Oliver Sacks, eminent physician and best-selling author, has opted for an advanced treatment, known as “hepatic artery embolization,” to deal with the liver cancer that has stricken him at age 81.
Writing in the New York Review of Books, Sacks describes the side effects that ensued from this treatment with eye-opening clarity. “I felt awful,” he reports, “If I had to feel like this from now on, I kept thinking, I would sooner be dead.”
Yet, after ten days Sacks suddenly began to feel well again. Indeed, at time of writing, he was experiencing feelings of exuberance and gratitude, even though he knew the time for this would be brief. His hope was only that “I may feel really well for three or four months …”
Seniors trying to develop a practical and realistic approach to the end of life face an almost insoluble conundrum. Like Dr. Gawande, we are concerned about the excessive, expensive, painful and uncertain treatments modern medicine can push us toward — treatments that can deprive us of a death with dignity. On the other hand, which of us would not opt for a treatment that could make us feel really well again, and give us a few more months of life? And how can we possibly know whether a particular treatment is worth trying?
There is no certain answer to this last question, but we can try to keep ourselves informed and learn from the experiences of others. Long before we become ill, we can try to find a primary care physician we trust for honest answers. We can talk with family and closest friends about our end of life wishes, and look to them for counsel and support when the time comes. Then we can only hope that like Dr. Sacks, we will make the right decision for ourselves.