Chapter 9

Boredom is the price you pay, for staying out of trouble.

Waking up the next day brought about memories of waking up the morning after drinking with Patricia. His head hurt, his body hurt, and if he had hair on top of his head he was sure that would hurt too. But none of that didn't mattered, he had to get up and go to dialysis.

They arrived for dialysis only to be told that he was to go to Internal Medicine and get a CAT scan before dialysis as the Oncologist and Dr. Sawyer wanted to see the progress that chemo was having on the cancer. So, off he went for a CAT scan followed by dialysis in which he got another hour of sleep.

When they got home that evening his mom informed him that they had an appointment tomorrow afternoon with Dr. Sawyer to review the results of the CAT scan.

Tuesday afternoon his parents were with him in Dr. Sawyer's office waiting for the results, hoping the news was good. But when Dr. Sawyer came in the office Patrick knew by the stern look on her face that the news wouldn't be good.

After the pleasantries Dr. Sawyer started off, "I have reviewed the results with Oncology and the cancer has spread further."

At this point Patrick zoned out. What need was there to hear more? He sat back in his chair and tried to think of what he was going to do, but his mind couldn't focus. No matter what he thought of his mind would veer off into some random direction. He shook his head trying to get things right but it was of no consequence.

He heard his dad say "Patrick? You with us?"

He looked to his dad, his face saying it all, he was stunned, hurting, and angry. He looked to his mom to find her face in her hands crying. Finally he looked to Dr. Sawyer, the face that conveyed strength and determination had softened to the point that she no looked as a doctor but as a parent, a mother, who wanted to take a sick child in her arms and make it all better. But that was not to be, and it showed in her eyes.

"Yeah Dad, I'm here. I spaced out there, but I'm back. So, I got the cancer hasn't stopped. What else was there?"

He felt his dad's hand on his shoulder as he said, "Dr. Sawyer says that, that further chemo treatments are not needed."

He looked to Dr. Sawyer and asked, "So, that's it then?"

"I am afraid so. The cancer's resistance to the current level of chemo treatments, makes increasing the levels fatal. There are other treatments but due to how quickly the cancer has progressed it would not be advisable to move to another."

He looked Dr. Sawyer in the eye and asked, "So the plan is, what?"

"Treat the effects of the cancer, not the cancer."

So that was it. Lost to cancer. His mom broke down crying, which was to be expected, while his dad put an arm around her as he asked Patrick if he was okay. With a nod his dad asked a few more questions of Dr. Sawyer, which Patrick tuned out, until his mom composed herself, allowing her to ask more questions.

Questions. All worthless. What does it matter? They knew what was going to happen! Asking more questions is like trying to describe another color of blue, what the fuck does it matter, it's blue! Does it really matter if it's a shade lighter or darker?

Patrick shook his head and stood up saying, "Thanks Doc. If you don't mind I'm going to go to the bathroom and wait for you in the reception area" and quickly walked out without waiting for their response.

As he walked to the bathroom he felt good, which he thought was odd given that the news he got was that he was going to die. But for a long time he kind of knew this was going to happen. Surviving cancer was, at the time, a miracle as the doctors didn't give him a more than forty percent chance to live. Not great odds, but it was something that he could hold onto during chemo, the effects of chemo, and the lengthy stays in the hospital away from his family.

But it all caught up with him and now it was time to pay the price. Shit, nothing is free, there's a cost for everything, and sometimes it costs more on the way out than what anyone would have thought.

The ride home was worse than when they found out he had cancer the last time. His mom sobbed on the way home, his dad was quiet, the only sounds were the that of the tires on the ground and the hum of the engine. What was there to say? What was there to talk about? Nothing.

They got home and when they walked in the door nothing needed to be said, Patricia and Valerie knew it was bad. And when mom walked past them crying into their bedroom followed quickly by dad, they also realized how bad it was. Patricia fell back onto the couch as her eyes became wet with tears. Valerie ran up to him and threw her arms around him hugging him tightly as she sobbed onto his shoulder.

After a couple of minutes Valerie released him from her hug and asked what happened. He sat down on the couch next to Patricia and pulled down Valerie to sit on the other side of him and told them the news they feared the most. They asked questions about treatments, second opinions, next steps, and as he answered he could see their hopes diminishing as his had. When they were done he hugged them each and went back to his room and lay down.

He was exhausted, both physically and mentally. He had suspected that something wasn't right when he went for the CAT Scan. There was just something about the technician, the way they informed him that he needed to get another CAT Scan, and the looks he got all day.

With everything that had happened to him, getting the worst news he had ever gotten had not seemed to have really hit him. Maybe it could have been him quitting and accepting his fate earlier. It didn't seem to matter at this point. His life was coming to an end and he wasn't upset about it.

