One of the strongest people I will ever hope to know, my cousin Tim, lost his battle with a rare cancer on Friday. I don’t know how I can even attempt to convey what has transpired in the last few months or even weeks in a blog post. So much has happened and time seemed to move so slow and yet so fast at the same time. I’ll try to write what I can down because even though this was the most painful experience, emotionally for some and physically for Tim, I don’t want to forget the details of what happened and how it felt.
After discovering a tumor in his leg in October, Tim was told that he would need to undergo chemo to shrink the tumor and would then have to have his leg removed. Forever a Giants fan, Tim and his wife, JoAnne, got tickets for a playoff game against the Phillies the night before he was to begin chemo. The Giants won that game, against all odds, and we were all hopeful that Tim could do what his favorite team had just pulled off.
Tim underwent two rounds of chemo at UCSF. Both made him incredibly sick and he ended up in the emergency room several times. Unfortunately, the chemo did not have any effect on the tumor nor prevented it from spreading. After two bouts of chemo, the tumor in his leg had grown and cancer had spread to his lungs. Since this treatment wasn’t working, Tim and JoAnne searched for alternatives or clinical trials that might be more effective. They got an appointment at Virginia G Piper Cancer Center in Scottsdale, Arizona and flew out immediately to meet with the doctors there. Unfortunately, after a day of tests, the doctors determined that he was not a good fit for their trials.
Discouraged but still hopeful, they were referred to a physician at Santa Monica’s Sarcoma Cancer Center. They were told that this was the “top dog” for Tim’s type of cancer. The doctor suggested a different type of chemo. He said it was effective in forty percent of the patients. After checking with the doctors in Arizona and San Francisco, everyone agreed that this was the best option to try. As they were preparing for this new round of chemo, Tim became very sick and had to go to the emergency room in Santa Monica. There was blood in his urine and the doctors feared he might have internal bleeding. They ran some tests and found that it was not internal bleeding. The cancer had spread to his kidney and bladder. Even the doctors and nurses seemed surprised at how fast it was spreading.
After a few days in the hospital, Tim was well enough to begin the new treatment. After he received the chemo, a process which lasted 24 hours, his wife rented an RV to drive him home because between the time they had flown to Santa Monica and began the treatment (a matter of mere days), Tim was no longer able to walk because the tumor in his leg had grown so much and wrapped itself around his bone and muscle.
Once Tim arrived home, he became violently ill again and had to go to the hospital because he couldn’t even keep his much-needed pain medication in his system. The hospital was able to give him stronger medicine for the pain and after about a week, he was able to return home. They were scheduled to go back to Santa Monica for another round of the new chemo in a couple weeks. However, after more tests and horrible sickness and pain, the doctor in Santa Monica and Tim agreed that this wasn’t working.
They had now exhausted all options within western medicine. Tim entered into hospice care via Hope Hospice in Dublin, California. Despite this news, Tim still seemed optimistic. He was grateful that he wouldn’t have to go through the intense agony of the chemo treatments again. They did research and found some cancer survivors whose doctors told them they only had a little while to live, but managed to survive by using alternative treatments. They ate apricot kernels and B-17 vitamins and drank juices that were full of vitamins and vegetables. Tim and his family stuck to these regimens and hoped against all hope for a miracle. For you see, Tim had already received a miracle once in his life.
When Tim was 21, he had been diagnosed with Ewings sarcoma, a usually fatal bone cancer. After 9 months of chemo and radiation, Tim experienced the same agony he was now undergoing. He stopped the chemo treatment and began alternative methods, including eating apricot kernels (illegal in the U.S. because they contain small amounts of cyanide, but can be effective in fighting cancer). Against all odds, Tim was able to beat his diagnosis and was cancer free for 36 years.
This time, though, the cancer was too fierce and had spread too far. As it continued to invade his organs and grow in his leg and spread to the other leg, the pain rose to a level I can’t begin to imagine. Hope Hospice were truly angels and provided Tim with as much medicine as he needed. Unfortunately, in order to reach a pain-free level, Tim wouldn’t be able to socialize with the many people that flooded their home everyday in hopes of telling this great man what a tremendous impact he had on their lives. So Tim chose to spend most of the day in pain so he could say the things he wanted to say to his loved ones and friends and could let them say what they needed to say to him.
Although the combinations of medication required to manage his pain were nothing short of shocking, I never once heard him complain of pain to anyone. He was so so strong, and yet apologized to his wife more than once for “being such a coward.” Those words out of his mouth bring tears to my eyes because he was the furthest thing from it. In the last few weeks, he was unable to walk on his own and the cancer had spread to the point that he was unable to even go to the bathroom because the tumor had moved to his rectum. Somehow managing to see humor even in this moment, when told of this by his hospice nurse, he responded, “So I’m full of shit?” His wife chuckled between tears and said, “Literally and figuratively.”
