How to choose?

It looks like Spring outside.  Grass is greening.  It’s sunny.  Only one or two more days of Spring training and the Red Sox will be back in town.

Mom is already at the kitchen table when I come downstairs.  She’s on her iPad.  She’s found clinical trials for recurrent DLBCL.  There is one in St Louis.  There is another at Stanford.  She has a yellow pad full of notes.

She’s forgotten most of what Dr. H told us yesterday.  I shift back into doctor mode and take a piece of paper.  I draw four big boxes to capture the four big options:  a) Aggressive chemotherapy and then bone marrow transplant, b) a clinical trial, c) palliative care, d) nothing.  Each box has a rough likelihood of success or failure. Each box has a rough estimate of lifespan given success and lifespan given failure.  There is no right answer.

We go over the four boxes again with dad – and he pulls out his notes from the visit.  Names of clinical trials, names of therapeutic options.  Numbers.

Dad reminds us how much he hated the time in the hospital.  He doesn’t want that again.  At all.  Option (a) is out.  No aggressive chemotherapy.  No bone marrow transplant.  Mom pulls out her list of clinical trials.

Dad spends the rest of the day calling friends and family.  He wants to tell them himself.  By dinner time, he’s exhausted.  They all got so upset.  He’s worked hard to help them.  To work through their sadness.  As a retired psychiatrist, I suppose it comes naturally to him.  But it frustrates me that he’s so focused on their needs and not his own.  I remind him that we can call some of these folks for him.

The doc is going to call dad’s cell at 10:00 Sunday morning to talk things through.  We’ve got two more days to let it all percolate.  This shouldn’t be a rushed decision.