Category Archives: Lincoln

Lincoln and Children on Remembering the Dead

Evening of Remembrance, City of Hope, March 28, 2018

(Gently edited talk delivered to the loved ones whose family members have died from cancer in the last year.)

Introduction

I’m here tonight, while officially on vacation — which may seem at first glance to be an odd way to spend my time away from work. Instead, I see it as absolutely appropriate to spend it with you, members of our City of Hope family. Like you, I have lost close members of my own family to cancer, including one just this past year, so I’d like spend a few moments of my life sharing my memories with you today. Not as a doctor, but as one of you.
I am reminded of my favorite President, Abraham Lincoln. Like me, he was a man who spent most of his formative years in the state of Illinois, in the state capital of Springfield. Nevertheless, his most memorable spoken words come from his few years outside of the land that proudly refers to itself as “The Land of Lincoln”.
In particular, I’m reminded of some of his words to commemorate the lives of those who died in battle in Gettysburg, Pennsylvania. In a similar way, we’ve all lost people who succumbed to their struggle against cancer.
Asked by David Wills, a lawyer in charge of planning activities, if he would give “a few appropriate remarks”, Lincoln gave his most iconic speech – in a mere 272 words, speaking for less than 3 mins.

This is always a reminder to me that much can be said is a few well-chosen words.

Ironically, within his speech, Lincoln told his greatest lie:

“The world will little note, nor long remember what we say here, 
but it can never forget what they did here.”

While we will never forget what Lincoln said, I hope you will forget what I say here tonight, but never forget what your loved one’s did in their lives. I their impact all around us, displayed proudly along the perimeter of this room.

Today is a day for us to reflect on our loved ones, those who didn’t get to see this day, and to remember those meaningful moments they brought into our lives. I have two members of life to reflect on tonight. I discuss them not to call attention to my own circumstances, but to join with you in reflecting on those we’ve lost.

 

Sharing My Experience

It has been almost 8 years since my father passed away from lung cancer. We had a relationship that was complicated, full of respect, but also including many differences of opinion that led to arguments – arguments that continued until the very end. At the time of his passing, I wrote about this, how challenging it can be for those caring for our loved ones when they are in pain, facing their final moments, struggling to be themselves:

“It’s been a couple of months since my father died. Sometimes I see him in my patients, especially the ones who seem defiant and defensive, those who are most skeptical of my care. Other times, I recognize his struggle in my cancer later in life older patients in my clinic who are dealing with the challenges brought on by cancer.”

“These days, I am more careful to tell my cancer patients and their families about the confusion and danger that may occur…And I’m more insistent about getting a [supportive care consultation for them. I try harder to prepare patients and their families for the possibility of a [dangers in the hospital] and how to avoid them. I tell patients’ families that no matter how exhausting, they should make every effort to spend time with a dying loved one to avoid regrets afterwards. I encourage them to involve grandchildren in the conversation about death and disease. I remind myself that few families are ‘ready’ for their loved one to die, even when given ample notice.”

In general, what I noticed at the time, in when caring for a dying person, it is much more difficult to be a son (or a daughter or a spouse or a parent or a sibling or a lover) than a doctor, when someone is gravely ill and suffering. I try to never forget it, and my heart goes out to you.

This last year, my wife’s sister-in-law passed away from an aggressive colon cancer – she was in her early 40s. She and my brother-in-law have small children, overlapping in age with our own. As she was getting sicker, she felt unable to talk with them, to share in the last moments of her life. She also felt unable to talk with us, which was confusing. Yet is reminded me, again, that every experience of life, including its end, is an individual you one. We have to treat each experience as unique, not a part of a statistical distribution.

In the book, “When Breath Becomes Air”, Paul Kalanathi, a young neurosurgeon dying from lung cancer, explains: “My relationship to statistics changed the moment I became one.”

And children are often our best source of truth. I still remember by one, my older son Xander, who was 7 at the time asking uncomfortable questions.

“Is Grandpa going to die?” he asked me one day.
“Yes, I’m afraid so.”
“Because he can’t breathe?”
“Yes.”
“Like when Harrison couldn’t breathe?”

Uncomfortable silence. Harrison, one of his younger twin brothers, recently had been hospitalized for a severe asthma attack. We had had to rush him to the hospital one night.

“No . . . it’s . . . different,” I stammered. “Harrison has asthma, which we are treating with medicine. Grandpa has cancer, and we don’t know how to treat it.”

Our three young boys understood the situation at various levels. We tried to be honest without scaring them. I was constantly impressed by their adaptability, their honesty and their straightforwardness in offering questions, thoughts and feelings. We could all learn from them.

“So, Dad, Grandpa is going to die.”
“Yes, that’s right. But not for a while.”
“Will we still come visit after that to play with Grandma?”
“Yes. Are you OK with that?”
“Well, Grandpa wasn’t very nice to us anyway.”

Unfortunately, despite his best efforts, that was true. My father was a smart, hard-working, dedicated man who lived his life with serious intensity. But he wasn’t always “fun.”