His nephews, who loved him like the father they never had, took turns coming to visit from Salt Lake City. Each with different strengths and personalities, somehow the right nephew for the time came just when they needed them. When Tim was still lucid and talkative most of the time, Bobby, the personable, caring, and sensitive nephew came. He made the juices for Tim, chatted with him about anything and everything, and helped JoAnne get the information she would need in the coming weeks and months. When Bobby had to go home, Tommy, the big, strong, pragmatic nephew came. At this point, Tim’s lucid moments were less frequent due to the required pain medication, and he was unable to move on his own. Tommy had to hold him up to carry him to the bathroom and place him on the bed. Although Tim had lost a lot of weight, he had always been in good shape and was a muscular guy. With this physique, Tommy was the only one who could physically hold him up and get him where he needed to be.
Tim had a particularly bad day one day, and JoAnne and Jon (their son, 20 years old) thought they were going to lose him then. They sat on the bed with him and said tearful goodbyes as Tim lay sleeping, taking unusually long pauses between each breath. Suddenly, Tim opened his eyes and said, “Can I have a popsicle?” I can only imagine how it would feel to think you’ve lost someone only to have them suddenly open their eyes and say something to you, even if those words were simply asking for a popsicle.
We came to visit on another bad day when Tim was clearly in intense pain. We took turns sitting with him and telling him how much he meant to us and the huge impact he had had on our lives. He went back and forth between being lucid and resting during this time, but always wanted to hold someone’s hand. As I sat with him, I decided to put on a DVD of a Giants game from the World Series (for those who know Tim, even just listening to baseball is about the best thing in the world to him). As soon as the game DVD started to play and he heard the familiar sounds of the Giants announcers, Tim opened his eyes, sat up with a look of unforgettable happiness and amazement, and said, “There’s a game on?!” It had instantly changed his mood and for a few moments he forgot about the pain and started asking, “Is that Timmy pitching?” Everyone has something that brings a feeling of comfort, and listening to the Giants play baseball was always that thing for Tim. I guess it reminded him of his childhood, his parents, and a simpler time in life. Of all the days we visited him in the last few weeks, there was only one day that he wasn’t wearing a Giants shirt. And that was only because they were all in the wash.
Tim’s cousin, Scott, came to visit from Alaska last Saturday. It was a particularly bad and painful day for Tim, but he asked the hospice nurses if they could help him make it through Super Bowl Sunday (the very next day) because many of his best friends and family were planning to come spend that day with him to watch the game. The hospice nurses were worried he might go Saturday evening, but Tim is a tough man and hung in there and was awake and holding court on Super Bowl Sunday. The guys hung out with him in the living room as Tim reclined in a big comfy chair one of them had brought for him. When Tim needed to be moved to his bedroom, he wanted to make sure the guys came and watched the game with him in there. He even snacked on some buffalo wings.
On Tuesday, we came back over to see Tim. He was having a much better day and I began to feel optimistic that maybe the natural medicine was kicking in. My dad, husband, and I sat and watched a Giants DVD with him and the guys talked baseball together. Tim looked happy and at ease and was making suggestions for what the team needed to do to make it to the Series again and sighing in disappointment about losing Uribe to the Dodgers.
Only two days later, my mom received a text from JoAnne that said only, “The end is near.” We told her we’d be right over and got in the car. The difference in Tim in those two days was like night and day. Tim’s kidney had failed on Wednesday night and the pain became unbearable. He told JoAnne and the hospice nurse he could no longer stand the pain. JoAnne and their son, Jon, sat with him and said their goodbyes. The hospice nurse increased the dosage of pain medication so he would be completely pain free in his final days. This also meant that he was asleep and could no longer talk with friends and family. He was also unable to swallow, so we gave him pain medication as needed by suppository.
The hospice nurse did everything she could to make him as relaxed, comfortable and pain free as possible. When she left for the evening, she said she thought he would go that night. However, Tim hung in there through the night and was still breathing on Friday morning. JoAnne sat with him most of the day. At one point, Tim stopped breathing. JoAnne sobbed deep, painful sobs for her husband whom she had loved for 26 years. Suddenly, Tim started breathing again. It was as though he had heard her and came back because he couldn’t bear to leave her. A few hours later, while JoAnne sat with Tim and a friend of theirs that came to visit, Tim again stopped breathing. The friend, a doctor, was unable to feel his pulse. JoAnne softly whispered, “It’s ok to go, love.” Just as she said those words, Tim began breathing again (the doctor in the room nearly fell on the floor from shock).
JoAnne was amazed by these moments, but also felt a tinge of guilt because she knew he was hanging on, despite the pain, because he didn’t want to leave her.
A few hours later, the hospice nurse came by to give him more pain medication. She asked JoAnne if she would like to have his wedding ring. She said she definitely would. Although he had lost a great deal of weight, the ring was difficult to remove because he had never taken it off in their 26 years of marriage. The hospice nurse twisted it around and got it to the tip of his finger. She let JoAnne take it off. Just as the ring came off his finger, Tim took his last breath.
Here is the website a neighbor made for Tim during the process: http://thebrians.wordpress.com/
After Tim passed, I sat and talked to his son, Jon. Jon is very shy and private, so I was never sure how he was handling everything. He had had a couple seizures in the past month, so many people thought he was internalizing everything and that was how his feelings were coming out.
But as I sat with Jon, he said, “I guess I deal with things differently. It’s not about physically being here. It’s the impact he made on people’s lives. And that’s not going anywhere.”