"There's more to it of course, but I wanted to give the flavor of the choices you can be faced with way before you think you'll need to."
That, my friends, is a message from Curt. Read it carefully, because it is a message from a young man who is facing a circumstance that none of us ever want to contemplate. His need to make decisions about his life and death came upon him without warning at a time when no one would have ever expected this to happen.
I don't know Curt personally. I have "met" him through a good friend and colleague, who in turn was concerned about his good friend who suddenly found himself facing his mortality. Otis Brawley-who is the American Cancer Society's chief medical officer-and I were consulted several times to provide advice to Curt and his wife during his time of need.
Curt is a young man with a loving, concerned wife and family who had just started a new job which I suspect he was looking forward to with enthusiasm. He had been engaged in this new position for about a month when suddenly one day he had a seizure and was taken to the emergency room.
The doctors treated the immediate medical problem, but then did their initial evaluation and delivered terrible news: it looked like cancer had spread throughout Curt's body, with hundreds of tumors in his brain, his lungs, his liver and probably elsewhere.
The seizures were stabilized, treatment was started. More complications came quickly thereafter, and then Curt-in a time of lucidity-had to make the ultimate decision: whether or not to continue his treatment, or pursue care with comfort.
Curt wrote a blog, and this was his entry (reprinted with permission):
"Real Life (and Death) Choices
Posted by Curt Ewald on August 26, 2010 at 12:38pm
"Sudden New Situation: Aggressive blood-clots in both legs and both lungs that will eventually cause breathing to get worse and worse. The lung clots will kill me in days or weeks.
"Choice A: Start blood thinners to help the lung clots dissolve, but will surely cause bleeding of my brain mets and a seizure-filled, painful death experience for the kids/family. Oncologist says he has never seen so many brain mets in a single patient (100's)
"Choice B: Switch to a "comfort & care" approach in a professional home hospice environment that is already proven and I like & trust. Choose DNR status and make it clear we're not going back to the hospital. Install a little cage (already done) in my blood vessel to catch any more clots rising from the leg. This is not giving up, it's managing the death process.
"BTW - Pain relief is very well covered. I get to play with morphine, marijuana and anything else that helps!
"There's more to it of course, but I wanted to give the flavor of the choices you can be faced with way before you think you'll need to."
When I read this blog, I stopped for several minutes and just stared, contemplating its power and its guidance, coming from someone whose life had so shortly before been so promising, and was now so mortal.
Perhaps you will be as impacted by Curt's words as I have been. But if I had my wish, I would want everyone to contemplate Curt's message, especially that last sentence. It's worth reading again:
"I wanted to give the flavor of the choices you can be faced with way before you think you'll need to."
Curt is now sedated, and probably unable to say much. But his words are profound, his message from the heart, and in this moment of sorrow for Curt and his family, perhaps there is solace in his words for others who have-and who will-face their own mortality at a moment when it is least expected.
Thank you, Curt. You are in our thoughts and prayers.
