Pamela's story for Thursday, 12/10

Lessons from Losing

My father, a larger-than life figure who dominates the mythos of my childhood, retained that pugnacious character through the slap in the face of his lung cancer diagnosis, to the boxing match of chemotherapy, to his death. To be sure, the power-duo of cancer and chemotherapy left an indelible imprint on his 59-year-old body; transforming the tall, imposing figure to a distorted shell of his former self. But when it came to the battle of wills, it was my father who emerged the clear winner. By never allowing the external changes ravaging his body to dampen his spirit or slow his mind, my father taught me the most valuable lesson of my 20 years of life. Through sheer force of unwavering conviction and will, my father showed me that the choices we make and the attitudes we maintain are vastly superior to any external challenges we may encounter.

My father’s internal struggle of helplessness versus control was mirrored in my own response to watching a loved one suffer and being unable to stop it and having to acknowledge the unbearable prognosis that cancer had spread to his liver. This transition marked the denouement of his cancer struggle; doctors predicted he had at most another month to live. But it also marked a dramatic transformation of my father’s attitude toward the disease. Where it had robbed him of the ability to make the most basic of decisions about his future, treatment and quality of life, the news that he would ultimately succumb to the disease produced a surprising reaction within my father.

With the announcement that the cancer would be terminal, my father began reasserting authority over his life, making decisions that would give him maximum autonomy over his body and allow him to regain the sense of dignity that chemotherapy had stripped from his life. He outlined these decisions and desires to me on a cold morning in December, when I had just arrived home for winter recess. In the faint light of his office, I watched as he told me how he would abstain from chemotherapy, preferring to spend the last month of his life celebrating the winter holidays and enjoying the company of his family rather than hurling at different smells and tastes and wrenching in discomfort. In that vein, he did not want any one crying for him or bemoaning his fate. After all, there were children in his cancer unit who were far unluckier than him. Further, he wanted to die at a hospice, so that he would retain his dignity and wouldn’t taint the house with his death. Life would continue on as normal after he died, with my sisters and me returning immediately thereafter to college. Indeed, not disrupting his family’s lives was one of my father’s greatest priorities during his battle with cancer. Although he was severely weakened by the chemotherapy, he turned down my offer to take a semester off to care for him when he received the treatments. Finally, he did not want a funeral- no fanfare over his death was permitted, just a private burial with immediate family members (so long as no major expenses were incurred.)

As he bulleted the plan, I stood before him, nodding solemnly with every pronouncement, as if to signal my tacit approval. On the inside, however, I was quieting every natural mechanism in my mind that contradicted practically all of his wishes. I shuddered to think of him alone in a cold white hospice, with squeaky floors and a smell of death: a place he would enter knowing he would never leave. I wanted to tell him to let his family care for him and stay by his side and beg him to let his family honor his passing with a funeral. I had not acquired my father’s sense of inner peace and composure, and his insistence that I not dote on him or worry about him, that I carry on life as usual, left me to wonder: What could I possibly do to help? My hero had just been sucker-punched in the stomach by life and would not recover, and I, his 18-year-old daughter whose closest brush with mortality occurred was a fifth-grade bought with mono, felt utterly inadequate for the responsibilities life had thrust on me. But the arresting example of my father, who maintained a stoic demeanor in the face of life’s ultimate emotional and physical challenge, taught me that I could not and would not succumb to fear and helplessness. In trying to follow my father’s example of inner control despite ravaging external forces, I started taking action and making my own personal decisions, most of which revolved around honoring my father’s wishes without forgetting my own emotional needs.

The central emotion that would shape my father’s decisions was the desire not to inconvenience anyone with his death. Remarkably, rather than lamenting his own misfortune, my father was most preoccupied with minimizing any negative impacts of his passing on my family. The most vexing aspect of his death was the impending loss of half my family’s income. To help secure my family’s financial future, my father and I spent the vast majority of his final days in a very unglamorous manner—labeling and categorizing expensive electronic equipment he had accrued throughout his career as an engineer that could be sold on E-bay for thousands of dollars. He felt comforted to know that this money could be used to finance college.

My father deeply wanted a festive holiday season and a strong, united family. My older sister and I, who were both well out of childhood, set to task one night by rummaging through the house for art supplies and spending the entirety of the night crafting holiday decorations. My father awoke the next day to discover his kitchen transformed into a glittering winter wonderland adorned with hanging snowflakes and paper snowmen. We also spent days traversing his favorite haunts, especially the Rhode Island coastline, and having no-holds-bar visits with his friends, one of which involved taking a shot of tequila at lunchtime.

