

0:40:55.480 --> 0:41:00.080
<v Speaker 1>the wants and needs that the family sees and the

0:41:00.120 --> 0:41:04.320
<v Speaker 1>patient sees are not always equal, and so sometimes family

0:41:04.320 --> 0:41:07.680
<v Speaker 1>members want to be more aggressive or do more believe

0:41:07.680 --> 0:41:11.080
<v Speaker 1>it or not. Sometimes they want to do less, and

0:41:11.320 --> 0:41:14.239
<v Speaker 1>I always assume that it's in the best interests of

0:41:14.280 --> 0:41:17.680
<v Speaker 1>the patient, because you know, everyone thinks they know their

0:41:17.760 --> 0:41:21.600
<v Speaker 1>family member and what they really would want, but that

0:41:21.640 --> 0:41:24.400
<v Speaker 1>does get clotted with what we want as an individual.

0:41:25.040 --> 0:41:29.000
<v Speaker 1>To add to that cloudiness is what the oncologist thinks

0:41:29.320 --> 0:41:34.760
<v Speaker 1>is best right, And sometimes all of those come together

0:41:35.440 --> 0:41:38.200
<v Speaker 1>like a perfect storm, like a come to a point

0:41:38.280 --> 0:41:41.960
<v Speaker 1>and and everyone agrees, this is something we can do,

0:41:42.560 --> 0:41:45.680
<v Speaker 1>this is something we should do, and this is something

0:41:46.040 --> 0:41:50.120
<v Speaker 1>the patient wants and the family wants. That's great, especially

0:41:50.120 --> 0:41:53.719
<v Speaker 1>when it works out and it's successful, but just like reality,

0:41:53.760 --> 0:41:56.279
<v Speaker 1>it's not always like that. And so a lot of

0:41:56.320 --> 0:42:00.600
<v Speaker 1>times what I think is best medically um based on

0:42:00.719 --> 0:42:03.279
<v Speaker 1>imperfect knowledge. You know, I try and look at all

0:42:03.280 --> 0:42:06.399
<v Speaker 1>the research that's been done. I try and reach back

0:42:06.440 --> 0:42:10.520
<v Speaker 1>to my experience as an oncologist, and and believe it

0:42:10.600 --> 0:42:12.560
<v Speaker 1>or not, I think back to even when I was

0:42:12.640 --> 0:42:16.680
<v Speaker 1>training in medical school and doing my residency and fellowship

0:42:16.719 --> 0:42:20.319
<v Speaker 1>training and oncology. I think back to, you know, what

0:42:20.520 --> 0:42:23.360
<v Speaker 1>my mentors would say in a situation like this, or

0:42:23.400 --> 0:42:26.879
<v Speaker 1>what would they recommend, And that does get trickier as

0:42:26.920 --> 0:42:31.080
<v Speaker 1>all the options change, but the way of discussing that,

0:42:31.160 --> 0:42:34.520
<v Speaker 1>in the way of offering that to patients and families evolves,

0:42:35.160 --> 0:42:40.120
<v Speaker 1>but doesn't really change. I think it's important to to

0:42:40.320 --> 0:42:44.080
<v Speaker 1>listen a lot as an oncologist, because if you don't,

0:42:44.560 --> 0:42:47.080
<v Speaker 1>you can end up saying this is what we're gonna

0:42:47.120 --> 0:42:52.239
<v Speaker 1>do because this is medically best. And that's something that

0:42:52.320 --> 0:42:56.480
<v Speaker 1>I think oncologists learn over time, because it's a really

0:42:56.480 --> 0:42:59.279
<v Speaker 1>hard thing to teach, you know. So if you if

0:42:59.280 --> 0:43:02.560
<v Speaker 1>you look at the discussions out in the public about

0:43:02.880 --> 0:43:06.160
<v Speaker 1>well did doctors learn to talk about death and dying?

0:43:06.239 --> 0:43:09.560
<v Speaker 1>Do they learn to talk about, you know, how to

0:43:09.800 --> 0:43:14.480
<v Speaker 1>decide on difficult differences between a family and a patient.

