Loading…
Defining moments: End-of-life care in the back of a truck
Dan had an advanced malignancy, with multiple metastases and lymphedema of his arm, oozing secretions. He was on his fourth course of chemotherapy, and had just started to use oxygen for exertion. Dan was a truck driver who used to drive a /o-foot tractor-trailer all over North America. With obvious...
Saved in:
Published in: | Canadian Medical Association journal (CMAJ) 2007-05, Vol.176 (11), p.1614-1615 |
---|---|
Main Author: | |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Dan had an advanced malignancy, with multiple metastases and lymphedema of his arm, oozing secretions. He was on his fourth course of chemotherapy, and had just started to use oxygen for exertion. Dan was a truck driver who used to drive a /o-foot tractor-trailer all over North America. With obvious emotion in his voice, he told us that his only journeys these days were to medical appointments. Between appointments the "hospital without walls" came to his converted mobile home, where he lived alone. During our first visit, he didn't want to talk about where he was with his cancer, his treatment or his future because, as he said, "Right now no one knows and I've been fighting this for 6 years." He didn't have the energy to shave or manage his personal care, nor would he allow anyone else to do it for him. We reviewed his symptom control and bandaged his grossly swollen arm. Then Dan said, "This wasn't quite the news I wanted on Valentine's Day." The contrast could not have been more stark. Just minutes earlier, we had bought Valentine's Day gifts for our families from a local shop, where there was gaiety, laughter and roses. Now I was forcing back tears, but crying didn't seem like quite the thing to do in the rear seat of another guy's truck. So we talked about the people he would need to tell. We listened and supported. We sat in that truck, the 3 of us, in the driving snow, the engine running, his oxygen supply hissing, talking about how he would get all the help he needed for as long as he needed it. The Extra-Mural Program would keep him at home as long as he wanted, keep him pain-free as best it could and do the best for his symptoms and for him, to the extent that he would allow. Dan would still call the shots. |
---|---|
ISSN: | 0820-3946 1488-2329 |
DOI: | 10.1503/cmaj.070511 |