EULOGY--PART III. THE GRACE - By John Dorn

THE EULOGY—PART III—THE GRACE

I recently found this handwritten draft of a letter in Kathy’s appointment book.  I’m guessing it was written late in 2015.  She used it to guide a visit with her primary dermatologist (wonderful Dr.)
I considered adding a list of her prescribed creams, lotions, ointments and drops (it is quite complex) but decided to just let her voice be heard.   

Dear Dr. B.—
 First, I want to thank you and all the other derm docs,nurses, and clerical staff for the excellent care you’ve provided me as we try to sort through this very complicated case. GVH, lichen planus, squamous cell carcinoma and just plain old advancing age have made it difficult to diagnose and treat. I so appreciate the effort.
 I’m not sure how much time has been allotted for today’s appointment, but I have a few things I’d like to discuss—if we need to schedule another appt. I’m fine with that.
 I believe the purpose of today’s consultation is to: check the wound on my right ankle, review suspicious spots, check fungal infection (breast), and determine how to proceed with future treatment.
 I am particularly interested in getting a better sense of what the future may hold.
 Some questions, concerns…
 1.    I’m experiencing a lot of pain from my feet to my scalp, most of it emanating from my feet, both lower legs and my fingers. I’ve been using thee prescribed ointments although I admit to skipping a step or two.
2.    I’ve been taking oxycodone with a combo stool softener and laxative.  I worry about having another bout of diverticulitis (I was hospitalized in early June with painkiller-induced constipation).
3.    I have an appt. scheduled with a therapist to discuss pain management and end of life issues.

About that last part…End of Life

I know you can make no predictions, no guarantees, but I need to get a better grip on what I might expect.  Today I’d like to find out how much more cancer I need to have removed.  Bottom line: if it’s going to be one more procedure after another on many (as I view it) suspicious areas, I don’t think I can handle it.  I am grateful the transplant afforded me 3&1/2 more years of Quality Life, but I am in a downturn now and feel the quality has diminished. Because of the pain I am experiencing, I am less mobile and active.  It’s taking a toll.
 Depending on today’s visit, my plan is to go for another 2 months.  If there is improvement and/or a realistic chance of improvement, then we can proceed as usual.
 If the prognosis is too speculative and there is very little light at the end of the proverbial tunnel, then I am prepared to discontinue treatment and start palliative care and/or hospice.
 Am I overstating the situation?
 With all my heart, I hope so.
 Kathy


TOMORROW:GRACE UNDER PRESSURE AT AN EARLY AGE