November 21, 2005

• I mean no disrespect, but what do you mean by "assist him with his transition"?
• Sorry to hear that kamus, that's sad. I don't know of any resources but if it was me I'd celebrate with him the good times of the past. Then I'd ask about what he'd like to get done in the remaining time and do whatever it takes to help him with it.
• I'm very sorry to hear this, kamus. You're a good friend to stick by him. You should contact your local Hospice and talk to the people there--they are best qualified to help with the mental/physical health aspects. They've been a great help to me and my family in our times of need. Here's some information on basic things you can do to help your friend. Here's a link to some information and myths about dying. Other aspects of palliative care are discussed here. There are also the lawyer matters--estates and advanced medical directive and whatnot. I can't offer advice here except to say that having these things in order is a great relief to anyone who must manage the estate.
• Techsmith- I guess the euphemistic language of the hospice workers tends to rub off on one. I meant, to help him die. Despite my advanced age of 50, I never had anyone close to me die and so I lack experience in what the dying need from those around them. I'm sure I could intuitively figure it out but thought that I could benefit from some Monkey's experience, though you are largely a young crowd. also, thanks SB.
• Even "to help him die" is open to interpretation; some might wonder if you were seeking means to hurry things along, should that be required. My guess is that what the dying need most of all is companionship. Sometimes people can be scared away by the approach of death, and you will do wonders for your friend by remaining close. You will also need to find solace for yourself.
• Might I pry into your friend's belief system? Might help to make better suggestions. Do you know if your friend is theist/atheist/pantheist/agnostic/other? Pretty much any book on this subject is going to be faith-specific, though I'm sure there's a wealth of purely psychologically-centered books on the subject. You might try Will the Circle be Unbroken?, Studs Terkel's oral history on death and dying. If you're not familiar with Terkel's oral histories, they're mostly amazing reads, and your friend might find comfort in the company of the people Terkel interviews.
• And so sorry for the tragedy, kamus. May your friend find peace and rest and comfort. Much love.
• I'm so sorry, kamus. All my best to you, your friend, and your friend's family right now. I would agree with fish tick. Lots of people get scared by hospitals/hospice/death in general and stay away, and I think that just sitting with the person can help a great deal. Let him know he's not alone. (Obviously, if he wants some alone time you'll respect that as well.) If he wants to talk about what's going on, then talk. If he wants to avoid it, then avoid it. Just let him know that, no matter what, you're there. At the same time, make sure you take care of yourself. Get some sleep. Eat. Go for walks and see good movies once in a while. You'll be a better companion to him if you're healthy and as sane as possible. Also, and this may be something for the family to get more involved in if he has them, make sure the facility where your friend is gives him adequate pain management. Cancer can be very painful, and most patients are under-medicated because of the fear of addiction. Your friend does not have to worry about addiction, so make sure he is always comfortable. There is no reason for him to be in pain unless he wants to be. When my grandmother died, there were about twelve of us in the room sitting with her. The hospital staff wasn't happy with us, but we knew she wanted us around, and it's a Southern custom to sit vigil while someone's dying. Although I was away taking a shower at her exact moment of death, I felt honored to sit with her as long as I did, and good that so many people who loved her were around at the end.
• I'm sorry for you and your friend, kamus.
