Thursday, November 22, 2007


A friend once told me the story once of an elderly family member. He was 98 years old, and tho frail, was living at home independently, as healthy as one can expect to be at that age. Unfortunately, he fell and broke his hip. He underwent surgery, and rehab, and was set to be discharged back home when he had a massive PE and died.

Of course, she was saddened, as anyone would have been. But it was her comment, "It's just not fair" that caught my ear.

Obviously, I didn't argue with her. But I can think of little that is more fair than living to a ripe old age independently, healthy, and dying quickly and likely fairly painlessly. We're obviously all going to go, and it sounded like a pretty good ending to me.

I think there is a difference in outlook between people who are exposed to death and disease often, and people who aren't. If you spend your working hours talking to young people with chronic disease, or watching 45 year olds roll in to the ER in asystole, or even just follow a number of geriatric patients as they experience the illness that takes their lives, you take your health less for granted.

"It's not fair" used to pop into my head when I would see a 38 year old women with breast cancer, or hear about a 50 year old who dropped dead of a heart attack.

But when you have a three year old with a metastatic brain tumor, "fair" takes on a whole new perspective. When you see teenagers walking the halls bald, in a mask, with their IV pole and chemo hanging on it, your life starts to look a lot more fair. When you hear the child in the room next door vomiting all night, the fact that your back hurts from sleeping on a crappy fold-out hospital couch fades.

Let us all be more thankful for our health, and less demanding on life to be "fair".


Anonymous said...

Of all the people I've spoken to who have been touched by your family's current challenge, every single one has already realized that they should be more thankful for so many things. Thanks for encouraging so many more to do the same. Dr. Smak, it sounds like you are well on your way to having a Thankful Thanksgiving; I hope it turns out to be a Happy Thanksgiving as well.

Jean said...

Something I do when I feel down about "fair" is to realize someone's situation is always worse than ours.
Thinking of you and your family everyday.

Femail doc said...

Well said, and a sentiment that we can all take to heart this day. Good thoughts to you and yours on the road ahead. Thanks for sharing bits of your journey.


Anonymous said...

Wishing that your lesson on perspective weren't such a terribly terribly hard one.

Love to your sweet boy.

janemarieMD said...

I bet the deceased man himself had a more sensible view; I've been impressed with my old-old patients' common sense about death. They know it's coming and many are accepting of it. Some of them smile at me when I say I'll see them at follow-up, and say "If I'm still around"!

Anonymous said...

Dr. Smak, As I have followed the illness of your son, I have often thought about how blessed my life and my kids' lives are. You are an inspiration....and i know that is not what you ever wanted to be.
take care k3p3

Mike said...

I just discovered your blog this evening. I'm still absorbing it all. I pray that your son makes a miraculous and complete recovery and that life is gentle to him, and to you.

"Fair" is a concept invented by English gentlemen for playing games. It has little or nothing to do with life.

Bad stuff happens to us all, and to some disproportionately or untimely so. I wish I knew the reason for the "unfair" distribution, but I don't.

I try to count my blessings frequently, but I know I don't do so often enough. I know that someday my perspective on all this will change, and I will be able understand it from God's point of view. Till then, all I can do is keep on keeping on.

You are not alone! Hang in there! He still makes miracles.