Dying With Courage

While the country watched Terri Schiavo, I watched my husband. He was in a hospital bed in our living room battling the ravages of kidney cancer that had spread to his bones and his brain. As I wrote about and commented on the Schiavo situation, I kept quiet about the end of life process I was overseeing in our home for the person I have been closest to for more than 20 years.

Tom died on Wednesday, just a day before Terri Schiavo passed away, and this is my tribute to him, and to the struggle about how and when to end life that many of us face. What Tom called "the endgame" began when we visited the oncologist's office together shortly after Thanksgiving last year. The doctor presented the choice before us in such positive terms that Tom at first thought it was good news. It was only when he saw me crying that he realized the recommendation to take a break from chemotherapy and regain his strength in the healing community of a home hospice was not another stop on the road to recovery.

Hospice means end-of-life care. The admission ticket is a diagnosis from a doctor that you have six months or less to live. Tom had been fighting cancer since June of '99 when a nurse called to say that tests had revealed a mass on his kidney. "I'd rather use the word nodule," Tom replied with his signature sense of humor. A year later tests showed the cancer had spread to his lungs, a diagnosis that would flatten many people. He reacted like a journalist who had just been handed a new assignment. He researched his disease, plugging in "lung metastases" and "prognosis" on Google. When the search results were gloomy, he would find a philosophical way to dismiss the statistics. He tracked down the latest clinical trials and submitted to treatment regimens that left him so feverish he had to be wrapped in ice.

Sprinkled among the political columns he wrote for the Cleveland Plain Dealer were updates on his medical condition. There was never any self-pity or whining in his reflections. He compared a stage 4 cancer diagnosis with being on the 90th floor of one of the towers of the World Trade Center. "You don't know whether you can make it out, but you're sure going to try." A sports reporter at heart, he said his battle with metastatic kidney cancer had him playing "prevent defense" like his beloved Cleveland Browns. He ended the column asking readers to join him in a chorus of "DEEE-FENSE."

This was a man who earlier in our marriage had trouble handling a sinus infection. Yet he was able to confront serious illness with a clarity of mind and spirit that made him an inspiration to others. When the disease spread to his brain 18 months ago, he welcomed the invitation to appear on "The Diane Rehm Show" on public radio and answer questions from Diane, who is a friend, and her listeners, about what we were going through as a couple. I was reluctant at first, but Tom convinced me that our story could help others. He was right. So many people have mentioned hearing us and gaining strength and courage from Tom's unflinching responses. He was never Pollyannaish. He knew the cancer would win in the end. He never indulged in any "why me" recriminations.

He set such a grand example in how to face death and dying that I could do no less. I had to muster the courage to end the journey with him. Once we enrolled in a hospice, the goal was no longer prolonging Tom's life but helping him to die without pain and with the dignity that he deserved. If you think of life and death on a continuum, finding the point where it tips is complicated. It cuts across all political lines and gets to the root of our humanity. It requires faith informed by years of intimacy that you're doing what's right for your loved one. I told Tom that I was really getting into being his caregiver. "Watch out," he said with a twinkle. "I hear they're recruiting from the ranks."

Tom Brazaitis was a wordsmith. The Plain Dealer's obituary called him "a provocative and elegant writer." His illness in its final weeks largely robbed him of his ability to speak, but there were still times where he could make his wishes known with the same force he once had. One morning when I was lining up the array of controlled substances to give him for pain, I remarked to the hospice caregiver that I figured I should just give him everything that's available. "Yes, please," he said loud and clear. On a Sunday morning in March as his condition worsened and the morphine dose was doubled, he asked me clearly, "What do you want to do this summer?" I said, "Take a trip with you," and then I went into the kitchen to fix his cream of rice cereal, and fight back tears.