• Kamus, are you looking for information on assisted suicide, or on hospice care-type information on preparing for a natural death? I have lost a lot of people, and both my stepmother and my grandmother died after long, protracted battles with cancer, so I feel this gives me the right to be a little blunt in these matters. If assisted suicide, there are many very good resources for this both online and off. Speaking from personal experience, the doctor will, at some point, give your friend a prescription for morphine. Your friend may ask to get an extended prescription, to save him from having to get the prescription refilled. The doctor will look a little sad, but will do so. He may say something pointed like, "Be sure to take these as directed, or else they can kill you." If his default doctor will not have this conversation with him, then he can ask around and find a doctor who will. If he's not planning to go this route, then the best thing you can do is ask him what he wants, and listen. When my grandmother was dying, everyone in the world wanted to sit beside her bed and keep her company. But being terminally ill means that not only are you smothered by friends and family members, but there is some kind of medical personel poking and prodding at you every half hour. What she wanted most was: a little time to herself. It was hard, very hard, to respect her wishes, but we did finally manage to explain to everyone that it wasn't personal, it's not that she doesn't want to see you, she just wants privacy for a few hours. If your friend wants company, lots of company, then call up everyone that you know and schedule them for shifts. They can watch TV together, chat, play cards, or just read a book - some people just want the comfort of another human being beside them. If he wants some time to himself, then appoint yourself his personal guardian, and start turning people away at the door. In any case, the best thing you can do right now is help him get what he wants. Don't assume he wants the things that you think he wants, or that the hospice workers think he should have. Have a frank, honest conversation with him about his goals for the next three months, and set up good lines of communication for the months to come. Your best value will come from listening to him, and using your skills and resources to help him get what he wants, whatever that would be. Good luck and best wishes, and let us know if he opts to go through chemo. I think there's a lot of knitters lurking here, and I for one would be more than happy to knit him a chemo cap if you email me his address (check the profile).
• kamus, my heart goes out to you. we lost my brother-in-law this summer without benefit of transitioning, and it has been hard. a book that has helped tremendously is Ram Dass's _Still Here_, which deals with aging, death, and dying in a way that will help your partner and those left to deal afterwards.
• If he's able, and not yet bedridden, I bet one more jam session with his buddies would pick up his spirits, and yours. *hugs*
• I can get you some book recommendations if you like, kamus. My mother-in-law has worked as an oncology nurse and so has spent a lot of time with terminal patients. The only book she has that I recall offhand is Elisabeth Kubler-Ross's On Death and Dying which is one of the more famous books about helping people with terminal illnesses. Let me know and I'll ask her what else she recommends.
• My best wishes to all the family and friends touched by this, especially your friend. My family has a long history with cancer and my mother died recently of it. So I'm quite familiar with the process. Though in all my instances much more time was given the person. Three months is very short indeed. My mother's final bout lasted twelve years though we were never sure how long it'd take as it could have been as short as a single year. My advice would be to be there when you can be, using up vacation time if need be, and don't be there when your friend wants time alone. Talk to your friend and do things as normally as possible. Also, talk about death and dying. Don't ignore the big pink elephant in the room. No one likes to be a basket case so be mindful of the person no matter what the friend's condition is. Hospice is a great thing. Period. They tend to medical, emotional and spiritual needs as required for both the patient and the family. And morphine. Together they can make the final days a much easier and pleasant thing for all. But say your final words now, not later, as the end will come quickly and your friend will not necessarily hear or appreciate your thoughts and feelings. Morphine puts you wickedly deep into sleep, not to mention the process of a body and mind shutting down hampering communications. Stockpiling for an assisted suicide would best be started immediately should that be desired. At your friends age with a terminal disease there's not going to be an autopsy unless a family member requests it. And take care of yourself after your friend dies. Whatever that may entail.
• Strenght for you and all those loving ones involved, Kamus. May sound rude, but yes, straighting up all legal matters is a priority. And if your friend is up to it, some kind of recorded legacy can be a great way to keep good memories for posterity.
• Oh Kamus, I am so sorry. You can certainly help make what time he has left incredibly meaningful and in turn help everyone around him, including yourself. Communication is a major key. I have been with many dying cancer patients and something that stands out in my mind is the amazing openness that comes about during a time like this. The difficulty lies with those who still have something to lose--it is often too hard for them to communicate the most important things. The cancer patient has an amazing ability to recognize what those important things are. It is up to those around them to allow for this openness and let all the walls down. I have heard recently that Joan Didion's book about her husbands death was remarkable. I have not read it, though. Nor have I read "Tuesday's with Maury" which is supposed to be quite good. Finally, all I can say is.......be there. Just be there for him.
• Another vote for Hospice, too. They are, without a doubt, incredible.
• My sympathies to everyone involved. I of course have no idea what your friend might want, but since you said he is a great musician, maybe you could arrange for some of the people he's played with over the years to come visit him?
• I'm sorry to hear it. I hope that there is little pain.
