“As a father,” Dr. S. said, “I have no right to ask this of you.” He paused and gently placed his hand on the man's shoulder. “I know it's unnatural.” It really was. Dr. S. was telling a burly, hard working, family-oriented middle-aged man that his beautiful and sprightly 31-year-old daughter was dying and there was absolutely nothing her father could do to help her. The father still could not believe the doctor's grim message. “I don't understand,” he choked, “My mother lived to be 90-something, and my wife's mother, too. There is no cancer in our family. We are healthy. How did this happen to my daughter? Did she eat something? Is it chemicals? What did we do wrong? How could this have been prevented?” It seems the hardest answer in medicine is “I don't know,” but, I must admit, even in the age of nanotechnology, stem cells, and molecular pharmacology, this answer isn't all that uncommon. Yet in this case, a phrase as simple and sincere as “I don't know” brought tremendous peace to a man who was struggling with one of the most unimaginably difficult situations in life: the death of a child. The girl's father found solace in these three simple words; after all, his daughter's untimely yet rapidly approaching death now didn't seem to be so much his fault and there was nothing he could have done differently to prevent it. In a way, the doctor's message freed him of his perceived guilt and shortcomings as a father. With his own burdens now lessened, the father became capable of more fully representing the needs and wishes of his daughter. Begrudgingly, he realized cardiopulmonary resuscitation efforts would be futile. It was time for him to let her go … naturally in this ever so unnatural situation.
Dr. S. walked into the girl's room. She lay there in her hospital bed, struggling with each breath and fighting to stay awake. She was emaciated and looked young for her age. Small masses could be seen amidst the ribs that protruded from her frail frame. Dr. S. later told us the masses were cancer, spreading viciously throughout every fiber of her body. Though exhausted and consumed, she had an air of nobility, composure, and calm to her. The dark shadow of death could be seen in her eyes, juxtaposed with an underlying serenity and sense of acceptance. She labored to whisper, “How is my father? How did he take it?” Though worn-out and hurting, her biggest concern was her father's well-being. She knew her time was limited and it seemed she had come to terms with it; perhaps she was even grateful to be freed from her earthly suffering. I think that's when it hit me: she was ready to go, but she was still fighting not for herself, but for her father; she was fighting for love. This young woman taught me a lesson I hope to hold dear for the rest of my career as a physician: death can be beautiful. As we approach the end, we can sometimes see the very best in people. We see who and what was most important to them, what they valued, and what they held most dear. We see selflessness and love, fortitude and courage, and ultimately, final peace. Dr. S. looked her in the eyes and told her, “He knows.” She closed her eyes and a hint of a smile crept on her face. Now that her father understood, she was ready.