0:43:15.040 --> 0:43:17.560
<v Speaker 1>You always hear, well, they don't teach that in medical school,

0:43:18.200 --> 0:43:20.200
<v Speaker 1>and I don't think that's totally true. I think they

0:43:20.239 --> 0:43:23.759
<v Speaker 1>try and teach it, but sometimes we're not ready, you know,

0:43:23.880 --> 0:43:28.080
<v Speaker 1>and sometimes um people aren't ready for information, and sometimes

0:43:28.160 --> 0:43:33.120
<v Speaker 1>oncologists aren't ready to learn that information. We go to

0:43:33.200 --> 0:43:36.600
<v Speaker 1>medical school wanting to learn the facts about medicine, and

0:43:36.640 --> 0:43:39.279
<v Speaker 1>I'm sure there are many exceptions to that, but but

0:43:39.320 --> 0:43:41.839
<v Speaker 1>if you look overall, people go to medical school and

0:43:41.920 --> 0:43:45.480
<v Speaker 1>learn facts, and the problem is not only do the

0:43:45.560 --> 0:43:49.920
<v Speaker 1>facts change, but your own experience and your environment changes.

0:43:50.600 --> 0:43:54.360
<v Speaker 1>So I think you have to learn from those experiences

0:43:54.480 --> 0:43:58.360
<v Speaker 1>and try and be patient, and try and be flexible,

0:43:59.520 --> 0:44:01.840
<v Speaker 1>and try and always think how can you turn it

0:44:01.880 --> 0:44:04.840
<v Speaker 1>back to what is really good for the patient, what

0:44:04.920 --> 0:44:08.680
<v Speaker 1>does the patient want? And sometimes that's hard for families,

0:44:09.280 --> 0:44:12.799
<v Speaker 1>and sometimes it's hard for oncologists or any professional dealing

0:44:12.920 --> 0:44:18.160
<v Speaker 1>with someone in these critical sort of life threatening decisions.

0:44:19.320 --> 0:44:21.560
<v Speaker 1>But I think we can learn. I think we can

0:44:21.640 --> 0:44:24.160
<v Speaker 1>learn to do it better. And and if we're patient

0:44:24.400 --> 0:44:28.680
<v Speaker 1>and we allow ourselves the chance to learn from our

0:44:28.719 --> 0:44:31.839
<v Speaker 1>patients and their families, um, we can do it better.

0:44:32.160 --> 0:44:34.640
<v Speaker 1>And and that's what I try to do. You know,

0:44:34.719 --> 0:44:39.360
<v Speaker 1>I try and even after a negative encounter where someone

0:44:39.480 --> 0:44:42.200
<v Speaker 1>is really mad that the treatment didn't turn out right

0:44:42.440 --> 0:44:45.439
<v Speaker 1>or I didn't predict something correctly, you know, I try

0:44:45.440 --> 0:44:47.799
<v Speaker 1>and learn how I can do better the next time,

0:44:47.880 --> 0:44:51.759
<v Speaker 1>and you know, how can that conversation go differently so

0:44:51.840 --> 0:44:54.200
<v Speaker 1>that you know, I can try and help people as

0:44:54.239 --> 0:44:56.959
<v Speaker 1>best I can, because that's got to be my job.

0:44:57.320 --> 0:44:59.879
<v Speaker 1>It's it's gotta be tough, you know. I mean, it's

0:45:00.040 --> 0:45:05.160
<v Speaker 1>it's uh. As we're talking, I'm realizing just how many things.

0:45:05.480 --> 0:45:09.240
<v Speaker 1>An oncologist has to balance everything with every single patient,

0:45:09.920 --> 0:45:14.960
<v Speaker 1>every single encounter. You know, so thank you for it's

0:45:15.120 --> 0:45:19.120
<v Speaker 1>incredibly important work. Obviously. Is there ever a point in

0:45:19.160 --> 0:45:24.680
<v Speaker 1>today's medicine and our culture here where an oncologist gives up?

0:45:25.040 --> 0:45:30.640
<v Speaker 1>Are there always treatments available even if the prognosis isn't good.

0:45:31.120 --> 0:45:33.640
<v Speaker 1>So there are so many different things we can do,

0:45:33.760 --> 0:45:38.319
<v Speaker 1>whether it's different chemotherapy, different types of radiation, different surgeries,

0:45:38.640 --> 0:45:42.319
<v Speaker 1>other different interventions to help people that we almost never

0:45:43.160 --> 0:45:45.880
<v Speaker 1>get to a point where there's nothing we can do.

0:45:46.040 --> 0:45:49.160
<v Speaker 1>And so if you watch TV and the doctor comes

0:45:49.200 --> 0:45:51.520
<v Speaker 1>in and says, I'm sorry, there's nothing more I can

0:45:51.560 --> 0:45:54.280
<v Speaker 1>do for you, I don't ever say that to patients

0:45:54.719 --> 0:45:58.040
<v Speaker 1>because I don't think that's fair. There's always something you

0:45:58.160 --> 0:46:01.200
<v Speaker 1>can do to help, but it may not be more chemotherapy,

0:46:01.400 --> 0:46:04.439
<v Speaker 1>may not be more surgery, it may not be more

0:46:04.560 --> 0:46:09.000
<v Speaker 1>radiation or CyberKnife treatment. And that's when the listening comes in.

