I would like to write about EP again this week while he is fresh in my mind. You may remember him from the story I wrote a few months ago entitled, “Addicted To Hope”. EP and I said goodbye this week. Our goodbye has me pondering the different ways we end up walking through life.
As a refresher, EP and I met in early 2022 after he was diagnosed with metastatic colon cancer. He struggled with addictions for most of his life. He was an active opioid addict at the time of his cancer diagnosis.
When we first discussed palliative chemotherapy, he balked and thought he would be better off ending his life by using one last time. He was prepared to walk out of our clinic room, find his drug, and check out. When I acknowledged this was a legitimate option, he looked at me sideways. I knew then he might be interested in more life.
It’s a peculiar thing addiction. One the one hand it takes those afflicted with the disease to the edge – always one drunk, one high away from death. Yet, in many individuals with substance use disorders, there seems to be an unexplainable survival instinct that can’t be known to those who don’t have the disease. EP was a poster child for this. He acted as if he wanted to die every single day but still chose to try to fight for his life when it came to his cancer diagnosis. Addictions really are a conundrum of the mind.
Fast forward over a year. EP has now tried three different chemotherapy regimens. Each of these drug cocktails worked for a while but his cancer found ways to continue to grow. He tried his best to stick to using his pain medication as prescribed. He wasn’t perfect. His addictions were hard for him to control. But he tried. He and I came to have a very good working relationship. He didn’t try to bullshit me. I expected honestly from him in exchange for the ongoing care and treatment he received at our cancer centre. Somehow, we worked.
Last week, EP started to feel unwell. His blood work didn’t show much trouble, but he was clearly clinically deteriorating. We tried to top him up with fluids a couple of times which didn’t improve his symptoms of fatigue or his description of “feeling like crap”.
I spoke with him over the phone a week ago Friday, knowing we were headed into a weekend. I cautioned him that if he continued to feel unwell, he would have to make a visit to the emergency room since we did not have one of those at my hospital.
When Monday rolled around, I was informed EP was admitted to a large hospital in our city. The information I gathered from our online system didn’t specify what his admission was for other than “failure to thrive” which basically means he was too ill to cope at home.
Wednesday, I received a call from the physician looking after him at that hospital. This doctor told me EP looked bad. He believed EP was dying. He was having trouble building rapport with EP and it seemed to him EP was unwilling to accept a consult with the palliative care team to discuss transitioning to hospice for his death. This physician asked if I would be able to reach out to EP. I said I would.
I called EP later that day. When he answered his cell phone, I told him I talked to his doctor there and it sounded like things were going downhill. EP agreed. I explained there was no other chemotherapy to try. He didn’t say anything. I continued explaining he was dying, and it might be soon. I asked him to consider allowing the pain team to help him – they would be able to set him up in a hospice where someone would help him with his pain and end of life care.
His answer to all of that was “I think I’ll check out then.”
I asked him if that meant check out of the hospital or check out of life. His answer: “check out of life”.
I told him that was an honest thing to say and that he would likely do that sooner rather than later. I reminded him of our first visit when he told me he might as well overdose on fentanyl and be done with it. I told him how impressed I was that he didn’t do that, instead choosing to fight his fight with chemo and grit, the type of grit only an addict who chooses life over using knows. Then, I told him I was proud of him and that I hoped he was proud of himself too. All he said after that was “bye”.
EP died the very next night. I received a message telling me he had had a massive gastrointestinal bleed. EP knew what was happening with the bleed and knew he’d die within hours. He was kept comfortable. Then, he checked out, just as he said he would.
I will always have a special place in my memory for EP – a fighter with and in his diseases of addiction and cancer. He was so rough around the edges but for some reason he rounded a few of those so he and I could form a therapeutic relationship. I see that as a beautiful bit of magic.
Author Notes:
The photo that accompanies this story was taken while I stood in line with my best friend waiting to enter The Gorge Amphitheatre June 10. We were eagerly anticipating what was about to unfold. Joni Mitchell was headlining her first ticketed concert in decades with the help of her loving and attentive friends. Brandi Carlile opened the party and played host for the entirety of the evening. It was more than magical – the music, the scenery, the love. It is still hard for me to describe all the feelings that arose for me being present in those hours. Thinking about it now though, the graffiti on that wall foreshadowed the entire night.
“I’m in love with my life.” What a statement! I’m not shy about sharing that I am. I can’t explain exactly how I fell in love with my life. I know there has been adversity that leveraged the pretty awesome feelings I now get to experience. Going through “stuff” makes all the great things more magnificent. I know being a small part of the lives of my dying and surviving patients puts life in perspective for me. If you’re there with me, in love with your life, might I suggest reaching out a hand and trying to help someone else get there too?
“Thank you.” YES!! An attitude of gratitude really does go a long way. Thank you, Universe, for keeping me safe when I might not have warranted safety. Thank you for all the things in my life that, at the time, I so badly wanted to work out but didn’t because it really wasn’t for me. I didn’t know it at the time, but such greater gifts have manifested on the other side of failures. Thank you for the gifts of hard work and love. And thank you for music. Music comes to me in laughter and sunshine, from acts of kindness and those little looks of understanding between my most precious humans. It really was something to see all the love on stage at the Joni Jam. I will never forget the love I saw and felt that night. I one hundred percent agree with Ms. Mitchell: “Love Wins” . . . every single time.
It’s not lost on me how “Oh Canada” is there too!! I have been blessed by being born and raised in a country that allows me to be me. I sometimes wonder what life would be like without this privilege. It’s not fair all women do not have the rights and freedoms I experience.
Let’s not forget “I am proud of you.” What a powerful statement for anyone to share with another.
From my point of view, Emery’s story contrasts this graffiti and how I see our world. So, I share the above with hope – that maybe he had bits of his life that were happy, that others who have addictions might find some peace.
I am curious to know, reader, are in love with your life? If so, why? If not, how can we get you there?