• So sorry this is happening, kamus. Have lost several I loved to cancer in recent years. Personally, I found it helpful to become aware of the mental and physical changes which might be encountered. Whatever's important to him and to you, talk about it now. Neither of you can count on his being able to during the time he has left. Don't put it off, start now. Cancer is often painful as it advances, and the palliative care meds can keep him snowed. If he has anything he needs you to do for him, he needs to tell you sooner not later. Suggest you discuss the issue of pain meds now -- being clear on this can make it much easier later on for all who are invovlvefd in his dying. Must be local groups in your area which deal with the dying -- hospice, cancer support, and aids support, etc -- and they may have some useful information on the subject -- doesn't hurt to ask around a bit. There may sadly come times when keeping him snowed is the best anyone can do. Hopefully most of his arrangements have been made already. he may want to talk about things like pets, funeral or memorial service. This argues a good degree of acceptance on his part -- and yours. Of course, see if he has anything he wants you can help him with. Ask what what your and his options may be as soon as possible -- does he want to be at home or go into hospice care right away, and so on. Think the hardest part is always in accepting that death is coming. Try not to deny the approach of it to him, but aim for calm accerptance on both your parts. People are so varied it's impossible to generalize -- and every death is such a personal experience. You can only go so far down the road with a dying person, the process of dying eventually cuts you ioff. Some people need to have a human sounding board they can express fear and anger and so on to -- a dying person needs to say what he needs to say, but there's no telling in advance what that may be. Some require someone they can vent their fears or their angetr=r to. If this happens, don't take it personally, it is part of what some folk need to fo in order to accept death and say goodbye. If this happens it will be even more stressful if you are unprepared for it. You may find you need to give yourself a break from time to time. Acceopt that your own health is going to be affected by his process. And make an appointment now to get a thorough medical workup for yourself say in four months time. and keep the appointment. Wish you both the possible ending to your journey.
• For another book recommendation, if your friend (or you, or his family) self-identifies as Christian I think that Peter Kreeft's Love is Stronger than Death is quite good. He discusses Death as a stranger, an enemy, a friend, and a lover, and the role mortality plays in giving meaning to life. His writing is beautiful, and he manages to get his point across without ramming things down your throat. I think Kreeft is Catholic, so you won't get any fundy stuff here. He's first and foremost a philosopher and an ethicist.
• And, some dying patients need some touch that isn't diagnostic. Depending on his persona, a hug, or massage, or spooning in bed, or whatever may be good. I remember watching a PBS special based on the Kubler Ross research. The most memorable thing was a dying woman who wanted nothing more than a kiss. She was fairly old, and the guy who was helping her go through all that was probably in his 20s. He was kind enough to give her a real kiss.
• My thoughts are with you, Kamus. The Monkeys have great things to say above. The only thing I can add is that you allow him to talk about his coming death. Twice now people have said to me before they died that the one thing that hurts is that their family and friends won't allow them to talk about their illness and death, and to express their fears, anger, or acceptance. Its not fun, but it certainly will bring you closer, and be educational, as well, to simply be there and listen for your friend. And I second the notion of another jam. Even if he can't play, I would think he would enjoy the vibes.
• I'm also very sorry to hear this kamus. I am someone who has unfortunately had a lot of experience with this. Both of my parents died of cancer last year (Dad was 55, Mum 54). My Dad suffered for 6 months, Mum 4 days. You basically just gotta be there for your mate. There may be moments of anger, of despair, of hope and sometimes even laughter. It seems the best thing is just to go with the flow of how they are feeling at the time. If he does go into a hospice then make sure there is enough of his stuff there to make him feel at home. Load up an iPod of all his favourite music. One thing that really made my Dad feel down was that during treatment food tasted strange to him. We all went out of our way to introduce him to a wide range of different things that perhaps he'd never really tried before. He finally found a new bunch of favourites and it lifted his spirits enormously. It takes a lot of strength to go through this with someone - but you will be glad you did no matter how hard it is. It's probably not even in your mind now - but don't forget to take care of yourself. Remember to eat well and get rest. Make sure you have your own support group in place to let off steam with, and when he passes, to help comfort you.