0:46:09.520 --> 0:46:13.919
<v Speaker 1>And when I see a patient and we're running out

0:46:13.920 --> 0:46:16.759
<v Speaker 1>of the best options, and I think that's sort of

0:46:16.800 --> 0:46:19.839
<v Speaker 1>what you're talking about, then what I try and do

0:46:20.000 --> 0:46:24.680
<v Speaker 1>is to offer some alternatives of thinking, do you want

0:46:24.719 --> 0:46:28.480
<v Speaker 1>to do something more aggressive that may cause you more

0:46:28.520 --> 0:46:32.320
<v Speaker 1>side effects and more difficulty and sometimes may not improve

0:46:32.440 --> 0:46:34.960
<v Speaker 1>improve your quality of life. Or do you want to

0:46:35.280 --> 0:46:38.680
<v Speaker 1>scale back and take an approach where we focus more

0:46:38.960 --> 0:46:44.640
<v Speaker 1>on managing your symptoms, dealing with comfort and quality of

0:46:44.680 --> 0:46:47.600
<v Speaker 1>life and being able to stay home and not spend

0:46:47.600 --> 0:46:49.880
<v Speaker 1>all your time going back and forth to the doctors.

0:46:50.480 --> 0:46:53.840
<v Speaker 1>And what I hope I can do with those conversations

0:46:53.920 --> 0:46:57.759
<v Speaker 1>is to help people see what I see as the

0:46:57.800 --> 0:47:01.319
<v Speaker 1>options and often choose what I might choose, but they

0:47:01.360 --> 0:47:04.200
<v Speaker 1>don't always choose what I would choose or even what

0:47:04.239 --> 0:47:06.920
<v Speaker 1>I recommend. And I think you're describing that. You know,

0:47:07.040 --> 0:47:10.880
<v Speaker 1>CyberKnife is a type of focused radiation that can be

0:47:11.040 --> 0:47:14.799
<v Speaker 1>very effective on a localized spot of cancer. So is

0:47:14.840 --> 0:47:18.160
<v Speaker 1>it worth going through all the logistics to get to

0:47:18.239 --> 0:47:21.279
<v Speaker 1>that for what the benefits going to be? And for

0:47:21.360 --> 0:47:24.359
<v Speaker 1>some people it is, and for some people in some

0:47:24.440 --> 0:47:28.200
<v Speaker 1>situations it is, and then other people it isn't worth

0:47:28.320 --> 0:47:32.080
<v Speaker 1>doing that, even if we think that might buy a

0:47:32.120 --> 0:47:36.920
<v Speaker 1>little more time. And those are those are hard conversations,

0:47:37.920 --> 0:47:41.840
<v Speaker 1>especially when our goals might not be totally in sync

0:47:41.920 --> 0:47:45.040
<v Speaker 1>with the patient's goals, or the or the family's goals

0:47:45.080 --> 0:47:49.320
<v Speaker 1>aren't totally in sync with the patient's goals. And again,

0:47:49.360 --> 0:47:51.960
<v Speaker 1>I think it's part of my job to help not

0:47:52.040 --> 0:47:55.719
<v Speaker 1>only the patient but also the family understand why would

0:47:55.760 --> 0:47:59.120
<v Speaker 1>you choose this option and how can that option be

0:47:59.239 --> 0:48:02.279
<v Speaker 1>a better option? And when it seems so obvious that

0:48:02.440 --> 0:48:06.080
<v Speaker 1>the other option is the right option and there's no

0:48:06.160 --> 0:48:11.040
<v Speaker 1>magic to that. It's it's patients and trying Wow, and

0:48:11.280 --> 0:48:14.280
<v Speaker 1>it's got to be uh, you know from what you're saying,

0:48:14.320 --> 0:48:19.000
<v Speaker 1>there is no to duplicate conversations that you're having. Yeah,

0:48:19.280 --> 0:48:24.319
<v Speaker 1>it's uh, it's completely tailored to that person, which is uh,

0:48:24.560 --> 0:48:27.080
<v Speaker 1>pretty crazy, you know if you think about it. Yeah,

0:48:27.160 --> 0:48:29.600
<v Speaker 1>but if you think about society and you know what

0:48:29.640 --> 0:48:32.640
<v Speaker 1>we see on TV and what we experience, you know,

0:48:32.760 --> 0:48:35.480
<v Speaker 1>driving down the street, you can imagine that there are

0:48:35.480 --> 0:48:39.080
<v Speaker 1>gonna be different ways of dealing with problems and different

