The Grey's Anatomy Effect

About four weeks after the last scan, when my dad was in the hospital for the first overnight stay in his four-plus years as a cancer patient, when it was abundantly clear that the chemo hadn't been working for a while, and that the cancer was spreading fast, it finally landed on me.

No, it didn't.

My dad was in bad shape, but he was still alive, dammit. And if someone is alive, then hope springs eternal.

Except that often, it doesn't.

His oncologist, whom we liked and trusted, tried to tell me, but I needed to be hit over the head. Hit me over the head, he did. His exact words still ring in my ears some eight months later, "The chance that your dad will respond meaningfully to any further treatment is zero." You'd think that would have done it. It didn't. I called in favors. I moved up appointments we had made at two brand-name cancer hospitals, and I was on the road toward getting him an experimental drug, even though the trials usually don't admit patients who have exhausted their traditional therapy options. If I could have arranged to wheel his hospital bed into an infusion suite to get that experimental drug into his body, I would have pushed the thing myself.

We opted for hospice care only when it was clear that his body was failing so completely that it was not physically possible to offer any further cancer treatment. That, and another doctor advised that further treatment could have hurt him, or ruined whatever time we had left.

So the big news yesterday that a major medical association was changing its guidelines to encourage physicians to be more candid about likely outcomes and options to help terminal patients plan for "a good death" was kind of a punch to my gut. It fed my need to wonder about whether I'd done the right things for my dad. But then again, my wife correctly pointed out that my family would not have gone quietly toward hospice any sooner than we did. Well, maybe we were wrong.

When someone you love dies you find a million ways to torture yourself. See all that stuff in the paragraph up there that I said I did? None of it stops me from wondering if I did enough, or if I could have done anything sooner or with more urgency. Partly this is a normal reaction. Partly it is because of what I call the Grey's Anatomy Effect, an overlooked cousin of the oft-reported CSI Effect.

Watch enough medical dramas on TV and you may become convinced that your loved one can be saved at the last minute by something risky, experimental, rare, or entirely dumb luck. Hell, maybe it was never cancer at all, but some previously unknown, but non-lethal disease. Unfortunately, this is almost never the case. But mix this bit of cultural conditioning with the normal feeling of not wanting to lose someone, and you can see why the doctor had to be so blunt.

Here's hoping that this new practice guideline in cancer care helps patients and their loved ones adjust and prepare for the inevitable, and do it with some peace of mind and physical comfort.