 

Looking Back, Looking Forth

It is why we are so fortunate, at City of Hope’s Department of Supportive Care Medicine, to have Child Life services, experts in helping adults talk with children about cancer, about the process of having cancer. Our supportive care team is full of people who can help in so many ways. I am lucky to be the Chair of such a wonderful Department.

Returning to Lincoln, who summed up his famous address so aptly, focused on the survivors and looking ahead, a call to those among us who are left behind in the wake of a family member who has died. “It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us — that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion.”

It is perhaps appropriate that children are so often still asked to memorize these words for school. We can learn so much from our greatest President and our children.

And that’s how I’ve seen my role since then, to be devoted to the cause of helping bring meaning to people’s lives when they have cancer, to help their families, friends, loved ones and colleagues to cope with the losses, and to carry on the commitment to make everyone’s lives a little better.

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Filed under Aging, Books, Chicago, City of Hope, Civil War, End of Life Care, Lincoln, Palliative Care

“I hope to have God on my side, but I must have Kentucky.”

Becoming a lay expert on a specific historical period, the American Civil War, two related methods for learning history have become crucial to me. First, having broad-based knowledge about this period deepens my understanding of specific local history. Second, travelling to a place to imbibe the local atmosphere where important history happened, brings the sights, smells, sounds and imagination to bear on that history. Both improve the richness of my full understanding of that time – and the human experience overall.

When travelling, I’ve taken to purchasing a book about local history, preferably about Civil War history, to bring these two learning tools together. My most recent experience in central Kentucky was especially delightful. The area we visited was Bowling Green, a place that switched hands several times throughout the war, as both sides tried to bring this crucial “neutral” boarder state into their fold. As newly-elected President Lincoln said about his birth state, “I hope to have God on my side, but I must have Kentucky.”

The book I found is Josie Underwood’s Civil War Diary, edited by Nancy Disher Baird. A passionate 20-year old woman from a prominent Kentucky family, whose father was a leader of the pro-Union elements in the state, writes movingly about the shattering impact of the war on the families in Kentucky. As the country descends from arguments about preserving the Union, the principles of the Constitution, and the status of slavery to outright war, the dissolution of families, friends, and communities into outright hostilities is heartrending. The articulate and beautiful young woman finds her life pulled apart as the miasma of a country in upheaval at a fulcrum point in history throws her life into disarray.
A favorite part of the book was her one-time meeting with Abraham Lincoln when in Washington with her father, who was being appointed by the President as Ambassador to Glasgow. Like many contemporary accounts of Lincoln, its cinematic quality is captivating:

“As we returned to the city, about sun down, there were no other people in sight on the road [from the Soldiers House] except a lone horseman we were meeting. He was on a long-tailed black pony (the horse looked so small) galloping along – a high silk hat on his head – black cloth suit on, the long coat tails flying – behind him. Pa called our attention to him—saying ‘some farmer – who has been in the hot city all day and is now eager to get home to supper and his family.’ So Miss Bell and I thought the man and he looked it. As we met, Pa had the carriage stop. The man did the same and Pa introduced us to Mr. Lincoln. He leaned over, shook hands with us, then slouched down on one side of the saddle—as any old farmer would do, as he talked for ten or 15 minutes with us.”

Can you imagine it? She captures so many historical facts in this one little story. Lincoln’s notorious lack of concern for personal safety, chillingly foreboding—His “everyman” demeanor of an uncouth Westerner—His benevolence toward humanity. It’s all there in this brief, personal account. She goes on…

“Pa and Mr. Etheridge thought is very imprudent and unwise risk for him in such a time of warfare and especial hatred of Mr. Lincoln himself for him to be riding unattended, unguarded out a lonely country road – and called his attention to the dangers—Mr. Lincoln’s smile—expressed kindliness to all men and fear of none—as he said—he ‘did not think anybody would hurt him that way’—shaking hands again with us—he galloped on, neither did we meet anybody else for quite a little way so it was very evident there were no guards—following him.”
Finally, she summarizes her impressions of the man she, and her contemporaries from the South, even those “Unionists” who supported the war effort.
“Lincoln in appearance certainly falls far short (though he is so long) of my idea of how a President should look. In fact a very common-looking man he is—but I must confess there was a kindliness in his face—that does not fit the tyrant—unfair man I have been thinking him…Thinking of his kind, troubled face I can’t believe it is.”

Absolutely spellbinding.

Much of this moving account, especially for a Civil War buff, is infused with details and examples of the local consequences of the war in the border states. I urge anyone with an interest in the times or who is visiting the area to read this mesmerizing account, especially during this 150-year anniversary of Lee’s surrender to Grant at Appomattox Court House. And to remember the 150-year anniversary of Lincoln’s untimely death at the hands of one of the people he so confidently believed wouldn’t “hurt him in that way.”

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Filed under Civil War, History, Lincoln, vacation