0:48:39.120 --> 0:48:43.279
<v Speaker 1>ways of trying to come to the best answer, right,

0:48:43.320 --> 0:48:46.080
<v Speaker 1>And so you know the reality is medicine is like

0:48:46.120 --> 0:48:48.480
<v Speaker 1>that too. They're the best answer may not be the

0:48:48.520 --> 0:48:53.279
<v Speaker 1>best answer for everyone. How do you work together to

0:48:53.320 --> 0:48:56.680
<v Speaker 1>get to either the best answer for that patient or

0:48:56.719 --> 0:49:00.040
<v Speaker 1>the best compromise for that patient, because sometimes it is

0:49:00.239 --> 0:49:04.080
<v Speaker 1>the best compliment. Yeah, I mean and that's ultimately what

0:49:04.280 --> 0:49:07.040
<v Speaker 1>was I think what it was with my mom was

0:49:07.080 --> 0:49:11.160
<v Speaker 1>that where the tumor was was at a place like

0:49:11.360 --> 0:49:14.200
<v Speaker 1>right next to an artery or something, so they could

0:49:14.320 --> 0:49:17.960
<v Speaker 1>do cyber knife, but they could also continue chemotherapy, which

0:49:18.040 --> 0:49:20.640
<v Speaker 1>was working and shrinking a little more, so the margins

0:49:20.680 --> 0:49:23.160
<v Speaker 1>were more and my my dad and I was like, well,

0:49:23.200 --> 0:49:24.799
<v Speaker 1>if they're saying they can do cyber knife, now, like

0:49:24.880 --> 0:49:26.880
<v Speaker 1>let's do it. And she's like, well, I don't know that,

0:49:27.080 --> 0:49:29.520
<v Speaker 1>you know. And and then of course what ultimately happened

0:49:29.640 --> 0:49:33.359
<v Speaker 1>was she had to stop chemo altogether, which they had.

0:49:33.360 --> 0:49:35.480
<v Speaker 1>She had done a chemo I think believe believe it's

0:49:35.480 --> 0:49:38.520
<v Speaker 1>called chemo holiday or something um where she went like

0:49:38.560 --> 0:49:41.840
<v Speaker 1>six months with no treatment and it had barely almost

0:49:41.920 --> 0:49:46.040
<v Speaker 1>nothing grew. So we were very hopeful. I mean, I

0:49:46.080 --> 0:49:49.560
<v Speaker 1>was terrified waiting for those results because I'm like, it

0:49:49.640 --> 0:49:51.640
<v Speaker 1>might have been three months or something, whatever it was,

0:49:52.120 --> 0:49:54.759
<v Speaker 1>I'm terrified waiting for those results. And then it's like,

0:49:54.920 --> 0:49:57.799
<v Speaker 1>oh wow, like it was almost nothing. But then you

0:49:57.840 --> 0:50:00.040
<v Speaker 1>got to this point where she couldn't get treating and

0:50:00.160 --> 0:50:02.600
<v Speaker 1>at all. Why didn't it do what it did when

0:50:02.680 --> 0:50:04.759
<v Speaker 1>she did the holiday? You know? Why is it all

0:50:04.800 --> 0:50:07.680
<v Speaker 1>of a sudden. Now you know, it's crazy and it's

0:50:07.680 --> 0:50:12.359
<v Speaker 1>a roller coaster. I would hang on any positive bit

0:50:12.400 --> 0:50:15.799
<v Speaker 1>of news that the doctor would give, like, oh, you know,

0:50:16.040 --> 0:50:18.440
<v Speaker 1>it's been three months, she has she said, no treatment

0:50:18.480 --> 0:50:21.239
<v Speaker 1>and it has you know, not grown at all or

0:50:21.680 --> 0:50:25.320
<v Speaker 1>microscopically grown or whatever. And I'm like, yes, that's awesome,

0:50:25.400 --> 0:50:27.719
<v Speaker 1>I'm happy and blah blah blah blah blah. And then

0:50:27.760 --> 0:50:30.040
<v Speaker 1>that follow up visit a couple of days before, I'm

0:50:30.080 --> 0:50:32.400
<v Speaker 1>all like nervous again, and I'm waiting by the phone

0:50:32.719 --> 0:50:35.239
<v Speaker 1>for my parents to get out. And it's kind of

0:50:35.280 --> 0:50:39.319
<v Speaker 1>hanging on to every word that the oncologist says. And

0:50:39.400 --> 0:50:42.600
<v Speaker 1>sometimes that's great and I'm up here, and sometimes that's bedding.