The next few days were difficult for everyone. Coming to terms with his impending death was manifesting in different ways for each member of his family. His mom was literally breaking down and crying when she saw him. Whenever Patricia saw him she would ask if there was anything that he needed, trying to make his life easier. His dad was caring and attentive, which was way out of the norm. And Valerie struggled to maintain a normal appearance, and she was successful for the most part, more so than anyone else.

On Wednesday he went to dialysis, and as he sat waiting for it to be completed had a lot of time to think about what he was going to do with whatever amount of time he had left. For one thing he knew that he didn't want to stay hooked up to this damn machine three days a week, so first thing he had to do was talk to Dr. Sawyer! And when he talked with her he would find out what his medical options are, what were the effects of the cancer as it spread and what were the effects on him WHEN he stopped going to dialysis. His biggest cause of concern, so far, was would he be unable to care for himself, having to rely on his family to feed, bathe, and clean up after him.

More than dying, he feared this the most. The act of passing on happens to everyone, but how you pass on to him was more significant given that it was imminent, and the loss of his dignity as he got closer to death was something that he would truly hate. The last memories that his family should have of him should not be of wiping his behind. Heck, they shouldn't even have to watch him die! But people in hell want ice water, doesn't mean that they'll get it.

The last thing that came to him was how would his family deal with his decision? He didn't see Valerie or Patricia as being a problem, though Patricia could be the wild card in this. He could see his dad going along with his decision, even if he disagreed with it. His mom was another story, she would want him around as long as possible, holding on to the faintest of hope that he could be saved even when everything pointed to the opposite.

The next morning he asked Patricia to take him to see Dr. Sawyer. She knew something was up, Patrick never went to see Dr. Sawyer without his parents, but she didn't say anything. The doctor's office wasn't crowded, there were only two people in the waiting room, and when he was let into her office after only a ten minute wait, he counted himself fortunate that Dr. Sawyer was able to see him on short notice.

He waited for only a few minutes when Dr. Sawyer walked and without looking asked, "So how is the Bailey family doing today?"

"Uhm, well it's only me today, but I'm doing fine."

She looked up in surprise as she walked behind her desk, and as she sat down said, "Well this is different, what can I do for you Patrick?"

"So, with the news that my cancer is not going to go away, I was wondering if continuing with dialysis would be the best thing for me."

Dr. Sawyer stared at him for a moment before asking, "Are you sure that is something that you would want to explore?"

"Yeah."

"And what did your parents say about stopping?"

"I think you know the answer to that."

"I don't think that it's right to talk to you without your parents here."

"Come on Doc, you know my parents, do you actually think that WE can talk about this with them here? I'm not asking to stop dialysis, though that's what I want to do. What I am doing is trying to get information on what happens if I stop."

"I can get into trouble by talking to you without your parents present Patrick. It might seem like a little thing to you to ask me medical questions, but without a parent or guardian I could get into trouble and lose my license."

All of the frustration that he held deep inside himself over the last few months came out in a rush as he slammed his hand on her desk and said, "Dammit Doc, I'm dying and all I want to know is what's the best way to die with whatever dignity that I have left. It's not like I'm asking you to write a note getting me out of dialysis, all I am asking for is information."

"Okay. Okay. What to expect. Well, when stopping dialysis, you would experience a loss of appetite and fluid overload, which is not in itself painful. You would begin sleeping more and more, sleeping most of the day, and when you were awake you would be restless. Your mind would start having difficulties, seeing people who don't exist, disorientation, confusion, and failure to recognize familiar faces. Noticeable changes in breathing would become more pronounced, as your body begins to store more fluids you would become more heavily congested, as well as changes in color and skin temperature. From what you've said in the past, the parts that you would not like would be nausea, vomiting, headaches, and seizures."

He was about to ask a question when she continued, "Any pain that you would experience can be controlled with medication, and some people experience anxiety issues or become agitated as the body begins to fail, these too can be controlled with medication."

"Eventually, your body will shut down, you'll slip into unconsciousness, and finally your heart will stop beating. It has been reported that most people who pass away from kidney failure have what can be described as a good death. There have been studies which reported that patients who discontinued dialysis described a good death as pain-free, peaceful and brief, which was also was echoed by people around the person."

"Well, that's good to hear, the no pain part. And a good death all around. And that's all there is?"

"Yes."

"It's good that my family won't have to see me in much discomfort as well. So, that leads me to my next question, how long it would take to, die, from kidney failure?"

Dr. Sawyer remained silent as she sat back in her chair, something she never did when she knew the answer. But when the look on her face changed from that of a professional doctor to something else, something he never saw in her before, Patrick felt a change in their relationship had occurred, as how she saw him. In the blink of an eye, Dr. Sawyer had changed from doctor, his doctor, a doctor who had in all his visits been calm and cool in her answers or warm and friendly when just talking, to a friend, a confidant even, which made him feel more at ease with what lay before him.