From the street, this silvery monument of glass shines with the limitless promise of modern medicine, gleaming even on a sunless day in late winter. But for a man sitting on a colorless chair in a colorless room on the seventh floor of the Massachusetts General Hospital building, it feels as if the world is shrinking. It has been eight years since Paul White discovered he had kidney cancer, and since then, the disease has taken up permanent residence in his body, moving from his kidney to his spine, hip, left arm, lungs, and skull. As his disease has advanced, there’s always been another new drug that has managed to slow down the cancer, even when a cure became impossible.
A better kind of care
At Mass. General, and a growing list of hospitals nationwide, teams trained in palliative medicine are changing the way patients and their families live with serious illness – and cope with its toughest decisions.
Now, however, White has started coughing up blood, a potentially fatal side effect of the most recent chemotherapy. White didn’t tell anyone about the blood at first, but when he did, his oncologist stopped the chemo. On this drab afternoon in March, White has driven with his two adult daughters into Boston to see another of his caregivers, Dr. Vicki Jackson, director of MGH’s palliative care unit. Her job is to help him feel as well as possible, even as he fights his disease, and she asks about his pain, his breathing, his medicine. But she also guides him through the complicated, emotional terrain of advanced cancer – an area not often emphasized in traditional medicine – and the possibility that no other chemotherapy could help him.
“If it isn’t an option for you, how do you think that would be for you?” Jackson asks him.
Jackson has rolled her black metal chair toward White, who, at 61, has a light gray goatee and thinning hair still stubbornly dark. His daughters, Laurie Alexander and Wendy Willis, sit beside him taking notes about his symptoms and medications. In the tiny, windowless room, Jackson’s knees are nearly touching White’s.
“Well, I’d have to think about that,” White says slowly. “I know what that means. I think it means that I’m running blind again.”
“You mean in terms of not having medicine to treat this cancer?” Jackson asks.
“Yeah. I’ve done so well over the years with the types of chemo they’ve had,” White says. “I was always hopeful that while I was on one, they’d come up with another one.”
“I know,” Jackson says sympathetically. “I know.”
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