0:50:42.600 --> 0:50:46.440
<v Speaker 1>I'm done here. But it's ultimately, you know, what I'm

0:50:46.520 --> 0:50:50.720
<v Speaker 1>learning is it's my mom's journey. You know, I'm along

0:50:50.840 --> 0:50:54.000
<v Speaker 1>for those highs and lows, and I want all the

0:50:54.080 --> 0:50:58.600
<v Speaker 1>highs obviously as she does. She did too, But these

0:50:58.600 --> 0:51:01.120
<v Speaker 1>aren't my decisions to make, you know, and that that

0:51:01.200 --> 0:51:04.839
<v Speaker 1>was the hardest thing I think for me, so so kindle,

0:51:04.880 --> 0:51:07.440
<v Speaker 1>I think what you're describing as something that a lot

0:51:07.480 --> 0:51:11.719
<v Speaker 1>of families go through, and um, you even said, you know,

0:51:11.760 --> 0:51:14.640
<v Speaker 1>when you saw the oncologists, you might pick up on

0:51:15.239 --> 0:51:17.840
<v Speaker 1>a little glimmer of hope, some piece of good news.

0:51:18.080 --> 0:51:20.320
<v Speaker 1>And I think what I try and do is to,

0:51:20.640 --> 0:51:23.880
<v Speaker 1>you know, see who's there and who's listening, and who's

0:51:24.520 --> 0:51:28.200
<v Speaker 1>hanging on every word. And when some people need to

0:51:28.239 --> 0:51:33.600
<v Speaker 1>hear something positive, find something positive to discuss, and when

0:51:33.680 --> 0:51:37.239
<v Speaker 1>some people sort of can't stand something that feels like

0:51:37.320 --> 0:51:41.320
<v Speaker 1>false hope, I try and temper that. And what's amazing

0:51:41.480 --> 0:51:44.960
<v Speaker 1>to me is that um people can come out of

0:51:45.000 --> 0:51:47.879
<v Speaker 1>a conversation and take what they want out of it. Now,

0:51:47.960 --> 0:51:51.600
<v Speaker 1>sometimes that's good and healthy. Sometimes it's not so good

0:51:51.640 --> 0:51:55.359
<v Speaker 1>and healthy because they get the wrong message, because they might,

0:51:55.600 --> 0:51:58.920
<v Speaker 1>you know, really grasp on to one part of the conversation.

0:51:59.560 --> 0:52:02.759
<v Speaker 1>But I think that's sort of like, you know, it's

0:52:02.880 --> 0:52:05.839
<v Speaker 1>it's reality, right. There are good and bad things and

0:52:06.239 --> 0:52:09.719
<v Speaker 1>everything that happens. How do we try and hope for

0:52:09.800 --> 0:52:14.000
<v Speaker 1>the best, but prepare for the worst. And some days

0:52:14.400 --> 0:52:17.400
<v Speaker 1>you're ready to grab that best part of it and

0:52:17.480 --> 0:52:21.120
<v Speaker 1>the hope, and other days you really need the reality

0:52:21.360 --> 0:52:24.680
<v Speaker 1>of I don't feel well today. I don't like what's

0:52:24.719 --> 0:52:27.680
<v Speaker 1>going on with my treatment. I don't like how the

0:52:27.920 --> 0:52:31.480
<v Speaker 1>cancer is behaving, and that's okay too. I Mean, one

0:52:31.480 --> 0:52:33.960
<v Speaker 1>thing I've found is I can't change all that. People

0:52:34.040 --> 0:52:37.400
<v Speaker 1>come in and maybe they've had a long discussion about

0:52:37.440 --> 0:52:39.600
<v Speaker 1>what we're gonna do if the scan is better or

0:52:39.600 --> 0:52:42.000
<v Speaker 1>the scan is worse, and how we're going to react

0:52:42.080 --> 0:52:45.719
<v Speaker 1>to that. And I come into sort of a dynamic

0:52:45.800 --> 0:52:50.240
<v Speaker 1>where there's a lot of water boiling, you know, and

0:52:50.239 --> 0:52:53.200
<v Speaker 1>and I can say one thing, and I really am

0:52:53.239 --> 0:52:56.719
<v Speaker 1>surprised by how much emotion can be released with that,

0:52:57.480 --> 0:53:00.680
<v Speaker 1>And so, you know, again, I try and think about, well,

0:53:00.719 --> 0:53:02.560
<v Speaker 1>what what would it be like to be in the

0:53:02.600 --> 0:53:06.680
<v Speaker 1>other chair and hearing this news, and how are things

0:53:06.719 --> 0:53:09.080
<v Speaker 1>going to be when they leave the room, you know,

0:53:09.239 --> 0:53:13.160
<v Speaker 1>because that's all something that I am not a part

