Hospice, Palliative Care and Death – Why is it so tough to accept?

Sky and Clouds

A few weeks ago, I received word from a very good friend, whom I have known for nearly 30 years that she was dying of cancer.  The doctors believed it started in her ovaries and then spread to other parts of her body.  She wanted to let her close friends know and that she had made the decision to not to seek curative treatments but would seek hospice and palliative care eventually.  After I allowed myself to get over the initial shock of this news, I found myself wanting to conduct research and to suggest ways for her to beat her cancer.  I had discussions with other friends who were kind and supportive and suggested many sites and treatment regimens that I could pass along.  However, after a time, I began to think about her personal journey.  You see, she’s a nurse who has been involved in the long term care industry for many years, so she is certainly not shy on healthcare expertise.  Also, she cared for her husband for four years while he battled cancer himself and witnessed first hand the toll it took on him.

After a bit of introspection, I began to realize that my desire to “fix it” ignored my dear friend’s wish to spend the remainder of her life in peace and comfort.  I felt a bit of guilt and anger towards myself for my selfish and insensitive thinking.  I had hesitated calling her for fear of talking about her prognosis, her impending death and her decision to forgo curative treatment.  Perhaps it wasn’t any epiphany, but I soon recognized the best thing that I could do as her friend was to fully support her choice.

I picked up the phone, dialed her number and was surprised to hear her familiar voice.  It had been a number of years since we talked-our communication had been primarily been through Christmas cards and occasional e-mails.  However, we had a fantastic conversation; it was as if all those years apart never existed.  We were able to talk frankly about her decision to accept her impending death and all the preparations that she was making so that her children could better cope with her absence.  I had to laugh (and also admire) the extent of her detailed preparation-it mirrored her approach to her professional life. I expressed to her my initial selfish desire to see her attempt to extend her life.  But, I then related how my thinking morphed into an understanding of her decision and my staunch support of it.  She expressed her frustration that she still had several friends that would not accept her choice and were still foisting their remedies upon her.  I hope they will all come around soon.

When I hung up the phone after nearly two hours of long distance conversation, I strangely felt great comfort and satisfaction.  I think of her every day and I must admit, there is a bit of sadness with the knowledge that one day, I will not be able to hear her voice or read her cards.

As a young man starting out in health care over 30 years ago, I never fully grasped how death and dying might impact me.  Every young person thinks they’re immortal and I was no different.  But now, as I have reached middle age, my life has been touched several times with close friends who have died.  How we face death is as much a part of life as how we choose to live.  I would like to encourage all of you who read this blog to watch a very special presentation produced by PBS and their “Frontline” series entitled “Facing Death”.  It will be aired on November 23rd-please check your listings for the time in your area.

While her choice may not be for everyone, I applaud my friend’s desire to seek hospice and palliative care.  It was a courageous decision and informed one too.  I am happy for her that she is at peace with it and I really hope that all of her friends and family can find it in their hearts to be at peace with it also.  I have chosen to spend our remaining days together supporting her choice and enjoying our friendship.



I posted the above blog about my friend who was battling cancer and her courageous choice to seek hospice and palliative care.  Not long after I posted this, I received word that she had passed away.  It’s not easy hearing the news that I knew would be coming, no matter how much you prepare.  I went out for a walk, said a little prayer and felt great sadness for the loss of my friend.

When you need proven expertise and performance

Craig Fukushima, NHA, MBA

Mr. Craig T. Fukushima’s health care experience spans more than 35 years with special expertise in the long term care sector, including implementation of innovative health care projects in domestic and international locations.

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6 thoughts on “Hospice, Palliative Care and Death – Why is it so tough to accept?

  1. Courageous blog post, Craig – just as your friend has made a courageous decision. This is a topic that a lot of people don’t want to write about – a difficult issue that somehow gets mixed up in sports analogies and our success culture. We “battle” cancer to the “final out.” We’re going to “win” against the deadly disease no matter what. Also, we must take a positive attitude, rather than a realistic one. Maybe we’ve heard too many motivational speeches and watched too many Rocky movies.

    Not sure I’d have the guts that your friend is showing, but I know it’s just as courageous a decision as those who “battle” and those who “must win.”

    1. Michael, thanks so much for your supportive comments. Unfortunately, in the past five years, I’ve watched three very close friends handle their impending deaths in a variety of ways. I’m with you-at present, I don’t think I have the courage that my friend possesses but I am happy that she has found peace with her decision.

      Once again thanks for your thoughts.

  2. Hello Craig,

    Thank you for this powerful blog post and perspective. Your story will connect with many people. Sharing our stories, our emotions and our perspectives regarding end of life has powerful impacts. We are going to share your post with our facebook group and our twitter followers. We would also encourage you to share your experience with our visitors on Canadian Virtual Hospice under “Your Stories”. This section of our website allows visitors a place to share their experiences and find meaning and connection with others’ stories.

    Thank you for sharing.
    The Canadian Virtual Hospice Team

    1. Tricia, thank you for your note and for passing along the blog via Twitter and Facebook. For me, the blog has been a catharsis of sorts and has allowed me to express my feelings. As you know, it’s one thing to talk about death and dying as a healthcare professional and a completely other experience when you experience it personally.

      Thanks once again for your support and keep up the great work you and your organization are doing on behalf of patients and families everywhere!

  3. Thank you, Craig, lovely story. I vote for your friend’s choice and that’s the beauty of living where we live or having the personal freedom that we do.. to choose. I know it is extremely difficult to let go of dear friends and loved ones.. I too want to hold on to them – but in the end – we all walk that path.

    Thank you,
    Carol Marak

    1. Carol-thank you for your supportive comments. Writing this blog is a bit of therapy for me and helps me to accept my friend’s choice. You are so correct that we all will walk this path eventually and I am so glad that we have an environment that allows us to choose our path. I think of my friend daily and celebrate the wonderful memories we have together. At the end of the day, I applaud her courage and her choice-in doing so, she has embraced life much more deeply than many others in her position.