(Sorry about that headline; I couldn't resist.)
When the medical people say you are now eligible for hospice and for medical aid in dying (MAID), you know the end of your time on Earth is nigh.
Not that I haven't known of that outcome for these past three years, but when those two services are on offer, any wishful thinking one might have indulged in is wiped away.
A large majority of pancreatic cancer patients – nearly 90 percent - die within a year of diagnosis. With the help of my excellent doctors and nurses, the universe granted me two additional years of golden time most of which, if you don't count chemotherapy side effects, was not too much different from life before cancer.
It got to be almost funny sometimes when whatever new health issue turned up, I couldn't figure out if it was cancer, COPD or old age.
So I have no complaints about the place in life where I have now landed. Except this: what I said above about having known the eventual outcome of my disease from the beginning and the implied acceptance in that statement? Maybe not so much.
I suspect I've been fooling myself or, if I had made peace with my death as I thought I had (with a hefty dose of help from psilocybin), it slipped away while I was enjoying those extra years.
My first clue to that was a bit more than two months ago when a variety of body aches began popping up regularly. It was not long before they became a daily routine. Certainly it occurred to me then that the cancer was on the move but I shoved the thought aside and took another ibuprofen.
The second clue turned up several weeks ago when the oncologist told me on a telephone visit that my recent CT scan was “not bad.” He said it in an uncharacteristically flat tone that told me it actually was not good news.
As I had done in the past, I could have read the visit summary doctors post to my online account within a day of our meeting but I skipped it this time and tried not to think about what he said. That wasn't wildly successful and the pain continued too.
On Tuesday this week, I spent an hour on a video visit with the man who has been my palliative care provider for more than a year. I like him enormously. He is the one who told me I am now eligible for hospice and MAID, and we discussed how that will work in general as we move forward together.
In future now, we will meet every two weeks instead of monthly. I feel safe with him.
What I do not feel is at peace. As I look back today at the early days of this journey, I am surprised at what now seems like arrogance in thinking something akin to, “I've got this. I can handle my end of days.”
I've spent some of the time since the Tuesday video visit talking with a handful of friends I am totally comfortable with but trying not to lean on them too hard.
Most strongly, what I feel now is sad. So achingly sad at the thought of leaving. To make it even more poignant, this is a most beautiful spring season here. I could be convinced that that is just because I've become a short timer but what difference does the reason make. I'm still sad.
Could I be at the beginning of working my way through Elisabeth Kubler-Ross's five (or is it seven?) stages of grief? Obviously – see above – I've had time with denial. Some unfocused anger has erupted. Just this week, the effin' ants returned to the bathroom. The whole outdoors isn't enough for them?
It could be that I am too pragmatic to bother with the bargaining stage of grief but who knows. I'd like to skip the depression stage too and go straight to acceptance.
I was so certain I had this end of life stuff under control. It's going to be awhile.