0:53:13.160 --> 0:53:17.040
<v Speaker 1>of um. And yet you and your family and your

0:53:17.080 --> 0:53:19.560
<v Speaker 1>mom were a part of all of that. Right, there's

0:53:19.840 --> 0:53:22.279
<v Speaker 1>that whole two weeks in between where I don't know

0:53:22.360 --> 0:53:25.200
<v Speaker 1>what's happened, you know, How do you catch up in

0:53:25.600 --> 0:53:30.520
<v Speaker 1>a half hour visit with all the fears and hopes,

0:53:31.360 --> 0:53:37.319
<v Speaker 1>you know, and emotions that have happened in between. One

0:53:37.360 --> 0:53:39.759
<v Speaker 1>thing that I'm or I think the biggest thing that

0:53:39.800 --> 0:53:43.040
<v Speaker 1>I'm taking away from our conversation is that you are

0:53:43.080 --> 0:53:45.880
<v Speaker 1>really not a doctor of death at which is I

0:53:45.920 --> 0:53:49.440
<v Speaker 1>think a big misconception that people have, like, oh, you

0:53:49.480 --> 0:53:51.040
<v Speaker 1>don't want to go to the oncologist, you know what

0:53:51.120 --> 0:53:55.360
<v Speaker 1>I mean, that's that's never good. Really, you're not a

0:53:55.400 --> 0:53:58.600
<v Speaker 1>doctor of death, but a doctor of hope because you

0:53:58.680 --> 0:54:03.520
<v Speaker 1>are offering potentially all of these treatments that could get

0:54:03.560 --> 0:54:08.120
<v Speaker 1>you to where you want to be. Yeah, I certainly

0:54:08.120 --> 0:54:10.840
<v Speaker 1>hope that's the situation. I have a lot of hope

0:54:11.040 --> 0:54:15.440
<v Speaker 1>in my work and hope that when I am interacting

0:54:15.480 --> 0:54:18.360
<v Speaker 1>with patients and families that I'm going to be able

0:54:18.400 --> 0:54:22.879
<v Speaker 1>to help them understand where things are. Part of that

0:54:23.200 --> 0:54:28.440
<v Speaker 1>is understanding the reality, and part of that is grabbing

0:54:28.480 --> 0:54:31.680
<v Speaker 1>some of that hope and saying, well, this is a

0:54:31.680 --> 0:54:34.600
<v Speaker 1>bad situation, but what can we do to make it

0:54:34.640 --> 0:54:37.400
<v Speaker 1>a little bit better. What can we do to understand

0:54:37.440 --> 0:54:40.239
<v Speaker 1>it a little bit better? What can we do to

0:54:40.840 --> 0:54:43.800
<v Speaker 1>work on it together? And and some of the things

0:54:43.920 --> 0:54:49.520
<v Speaker 1>that we work on are, you know, improving communication, improving relationships,

0:54:49.760 --> 0:54:53.600
<v Speaker 1>and improving understanding. Even if we can't fix the cancer,

0:54:54.880 --> 0:55:00.359
<v Speaker 1>which is important because that gives any remaining time that

0:55:00.400 --> 0:55:04.080
<v Speaker 1>can make it more meaningful. You know, yeah, I hope so,

0:55:04.360 --> 0:55:08.320
<v Speaker 1>because that that's what there is, is trying to grasp

0:55:08.520 --> 0:55:11.920
<v Speaker 1>whatever you can of that time that's left. And you know,

0:55:11.960 --> 0:55:15.719
<v Speaker 1>you talked about trying to have memories of you know,

0:55:15.760 --> 0:55:17.880
<v Speaker 1>maybe some of the better times or or some of

0:55:17.880 --> 0:55:20.879
<v Speaker 1>the good times. I think that's an important thing that

0:55:20.920 --> 0:55:24.840
<v Speaker 1>we can focus on. And sometimes going through more treatments

0:55:25.120 --> 0:55:28.720
<v Speaker 1>or at least discussing more treatments allows that chance for hope,

0:55:30.080 --> 0:55:32.120
<v Speaker 1>but that has to be balanced with you know, what

0:55:32.239 --> 0:55:35.279
<v Speaker 1>are the consequences of more treatment and how is that

0:55:35.360 --> 0:55:39.120
<v Speaker 1>going to potentially drag someone down? And ultimately, you know,

0:55:39.239 --> 0:55:42.760
<v Speaker 1>my goal is to help the patient and the family decide,

0:55:43.040 --> 0:55:45.680
<v Speaker 1>you know, what's the best choice for them with some

0:55:45.760 --> 0:55:47.759
<v Speaker 1>guidance from me. And what I think is, you know,

