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Monday, August 13, 2007

He bolstered the lives of others: Terminal cancer

Norman Cousins: The judge's story

A physician in Sherman Oaks telephoned and identified himself as Dr. Avrum Bluming. He was calling about his patient, a judge, who was in the terminal stage of cancer and who was then at the Encino Hospital. He said the judge's mood was understandably bleak. All of his personal and professional life he had been known for courage, determination, and a positive outlook on life. His illness, however, had given him the psychology of fatalism. He told his wife and children that there was no hope and that he expected to die very soon.

Dr. Bluming told me that the effect of the judge’s mood on the family was catastrophic. He said that the judge's seeming willingness to give up without a fight was totally out of character. They physician was worried that the judge's wife might be vulnerable to serious illness.

On the way to the airport for the flight to China, I stopped off at the hospital. Before entering the judge's room, I met with Dr. Bluming, who told me that the judge had virtually stopped eating and was resisting intravenous feeding. At the present rate, he said, it was doubtful that he would survive more than two or three days.

When I entered the room, the judge bade me sit close to the bedside. He spoke in a hoarse whisper and it was difficult to follow what he was saying, but I picked up enough to learn that he had been a long-timer reader of the Saturday Review and had sympathetically followed its various enthusiasms and concerns.

I took his hand and thanked him and told him that few things in my life were more gratifying than to meet readers of the magazine. I asked how he felt. He closed his eyes and shook his head.

I said that Dr. Bluming had given me a briefing on his condition and that I was also concerned about his wife and sons and in fact, about all the people who loved him.

His eyes narrowed in a way that indicated he wanted me to explain myself. I said I understood that all his life he had been a fighter for things he had considered just and right.

He nodded and again he narrowed his eyes as though to find out what I was getting at.

I said that one of the things I had learned at the medical school was that attitude of the patient had a profound effect on members of the family. Their health could be jeopardized by negative attitudes of the patient. I said I hoped he would forgive me if I said that his family was anguished by the judge's apparent defeatism. Such defeatism might seem natural in anyone else, but in the judge…

The judge closed his eyes momentarily. Then he looked at me and uttered just two words: "I gotcha."

The sense of purpose in his whisper was unmistakable, as was the pressure of his handshake before I left.

When Ellen and I arrived in Hong Kong, the first thing I did was to telephone the hospital. Dr. Bluming went out to the nurse's station to take the call.

"Something is happening there that you’ll find difficult to believe," he said. "When the nurse began to rig up the intravenous device, the judge demanded that he be given breakfast on a tray. This was done. He got the food down, and kept it down. How he did that I'll never know. When his wife arrived, he called her to the bedside, then invited her to work on problems that come up in bridge games. The judge used to be a tournament bridge player. Where he got the energy to concentrate on bridge, I have no idea.

"This isn’t all," he continued. "After bridge, he asked for a robe and slippers, got out of bed, and went to the bathroom on his own. When the nurse tried to restrain him, saying she wanted him to use the bedpan, he waved her off and said he could take care of himself. He was crusty and strong-willed—just the way people had always known him."

I asked if this was any indication that the underlying situation had changed.

"Not as far as I can tell but it sure has made a difference in the lives of his wife and children. He’s going to survive this weekend and then some."

After I arrived in China, we were escorted into the interior of the country where international telephone facilities were not readily available. It was not until two weeks later, when we arrived in Shanghai, that I was able to telephone the hospital again.

This time, the judge’s wife went out to the nurse's station to take the call. Her voice was strong and cheerful

"The judge's spirits have been wonderful," she said. "He has had good talks with our sons. He follows the newspapers and makes his usual witty comments. He now takes walks in the hospital corridors and chats with other patients. The ultimate outlook hasn't changed, but the general atmosphere has. We are…well, a lot less dependent than we were."

The judge survived for several more weeks. It was a magnificent example of how the human spirit could make a difference-not just in prolonging one's life but in bolstering the lives of others. The judge's deep sense of purpose didn't reverse the disease—the cancer had spread so widely to his vital organs that it was only a question of time before it would claim his life. But he was able to prolong his life beyond the expectations of the physician. He was also able to govern the circumstances of his passing in a way that provided spiritual nourishment to the people who loved him. He died in character. This was his gift to everyone who knew him.

Hope, faith, love and a strong will to live offer no promise of immortality, only proof of our uniqueness as human beings and the opportunity to experience full growth even under the grimmest circumstances. The clock provides only a technical measurement of how long we live. Far more real than the ticking of time is the way we open up the minutes and invest them with meaning. Death is not the ultimate tragedy in life. The ultimate tragedy is to die without discovering the possibilities of full growth. The approach of death need not be denial of that growth.

Advice: You may be able to give something to others even during your toughest moments.

Read one of our hospice stories, or read more from the source, Norman Cousins’ book, Head First: The Biology of Hope.

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