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September 19, 2007


The post below was written by my nephew Cody Clinton, a second year medical student. The "grandmother" he writes about is my mother who, for the last twenty plus years has bravely battled the horrors of Parkinsons and the side effects of the medicines which slow but don't stop its progression.



What does this word mean to you? Is it about living healthy, exercising, and studying hard? Most medical students would probably agree. Could it be a state of mind; a belief system affirming you will not accept what others tell you will inevitably occur? For a lot of cancer survivors, this may have been a mantra that kept them alive. But could it be the exact opposite? Could it be accepting what others tell you about your road ahead, even when you know it scares the hell out of you? Ask a terminally ill patient. My guess is that they relate better to this last admission, are prepared to end their life, and may even feel more at peace about their situation than you do. For a family member, this is a tough pill to swallow.

So, what is the true meaning of livestrong? This was a question I asked myself over the last few weeks. I experienced all of these different scenarios above, albeit some vicariously, and still struggled with the answer. The problem being, that each group of people was absolutely committed to their own ideals. They were convinced that they were right and were not about to change their minds, in spite of the best advice of those around them. Never had I seen more determined individuals in all of my life. Unfortunately, it took 24 years to see it. Fortunately, it took getting my head out of the books and grasping the opportunity to experience real medicine for the first time since I entered medical school.

It all began on August 26th, when students at our college provided medical support for bike riders taking part in a 100 mile Livestrong Challenge. First, let me preface by saying that a 100-mile bike race in extremely hot conditions, on a hilly course is not easy. It is a grueling test of your endurance, muscle strength, and mental composure. In short, it is downright masochistic. I do not recommend it. Yet these riders were out in full force. The riders were largely composed of cancer survivors, as well as family members, friends, and loved ones of cancer victims. There was even one female rider who flew in from Chicago and completed the entire course while in the middle of a chemotherapy regimen! It was absolutely jaw dropping. A member of our medical team, who had recently battled Non-Hodgkin’s lymphoma, described this rider as “ needing to finish the race, in order to keep her mind off the reality and gravity of her own situation.” By the way, this medical student waited at the finish line, even while the race was over, and made sure that her newly found friend made it to the end.

Over the course of the day, we witnessed riders speeding down flats and attacking hills, completely by themselves. Yet, you could feel that deep down they were back on the pavement with their old friends or loved ones, rehashing past experiences. It is a very difficult scenario to have to imagine and an extremely sobering sight to see. It meant much more that simply finishing a long bike ride, instead signifying a step closer to maybe finding some closure to a situation that they were not ready to face. You could see in all of the riders’ faces that living strong was much more than just a physical challenge, but an emotional challenge one as well.

The next unexpected development occurred shortly thereafter, on a morning when the only decision I was planning on making was whether I wanted hazelnut or regular coffee to get me through the morning. I received a call from my family notifying me that my grandmother was in septic shock and might not make it through the day. I immediately rushed up to the hospital where she was being treated, not knowing whether I would be staring at a blank corpse or my last remaining grandparent. Thankfully, she was still alive, was being stabilized, and had a good prognosis. Yet, even stable, she was suffering from Parkinson’s disease, congestive heart failure, a collapsed lung, immobility, and blindness. I wanted to do everything in my power to get her better as quick as possible and back into her home where we could take care of her. But this was not what she wanted. What she desired, and had told my mother repeatedly, was not to be resurrected every time she fell ill, but rather left to let “nature take its course” and die in her own home. I wasn’t ready to hear this kind of news. After some tough reflective time, it soon became clear that the choice my grandmother had made was completely justified because it was what she wanted, not what the people around her felt was best.

Witnessing these difficult decisions gets me thinking about what the term livestrong means for patients that are nearing the end of their lives. For them, living strong is about being confident in their choice to die. Terminally ill patients, unlike the riders and cancer patients, do not find strength from rage or unresolved opportunities. They take solace knowing that they have fought hard, and hopefully will find a place that rids them of their suffering and rewards them for their sacrifices. For them, livestrong is about resolution.

The truth is, as I am sure you know, is that the meaning of this word conjures a different ideology for each person and likely will vary throughout his or her life.  Gratefully, we are all distinct. Yet, we all share a similar passion. Health professionals, cancer survivors, and hospice patients alike, we all want to be content with our actions and decisions throughout our lives. It doesn’t matter if these decisions might not be the most sensible, or if we are going “against the norm”. As long as in the end, we have weighed all our options and trusted our own instincts, can we can go to sleep soundly. Only then, will the word livestrong hold meaning.

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