Altra ~ One day you’ll see your dear daddy again! He’s not gone forever.

Dearest Altra,

Just read your comments under the topic, “A DIFFICULT QUESTION” (http://csn.cancer.org/node/254406).   Hope you will take these comments from my heart to yours.  Just couldn’t help but be saddened by your words.  “Nick” was unable to make it through the tough struggle that is “Esophageal Cancer”, a formidable foe indeed.    You write,  “…He was STAGE III when diagnosed, and AT THE TIME, going through chemo/surgery was the most practical option.   BUT seeing his decline after the surgery really makes me WONDER IF we made the best decision…”

From reading about the history of progression of your father since his diagnosis was confirmed, I see that the March 13^th first-year anniversary of Nick’s passing is coming up soon.   You said, “March 13- Daddy passed away just after midnight after three weeks on Hospice care. He was able to be flown home at the end of February by the generous pilots from Angel Flight NE, and was able to spend his last weeks in peace, surrounded by friends and family.”

For many even a year later, I know wounds are still fresh, and the memories of Dad’s struggle are all understandable.   In one sentence, I can see the positive foresight that Nick exhibited going into the battle.  Having some knowledge about EC because of those I know who have been diagnosed, I observe that rarely does a Stage III EC patient forego the chance at life and opt for no chemo/radiation treatments and surgery.  A surgical solution is a possibility for those diagnosed Stage III and under, because the cancer has not yet spread beyond the Esophagus and lymph nodes nearby.  If the lymph nodes have spread to another major organ, that constitutes a Stage IV diagnosis.  In that case only palliative measures can be taken but no Esophagectomy will be possible.  Your Dad was diagnosed Stage III.  For that stage, clinical trials have proven that “Tri-modal” treatments have been proven to be the best “plan of attack.”  Rest assured Nick chose the “best” course of action. Many times when the patient has chosen excellent doctors, yet things just don’t always work out for good.  A surgeon once told me, “Sometimes things just don’t work properly even though the surgery is performed correctly.” 

            Your second sentence begins with a “BUT”.   As the day draws near I see that the “BUT” is giving you pause about the whole ordeal.  Think of it this way.  “IF” we could see our FUTURE, would we be able to “be” in the present or benefit from life today?    

  Dad dared to peer into the future and decided to “go for it” because he loved you dearly, and wanted to be around to see you live out your dreams.   That’s a decision that really only the patient themselves can make because they are the ones who will have to endure the accompanying pain and subsequent struggle.  And yet, the family suffers too.  The closer the relationship, the more agony one feels.

If we had known all the things that would transpire in our lives till now, I venture to say many of us would want to crawl back into a warm place in our mother’s womb where everything was safe.  There’s an old saying that “IF a frog had wings, he wouldn’t bump his tail.”  In the Esophageal Cancer world, the moral of that saying is, if we could peer into the future and were forced to rely only on the grim statistics, few would ever take the plunge and opt for treatment.  We would all just put our house in order, make amends where we could, and prepare to leave this world immediately.  Hopefully, we would all be prepared to meet our Maker if we choose to believe in the Resurrection.  I do!

            BUT WAIT, how do we know that death is all that awaits one who has been diagnosed with Esophageal Cancer at any stage?  From reading this site, you can find stories of both great success and abysmal failure.   All of us grieve when things are not working out.  At the same time we rejoice with those who are having success.  Having just read Rose’s remarks about William Marshall who will soon celebrate 11 years of being cancer free after his tri-modal treatments, (http://csn.cancer.org/node/254180), we all find his success story greatly encouraging.  Knowing that some EC III patients are still alive and well 10 years later is cause for celebration.  What newbie wouldn’t opt for those odds?  If we know of success stories like that, must we not have the courage to face the EC monster?  Yes, I know that sometimes there are pre-existing conditions that preclude the option of treatment, but obviously such was not the case with your Daddy Nick.  At the time, did you want him to quit before he began?  I think not.  Oh to be sure there are always doubts about the eventual outcome but if no actions is taken, the cancer wins hands down.  Esophageal cancer will only spread if no action is taken.  (Likewise, we know that sometimes it does spread even when we have taken all the steps we know to take.)  Nick knew that and made the very best decision.  He took a chance on beating his cancer and opted for treatment.

 To now begin to second-guess his decisions only leads to more grief.  Time moves slowly when grief is with us.  Even when we know our loved ones are with the Lord in a place of bliss, we’re left here on Planet Earth where time seems to stand still.  Grief sometimes is overwhelming.  We all wish that death were not a part of our life’s existence because it steals away the ones we love most.  But based on past history, only One has returned thus far.  That’s why we write the date as February 15, 2013 A.D.  There is a time to cry and God knows that.  Much is written about life and death in Ecclesiastes 3.  There we read that there is a time for everything, and a season for every activity under the heavens.  Life confirms that truth.  There’s “a time to be born and a time to die”, just like there’s “a time for weeping and a time for joy.” 

I truly pray that when you find yourself beginning to “wonder IF” Dad made the decision to opt for treatment, that you will reaffirm the wisdom of the choices he made.  Haven’t we all had our “But and what-if” moments but we can’t let them linger long.  There’s another saying that I liken to dwelling too long in the land of negativity.   Have you heard this one?  “You can’t keep the birds from flying overhead, but you can keep them from building a nest in your hair.”  (And Altra, from your picture you have beautiful hair.)  I don’t think a bird’s nest would add anything to your beauty.   So Altra, I’m hoping you will resist the impulse to allow the birds to build a nest of regrets in your hair.  If you do, they will cloud your vision and rob you of all those memories of special moments you had during all the years that you felt the touch of your Daddy’s hand.  I’m sure you were the apple of his eye.    

Altra, my prayer for you is that “in time” you will be convinced that the decisions your dad made were the “right ones at the right time.”  Dad did the right thing but the diagnosis of Esophageal Cancer would turn out to be the illness that marked “his time” to die.  Easter will soon be here, and for those of us who “choose” to believe it, it offers great consolation that you and Nick will one day be reunited.  At that time he will tell you even more.

            If Dad had not appreciated the valiant efforts of doctors to save his life, I doubt he would have wanted to donate his body to science.  This was a great service for humanity.  He believed that his contribution would help researchers to find a cure for this dreaded cancer.  I agree and applaud that decision.  Having observed many that die from different cancers, I know of no other that causes more suffering than Esophageal Cancer.  Even as he faced those last awful days of suffering, he was thinking about others and what he could do to make his family proud and make this world a better place for mankind.  That was a great decision and I know you are happy about that. 

           Saying goodbye is often overwhelming.  For you I pray that “Time” will help to ease the hurt you now have in your heart.  May God give you the ability to savor only the best memories that your loving father left for you.  Dwelling on the positive things in your Dad’s life, rather than spending too much time in the rut of regrets, would make Dad the happiest, and you as well.

Lastly, just like those were “angels in disguise” who flew Nick home so that he was able to spend his last moments in peace, surrounded by friends and family.  Likewise, you could not see but God’s angels waiting in the wings to take Nick to his eternal home.  There he is also spending time with family and friends who have preceded him.   So maybe one of the ways to find some comfort in the March 13^th date would be to write Dad a love letter if only in your secret thoughts.  Just put all those “ifs and buts” in a journal, and save them.  When you see him again, you can clear all those things up then.  For now, try to dwell on the happy times and remember all the little things Dad did that made you the happiest.  Dad would want it that way.

From my heart to yours,

“Flo”