• Thank you everyone. Your responses were all I had hoped for and I'm touched by your generosity of your time and the spirit of kindness that you have shown me, a stranger to you, save for our interactions here on MonkeyFilter. Some random responses to comments: Mike is going into a hospice so I am gratified to hear the positive impression they have made on many of you. He has bone cancer which is reputedly one of the more painful varieties but have been assured by the hospice folk that he can be made comfortable. The idea of assisted suicide frankly never occurred to me but now having been raised, I will have a discussion with Mike and his family along those lines and see how they feel if his situation becomes intolerable. I had read On Death and Dying years ago and was aware that it was one of the seminal books on the subject. When I found out later that she took a wacky turn later in life (arranging encounters with angels etc) I began to doubt her earlier work, so I was gratified to hear some further suggestions. Still, her description of the seven stages seems to have become part of the culture. I'm not exactly sure of Mike's belief system since he doesn't tend to talk about that, but I suspect that he is, like myself, a spiritual person who doesn't subscribe to any organized religion or defined belief system.
• Tell him people in deepest darkest Australia dig his work.
• Wolof, I'm sure that will cheer him up- thanks. BTW, Just so you all know that that upon re-reading my last post I'm conscious of the crappy writing errors that seem obvious now.
• Sorry to hear this. This is an awful thing for the both of you - especially him - to go through, but a true hallmark of a true friend is to stick by him in a time like this. One thing that can help him in this time is to assure him, and make sure that he knows this in his heart, that you will look after those he holds dear. Just so that he knows that you'll be available if one of them needs some sort of important aid. It will give him some reassurance that it's OK for him to leave them, that they will be OK. Most importantly, don't put anything off. Things can go south in a hurry, and you never know when he'll be incommunicado. Could be tomorrow. Could be 5 years from now.
• May I ditto on taking care of yourself as well? It would only hurt him if he saw you exhausting yourself. And whatever you want to say to him, tell him now. I'll always regret that I didn't tell my first boyfriend's mom that I loved her before she passed away (she had stomach cancer, but died from something else). My thoughts go with you both.
• I'll second the hospice contact advice given by patita upthread. Other than that, it's difficult to give much more since we don't know him or his disposition. Dying people are no more a target demographic than teenagers or tall people. For instance: my nephew was diagnosed with cancer just over a year ago and given at best a 30% shot at survival longer than six months. Today he's as healthy as can be (well, relatively) and gives some credit to his friends and family who didn't get horribly maudlin on him or pass him books about 'transitioning' (not that I mock your words, just pointing out he would have hated that). Instead he got lots of hand-drawn and photoshopped black humour mockery zeroing in on dying and cancer and nastily invasive surgeries and other patently un-fun problems. He directed those close to him (throughout his life and after diagnosis) to never mollycoddle or affect cloying concern, and even the more conservative and religious in his sphere have been up to the challenge. A hint at his outlook -- he asked me to help him construct his own tombstone, which he stopped working on after he entered heavy chemotherapy (and was physically too weak to do much) and subsequently seems to have beaten the cancer. That was rather long, but you get the idea, I'd bet. Puzzle out (and ask him) what he wants, and help realise it.
• i'm sorry for you and your friend kamus. jamming, recording, finding out what your friend would like to do - i can't improve on any of these ideas. i would reiterate the point about taking care of yourself (and try to make sure your friend's family take care of themselves).
• It will give him some reassurance that it's OK for him to leave them, that they will be OK. YES! So many seem to hold on in agony worrying about those they leave behind.
• What's most important in a situation like this is the persons attitude. The happiness of he patient has a dramtic effect their health. saddness has been statistically proven to raise the risk of cancer quite dramtically. There have been miracle cases where people have gone into remission through faith and prayer. Keep the person happy and healthy, looking forward to the afterlife.
• Thanks to you all. Your words were both useful and comforting. Just to let you know that Mike passed away early this morning. He went quietly and with humour and dignity up until the end. He will be sorely missed by those of us that loved him and the music world has lost a great artist.
• I'm sorry, kamus. I'm glad that he wasn't alone at the end. .
• i'm sorry for your loss.
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• kamus, I don't have any advice, only empathy. In my experience, the end of every life is as individual as the course of every life. I think just being there is enough.
• Oh, I missed your last post. My sympathies.
• /me puts Mike's record on
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