"I am afraid the chemotherapy is not helping." "Please don't say that", she sobs. "I feel I have no hope." My fight or flight response kicks in. Suddenly, I hate this conversation that moments ago seemed so important. I am ready to do anything to avoid being branded as the destroyer of hope. Why should I take on the burden of contaminating our easy relationship?But I have lost count of her drugs. Every treatment is toxic. The central line hurts. She has lost her hair, endured multiple infections, and suffered nearly continuous nausea, vomiting, and fatigue. She has spent more time in the chemotherapy chair than with her youngest child and is prone to the most disabling side-effects. After several nights of steroid-induced insomnia, she said "My mind is racing, I want to kill myself." The fluid loads bloat her. When her skin peels she cannot walk. Her cancer returned barely a year after supposedly curative surgery. Various therapies kept it under control but lately there have been signs of resistance. She was so distressed recently that I sent her on a round of second opinions. It took nearly 2 months of expensive tests and appointments to conclude what we all knew: there was no cure.
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