Two Americas, Both Get Sick
Democratic Presidential candidate John Edwards of North Carolina likes to wax poetic about the travesty of two Americas, one of the "haves" and the other of the "have nots." Edwards himself grew up in modest circumstances but has moved on up into the realm of the "haves." Tragically, he is learning that there are some things money can’t buy.
Elizabeth and John Edwards on Thursday described her cancer recurrence as a chronic condition that she’ll have the rest of her life.
How long that will be, her doctor said, is unknowable.
[ . . . ]
On Thursday, her doctor, Lisa Carey of the University of North Carolina Medical Center, described Edwards’ condition as Stage 4 metastatic breast cancer, meaning the cancer has spread beyond her breast and lymph nodes. In addition to the spot on her rib, there may be other areas of cancer, the doctor said. She specifically mentioned "very small" abnormalities in the lung that are "too small to say what’s going on there."
The doctor said Elizabeth Edwards’ treatment hadn’t been determined, pending more test results. It could include hormone therapy or chemotherapy. Stage 4 breast cancer is considered a systemic disease, meaning it is no longer contained in one area but is throughout the body. Surgery isn’t usually considered effective because it will remove cancer cells only from one area, but the cancer is more likely located in other places.
In a fashion typical of a politician, Sen. and Mrs. Edwards are talking about optimism and a good prognosis and the cancer being "treatable." Unfortunately, treatability doesn’t mean the treatment will be effective in preventing a premature death. According to an article published at Medscape.com:
Although seldom curable, advanced breast cancer is a highly treatable disease. Palliation or prevention of symptoms is the primary goal of treatment. The median survival after diagnosis of metastatic disease is about 2 years, although the range is great. Longitudinal studies have documented a few long-term survivors, most of whom were patients with indolent disease. Several recent clinical trials have documented small improvements in survival with some of the newer therapies.
Still, Mrs. Edwards has reason to believe that the time she does have left will be of good quality. I had a friend who many years ago was diagnosed with bilateral metastatic breast cancer and then lived for almost nine more years. She was still only 41 when she died, but she had those nine more years with her family, nine more years to raise her children, nine more years to do the things she felt were important to do. She had a chance many of us won’t have: to prepare for our own deaths and to make sure our families will be taken care of after we’re gone. In one sense, she was lucky for that opportunity. I suspect Elizabeth Edwards may take similar advantage of her opportunity, whether she has a few months or many more years left. But I digress.
What I said to some friends today is that despite the advantages that money can bring in terms of access to cutting-edge medical treatment, there are some conditions that remain stubbornly blind to class, wealth, race, and other factors that still matter in our society despite our best efforts. Sorrow and suffering know no socio-economic bounds. As motivational speak Rita Davenport once said (and I’m paraphrasing from memory), "How much of her family’s wealth do you think Rose Kennedy would give to get her dead children back? I’m guessing all of it."
At least for now, Sen. Edwards is saying he will continue his campaign. You can’t blame him and his wife for wanting life to go on as normally as possible, though I’m sure some people find his decision callous. They should remember that like death itself, the prospect of it is something different people handle in very different ways. It’s best not to criticize, especially if you’ve never walked that path.
On the other side of the socio-economic divide, my uncle died yesterday morning of emphysema and chronic lung infection. He was the youngest sibling on my father’s side, and also my godfather. A Vietnam-era Air Force veteran, he lived his last years at the Connecticut Veterans’ Home and died at their hospital facility after very compassionate Hospice care. His daughter, grandson, brother (my father), and sister were with him when he died; others of us had taken turns visiting over the last week. He didn’t have a lot of money and didn’t need it in order to have a dignified death surrounded by those who loved him.