Instead of fretting over his bedtime, we talked late into the night discussing my plans for the future and acknowledging mutual regrets of our contributions to my father and my strained relationship. By accepting the reality of my father’s death, I understood the urgency of honestly conveying all my emotions, positive and negative, to my father. I apologized for things that I wish had done differently, divulged details of my personality that the distractions of life prevented him from understanding, and—most importantly—professed love and gratitude. In a bittersweet admission, my father confessed that he had not fully appreciated my personality until we began having those candid conversations. The same held true for me. Although I regret not having more time to enjoy the newly forged friendship, I am incredibly grateful to have had that momentary convergence.

My father wanted to maximize time with his family and autonomy over his treatment: This would be the hardest of his decisions to accept. Convinced that medication would hasten the deterioration of his mind, my father vehemently resisted any attempts by family members or caregivers to convince him to take painkillers. Instead of spending his last week sleeping comfortably in bed, as I would expect of most terminal cancer patients, my father kept busy and resisted the urge to doze off. Despite my father’s efforts, however, his cancer quickly and aggressively encroached on his strength and physical autonomy. The outward manifestations of the inner battle in his body were obvious. The voice that had once dominated dinnertime conversations, booming out proclamations of Italy’s superiority to the rest of the world and quizzing me on current events, was now gravely and soft. He had to draw in labored breaths in order to manage a few winded sentences. His belly was so distended that he looked like he was pregnant and could only fit into sweat pants and shirts. His feet were so swollen, as a result of his body’s inability to process toxins, that they looked like baby feet. The muscles in his neck seemed to have atrophied, so that it became incredibly difficult from him to hold up his head. And as the days went on, I would notice him stealing a moment of sleep when he thought no one was looking.

Perhaps the most painful example of the loss of physical autonomy cancer wrought on his body occurred during the last dinner we had as a family. My mother had prepared a 10 pound lobster­­­--his favorite food--in hopes of pleasing my father and creating a festive atmosphere that would lead to another happy memory of family togetherness. The mood at the table was anything but. It was not that my father didn’t appreciate the lobster. The physical deterioration of his body was so much that he could not muster the strength to enjoy it, transforming the gesture of kindness into a bright, shiny red reminder of the incapacitating consequences of his cancer. My mother, sisters and I watched on in silent horror as my father fumbled again and again with the lobster crackers, knowing he would refuse our attempts to assist him. “I will not go down this way,” he said. “I will not go down like a sack of potatoes! I am a lion!” His face grew crimson and the veins in his neck bulged as he summoned every ounce of strength in his body to crack the claw. In one agonizingly slow, strained gesture, he clutched the lobster meat roughly in his hand, shoved it into his mouth, and dropped his arms in exhaustion, panting for breath. My father had won once again, in another act of refusal to let cancer stop him from business as usual. But at what cost? As touched as I had been by his efforts to hang on, I believe that on that night my father and I both accepted the inevitable. Our desire for more time was supplanted by the knowledge that my father would not want to exist, nor be remembered, in a state of indignity and loss of control. In the greatest irony of his disease, it was only in letting his body be beaten that his mind and heart were finally set free.

The inner peace that the situation forced me to acquire—I would have only caused my father anguish if I protested his decision not to take medicine—allowed me to recognize and extract the incredible and profound value of my father’s resilience. By accepting a fate worse than death in order to remain lucid for as long as he did, my father demonstrated the unshakeable, immovable and immutable power of commitment. When he drew his last breath, my father, whose body was a frail shell of its former self, who relied on a wheelchair for mobility, whose belly swelled so big he was confined to a raggedy pair of sweatpants, emerged the victor, his cancer beaten. Through his refusal to succumb to the soul-dampening, joy-stealing, fear-inspiring, pernicious and seemingly all-powerful influence of his cancer, my father proved to me that external influences are no match for an unwavering conviction. Because of my father’s bravery, I was finally able to shed all vestiges of the frightened little girl who stood before him in his office the night he uttered his fate. Now, even as I am forced to recognize my impotence to prevent external forces from dictating the outcome of my life, I emerge stronger and more powerful. For just as it did within my father, there lies within me an inner fortitude to against which no force of nature stands chance.