0:55:47.840 --> 0:55:52.359
<v Speaker 1>medically the best option, but not with a feeling like

0:55:52.880 --> 0:55:56.160
<v Speaker 1>they're letting me down if they don't have treatment, because

0:55:56.239 --> 0:55:59.760
<v Speaker 1>I think that's a real thing. I think, especially over time,

0:56:00.160 --> 0:56:03.600
<v Speaker 1>people are are afraid of letting you know, the patients

0:56:03.680 --> 0:56:06.839
<v Speaker 1>particularly are afraid of letting their family down if they

0:56:06.840 --> 0:56:09.759
<v Speaker 1>don't do something, of letting their doctor down or the

0:56:09.880 --> 0:56:14.520
<v Speaker 1>nurses or you know, other people who are helping them

0:56:14.600 --> 0:56:17.560
<v Speaker 1>if they decide not to do a treatment, why are

0:56:17.560 --> 0:56:21.319
<v Speaker 1>they deciding that? And and if they're deciding not to

0:56:21.360 --> 0:56:24.000
<v Speaker 1>do something that maybe we think could help. Part of

0:56:24.000 --> 0:56:27.640
<v Speaker 1>my job is helping everyone understand, well, that's okay, because

0:56:27.680 --> 0:56:30.600
<v Speaker 1>we're making our own choices and we're trying to decide

0:56:30.640 --> 0:56:35.080
<v Speaker 1>what's right for me. Now to end on a bit

0:56:35.120 --> 0:56:38.080
<v Speaker 1>of a positive note or a big positive note. When

0:56:38.120 --> 0:56:43.200
<v Speaker 1>my mom's cancer journey started, the five year expected survival

0:56:43.320 --> 0:56:47.120
<v Speaker 1>rate of pancratic cancer was nine percent. Three years later,

0:56:47.360 --> 0:56:50.200
<v Speaker 1>now it's eleven percent, which is a huge jump in

0:56:50.320 --> 0:56:54.120
<v Speaker 1>three years when it was nine for the previous decade.

0:56:54.719 --> 0:56:58.080
<v Speaker 1>How do you, as a professional see Are you seeing

0:56:58.400 --> 0:57:04.279
<v Speaker 1>a trend positive we in regards to cancer treatments? Obviously

0:57:04.920 --> 0:57:10.000
<v Speaker 1>from my understanding, I believe that cancer diagnosis is have risen,

0:57:10.920 --> 0:57:15.560
<v Speaker 1>but it also seems like cancer treatments have also become

0:57:15.640 --> 0:57:19.000
<v Speaker 1>expanded as well. Can you talk a little bit about that?

0:57:19.120 --> 0:57:23.480
<v Speaker 1>Is that accurate? As so, we're getting better at understanding

0:57:24.120 --> 0:57:28.920
<v Speaker 1>medical diseases and particularly understanding cancer and understanding the biology

0:57:29.000 --> 0:57:33.240
<v Speaker 1>of cancer. So as we understand how to reduce risk

0:57:33.280 --> 0:57:38.200
<v Speaker 1>factors for cancer, as we understand how to encourage people

0:57:38.200 --> 0:57:41.480
<v Speaker 1>to quit smoking, to exercise more to eat healthy, to

0:57:41.600 --> 0:57:45.760
<v Speaker 1>get their screening tests. UM, we can improve the outcomes

0:57:45.760 --> 0:57:49.920
<v Speaker 1>for cancer. Also, as we understand the biology of the cancer,

0:57:49.960 --> 0:57:52.880
<v Speaker 1>we can offer better treatments. We can come up with

0:57:53.200 --> 0:57:58.120
<v Speaker 1>more targeted or precise treatments for individual patients that may

0:57:58.160 --> 0:58:01.040
<v Speaker 1>not cause as many side effects but may offer a

0:58:01.080 --> 0:58:04.280
<v Speaker 1>better chance to control the disease. We're seeing more and

0:58:04.320 --> 0:58:08.320
<v Speaker 1>more that some patients have long term control of their disease.

0:58:08.360 --> 0:58:12.240
<v Speaker 1>So even something where before we would have said, well,

0:58:12.280 --> 0:58:16.640
<v Speaker 1>there's no cure, now we're seeing many patients live beyond

0:58:16.680 --> 0:58:21.080
<v Speaker 1>five years, and and some of those patients maybe are cured. Um.

