When my husband’s step mother was diagnosed with Primary CNS Lymphoma (brain cancer) last February, we were all in crisis mode. She was confused and disoriented, and experiencing a lot of pain. Thankfully, we had engaged in conversations about end of life prior to this and my father in law felt as though he knew what her wishes were in a general sense. As steroids and chemotheraphy shrunk the tumors, my mother in law regained her capacity to engage in meaningful conversation. We had many. We talked about treatment options and the potential outcomes of those treatments. We talked about what was important to her in terms of the goals she would hope to acheive in her life, and what her hopes were for her healthcare. Some days we talked about the coming months. Some days we talked about what the final days would look like. Many of these conversations were just between her and I, in quiet moments while chemotheraphy drugs were dripping into her veins. Many others included her children and her husband. A few included her health care team – she was abundently clear about certain aspects of her care and had specific wishes around intervention she would and would not be accepting of.

We revisited these specific wishes with each change in her health circumstances. And when her goals for her care changed, we were sure to communicate those goals to her health care team. Now, 11 months after diagnosis, we are near those final days. She is more confused now and it’s hard to know for sure what she does and does not understand. Yet, we continue to talk.
This journey has been a difficult one. There is nothing easy about watching someone you love experience pain and distress. But  A gift that she gave to us by being so open and courageous in speaking about her life and her death with us. We are sad. But we are not in distress. We are facing these days with her, advocating for her, and supporting her health care team in honoring her wishes.

Conversations matter.

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