So Wanted to Say Goodbye… : 8/17/2014

So Wanted to Say Goodbye… 


by Dr. George H. Elder

             I met Jack in rehab at the Genesis Center in Lebanon, NH. Oh, this isn’t the kind of rehab center celebrities go into when they get too drugged out or otherwise self-indulgent. No, it was a place for physical rehab wherein one does various exercises to get out and about–as in being able to walk, go to the bathroom, and perform the most basic parts of our daily routines. Jack had been laid low by a severe stroke following the use of an experimental chemotherapy drug to treat his bladder cancer. I was coming off a very bad reaction to anesthesia which aggravated an existing coordination problem.  

            In any event, we were roommates for a short while, striving to get through the protocols needed to get home. Hardly anyone wants to be in a nursing home, no matter how “nice” that home might be. However, some people have no choice because they simply cannot do what is needed to maintain an independent existence. Yet Jack and I were determined to go home, so we worked our asses off. My journey was easier than his. I was younger (62 vs. 71), less impaired, and a former coach–meaning I already had a mad-dog attitude about achieving goals. 

            However, Jack was also very determined. He was a teacher who worked with autistic children–and he sure as hell wanted to continue with the job. Jack played tennis and was otherwise very active, but that damn chemo made a mess of things. Still, he had gladly taken the risk, for his cancer was aggressive and Jack showed a warrior’s spirit in fighting it. Nor did he back down from the consequences of the therapy. Jack would put on his bionic braces, as we called them, and troop up and down the halls–being aided by one of the PT staff.

            I was horrified by how weak and clumsy I had gotten, but worked hard to regain a bit of balance and control. My battle only took about 12 days, though Jack’s struggle had been about four times as long. Still, we got out of that place within a few days of one-another and kept in touch. Jack went back into chemo and my glacial slide continued, a condition called Multisystem Atrophy (MSA)–or so they say. We spoke on the phone, occasionally for very long times. 

            Then came that call wherein Jack told me that the treatments had failed. We both knew what that meant, and I was miffed that he had been so casually sent home to die. I thought it callous, especially considering how the treatments had degraded his quality of life. Jack’s needs soon exceeded his wife’s capacity to provide, and he ended up back at the rehab center–having lost a great amount of weight and strength. This is typical of the wasting some cancers cause. I tried to call him on Monday, August 11, but the attendant told me that phones had become difficult for Jack. I asked if I could see him later in the week, and the fellow said yes. I asked if I should get there sooner rather than latter, and he said I probably had some time. 

            So I went to Genesis on Saturday, bound and determined to give Jack some company. But he had died the day after I called. I was stunned. The nurses would not tell me any details, for such are the laws governing privacy. But I managed to talk to enough people to piece the story together. And I am still so very upset. As I type this, tears flow. I damn myself for not being there for a friend, for not saying a final goodbye. We don’t get second chances at such things, and I am beyond sad. Jack fought for life, like we all do–and strived against long odds. I recall the conversation we had about his kid while at Genesis.

            “How am I going to tell him?” Jack asked.

            “I would think he knows.”

            “Maybe,” he said with a frown. “But I try to keep the details from him.”


            “I don’t want this on his mind. He’s got classes to worry about, and I want him doing well. He has to take school seriously.”

            “God, I wouldn’t know what to say. Damn cancer. Took my Mom and raised hell with my family.”

            “But we have to keep trying.”

            “We do. I see you doing that with your walks.”

            “I think it drives the attendants crazy, but I have to keep trying. Just hope I’m not too much of a burden on my wife.”

            “Hell, she knew the job was dangerous when she took it.”

            “I don’t think she bargained for this,” Jack sighed.

            “Maybe it won’t be so bad. You can walk on your own now.”

            “A little bit. Doubt I’ll ever use this hand again.”

            “But your mind’s still there.”

            “If you say so,” Jack replied with a smile.

            “I know so. Well, I have to get down there in a bit. Got my big evaluation today. I am going to kick some serious ass.”

            “That’s the spirit!”

            And so it went. Jack was high maintenance due to the effects of his stroke, but he made it out of Genesis shortly after I left. Over the coming months we called one another and shared various stories and updates about how our lives were unfolding. Occasionally, we talked about falls or medical problems, which are minion in anyone with chronic diseases. But mostly, we discussed life in general, as in Jack’s love of the many types of birds that flocked to the feeders at his house. Then I got the call wherein Jack related that the doctors at DHMC told him that further chemo was pointless. The cancer had spread from his bladder.

            I begged him to try Cancer Centers of America or some other hospital, but he was worn and weak. One often hears death in a person’s voice well before it pays a final visit. There were times I called when he could not speak very long, though he reported about the weight loss, lack of appetite, and all the rest. He said he was going back to Genesis, and we both knew it was a one-way trip. I promised I would visit, and thought there would be more time. But I failed my friend, not that there was anything I could have done to ease his passage.

            Time… It’s all about time. We only have so much of it, and squander hours on end in useless and trivial pursuits. We march toward that final period that ends all sentences, and seldom fully consider the things that are truly important while life’s lines are being written. Jack knew what was important, and it all went back to family for him. There he was, ravaged by a stroke and cancer. Yet his concern was always for his son and wife. To my way of thinking, such a perspective is an act of love. And when one loves, one is living fully. I am positive that Jack lived fully until his time came, and hope that I am half as courageous when that period is placed on the end my last sentence. 

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