0:58:21.240 --> 0:58:25.280
<v Speaker 1>New targeted therapies that that target a specific gene mutation,

0:58:25.880 --> 0:58:30.280
<v Speaker 1>or new immuno therapies that target the body's response to

0:58:30.320 --> 0:58:33.160
<v Speaker 1>a cancer and using the immune system to help fight

0:58:33.200 --> 0:58:36.120
<v Speaker 1>off the cancer are things that in the past we're

0:58:36.200 --> 0:58:39.240
<v Speaker 1>really just hopes and now are our reality. And so

0:58:39.760 --> 0:58:44.760
<v Speaker 1>continuing to understand the disease and to help people understand

0:58:45.040 --> 0:58:49.440
<v Speaker 1>the options available and hopefully to understand that oncologists are

0:58:49.480 --> 0:58:52.880
<v Speaker 1>there to help with those decisions, that's what gives me hope.

0:58:53.720 --> 0:58:56.680
<v Speaker 1>Thank you, doctor, I really appreciate you being so open

0:58:56.760 --> 0:58:59.920
<v Speaker 1>and honest and candid about your career, the mist of

0:59:00.040 --> 0:59:03.720
<v Speaker 1>buying a lot of the myths and kind of opening

0:59:04.440 --> 0:59:07.520
<v Speaker 1>the curtain if you will, into something that can be

0:59:07.600 --> 0:59:10.880
<v Speaker 1>scary for a lot of people. Just your professional title,

0:59:11.000 --> 0:59:14.560
<v Speaker 1>no offense, but I think it's extremely important what you've

0:59:14.600 --> 0:59:18.160
<v Speaker 1>had to say to you know, help to demystify that. Yeah,

0:59:18.200 --> 0:59:21.920
<v Speaker 1>and thanks Kyle for going after such a difficult discussion

0:59:22.000 --> 0:59:24.800
<v Speaker 1>that obviously hits close to home for for you and

0:59:25.080 --> 0:59:27.720
<v Speaker 1>for many people. And it's important to be able to

0:59:27.760 --> 0:59:30.280
<v Speaker 1>talk about these things and to give a chance to

0:59:30.600 --> 0:59:34.160
<v Speaker 1>let people learn, because I think knowledge and understanding and

0:59:34.440 --> 0:59:38.720
<v Speaker 1>communication and information is is critical. So I'm glad you're

0:59:38.760 --> 0:59:48.520
<v Speaker 1>doing this. Thank you, Thank you very much. It gives

0:59:48.560 --> 0:59:52.880
<v Speaker 1>me comfort to know that oncologists truly are doctors of hope.

0:59:53.720 --> 0:59:57.000
<v Speaker 1>Dr Master's certainly opened up my eyes to the humanity

0:59:57.080 --> 1:00:01.040
<v Speaker 1>behind not just oncologists, but the entire are oncology care

1:00:01.120 --> 1:00:04.800
<v Speaker 1>team or any team relating to end of life care.

1:00:05.680 --> 1:00:09.360
<v Speaker 1>These are people who choose decades of study followed by

1:00:09.400 --> 1:00:13.439
<v Speaker 1>a lifetime of work in this field. They want Mom

1:00:13.520 --> 1:00:17.080
<v Speaker 1>to succeed, They want your loved one to succeed, They

1:00:17.120 --> 1:00:22.560
<v Speaker 1>want you to succeed. Knowing that mom had a team

1:00:22.560 --> 1:00:25.440
<v Speaker 1>behind her like that does bring a smile to my face,

1:00:26.080 --> 1:00:29.560
<v Speaker 1>knowing that everyone working with her was giving her everything

1:00:29.600 --> 1:00:33.440
<v Speaker 1>they had and for now, that's all we can ask for.

1:00:43.920 --> 1:00:47.400
<v Speaker 1>On the next episode of Death, Grief and Other Ship,

1:00:47.480 --> 1:00:51.440
<v Speaker 1>we don't discuss we explore what happens before people pass

1:00:51.480 --> 1:00:55.360
<v Speaker 1>away and what about people who have passed away and

1:00:55.440 --> 1:00:59.560
<v Speaker 1>come back. I talked with Dr Jan Holden, president of

1:00:59.600 --> 1:01:03.320
<v Speaker 1>the Inner National Association for Near Death Studies, about the

1:01:03.400 --> 1:01:10.840
<v Speaker 1>science behind near death experiences and more. For more information

1:01:10.880 --> 1:01:15.120
<v Speaker 1>and resources, please visit our website at Death and Grief

1:01:15.160 --> 1:01:19.000
<v Speaker 1>dot show and joined the conversation on our Facebook and Twitter.

1:01:20.160 --> 1:01:30.240
<v Speaker 1>I'm going to see my mother, she said, She me

1:01:32.920 --> 1:01:39.240
<v Speaker 1>me when I crab. Just Google