Miracles in the Making: Offering Hope to our Patients

Last month, my 58 year-old aunt was diagnosed with metastatic pancreatic adenocarcinoma, giving her an average of 10.5 months to live if she receives the best treatments. As the only physician in the family, I have attended her appointments along with my 91 year-old grandmother, who lovingly provides most of the emotional support. Thus, my role is to restate the answers that my aunt (and the rest of my family) is unable to hear when face-to-face with the oncologist.

My first obstacle in this new role occurred when my aunt declared she wants no knowledge concerning prognosis. Specifically, she does not want to know how long she is "supposed" to live. Instead, she wants to surround herself with the hope of a total cure and fears prognostic information will disrupt her shield of optimism. Now, being an educated woman, she might not know exact figures, but she does know pancreatic cancer has a grave prognosis. Thus, her hope, like that of so many of our patients, is in waiting for a miracle.

As her appointed "voice of reason", I worry that her chosen ignorance will prevent her from preparing for death. And I want my aunt to die a beautiful, happy death. I want her to have time to say all she needs to say, to experience all she needs to experience, and to love all those who she has not had time to love. I want her to heal any hurts, angers and fears that she has buried within her so that when she is ready to go, it is a death filled with the peace in knowing her final destination.

So I struggle. I feel I must choose between doing nothing or going against my aunt's wishes, choose between being a practical scientist and a woman of faith. But in my heart, I keep hearing "hold fast to the Lord, your God" (Joshua 23:8) and it occurs to me that maybe, as her "family" physician, I could be both the voice of hope and the voice of reason. For certainly, the path toward a peaceful death and the path toward opening oneself to the possibility of a miracle are one in the same. Both rely on deep prayer, forgiveness, intimacy with God, intimacy with family, healing of heart and mind, and of course, hope. So I now understand my role in caring for the terminally ill. No matter how many statistics or "end-of-life" directives I offer, my most critical message will be "Hold Fast to the Lord" for, in Him, lies the answer and in Him lies your hope.

–CWH, MD (Family Medicine)

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