His Last Breath: My Father's Battle With Lung Cancer

It rained the night before my father died. One of those warm summer rains that leaves the air more sticky and humid than it was before it started. 

It was still raining as I rushed to the hospital the next morning. I remember thinking my hair would be a disaster all day. A riot of big, frizzy curls.  

In hindsight, it seems such a bizarre, unimportant thing to be concerned about when you know your father is about to die. 

  

But already my brain was switching to self-defense mood. It needed to be elsewhere. 

Anywhere but signing his death paperwork and planning his funeral. Anywhere but saying goodbye. 

My father took his last raspy breaths just before I entered his hospital room. 

  

I paused briefly at the door. My brother Shawn, the first one to arrive, looked up at me, his grief-stricken face streaked with tears.

He didn't have to say a word.

I'd seen that same anguished look on the faces of my children three years earlier when I told them their father had been killed.

I was too late. My father was gone. 

  

I quickly crossed the room and placed my hand on his still warm cheek. With my other hand, I stroked his hair as his lungs exhaled their final breaths of air. 

  

I barely recognized the shell of the man left in the bed, his face sunken and hollow and contorted in death. 

  

The night before I had kissed him goodnight before I left. 

  

I love you, Daddy. 

  

He was so heavily medicated, I wasn't sure he'd heard me. 

  

"I love you too." 

Are you sure? I'd asked. 

  

"Yep, pretty sure. Night dear."  

My father's death was neither sudden nor unexpected. We had been anticipating it for several days beforehand.  

In truth, I'd been expecting it for months.  

And yet, that made it no less painful. 

My dad died of metastatic lung cancer. Seven months after he was diagnosed, he was gone. 

Last year, I knew nothing about lung cancer.  And now I know more about it than I ever wanted to know. Cancer has a sharp learning curve. Biopsies, thoracentesis, pleural effusion—it was so hard for me to keep all of the terms and procedures straight. The amount of information overwhelmed me. And I wasn't the one living with cancer; I can’t even begin to imagine how he felt.  

Late last fall he'd developed a cough he couldn't shake. He never told any of us about it though. It was no big deal. Just a cough.  

A retired industrial electrician and former smoker, my father had been cigarette free for almost a decade. It never occurred to him he had cancer. 

  

It never occurred to any of us he had cancer. 

  

In hindsight, we should have known something was wrong, long before he developed the cough. He hadn't been himself for months. He was always slightly grumpy (my kids even called him Grumpy), but over the previous year, he'd become withdrawn and irritable. It seemed like he was always complaining about something. 

"Your mother never listens to me."  

"Your mother can't remember a thing I tell her."  

Your mother this, your mother that. My poor mother couldn't seem to do anything right.  

We chalked it up to old age.  He’d turned seventy-five on his last birthday, and had definitely slowed down over the last couple of years. He didn’t seem to have the same energy he used too. But it wasn’t just old age, it was cancer. His fifty year, two-packs a day smoking habit finally caught up to him ten months ago when the cough first started. 

But really, it caught up to him long before that. He’d had a ticking time bomb in his lung for years and had no idea. 

  

My dad was dying long before we even knew he was ill. 

  

Last January, I'd sat beside him as the doctor gave him the results of his first biopsy. Non-small cell carcinoma; squamous cell carcinoma to be exact, the type of lung cancer most strongly linked with smoking. He had a tumour the size of an orange nestled against the membrane of his heart. Surgery was impossible; his only options were radiation, to shrink the tumour, and ease his symptoms, and chemotherapy to try to stop the cancer from spreading. 

  

And then the news went from bad to grim. Two more biopsies subsequently revealed he had a different type of cancer, adenocarcinoma, in his right lung. 

  

Concurrent primary malignancy.  

My Dad was living on borrowed time.  

His mood didn't improve after his diagnosis. He was angry—angry at the world, angry at cancer, angry at the health care system that was letting him down, angry at himself for ever having smoked in the first place.  

“Everyone else is making the decisions. It doesn’t matter what I say,” he’d grumbled to me after his last visit from the palliative care nurse.  

“I’m just a passenger along for the ride.”  

Yes, Dad and cancer was driving the car.  

He had every right to be angry.  

Cancer is such a cruel, merciless disease. My once strong father, who could haul lumber and logs effortlessly, was bedridden for the last six weeks of his life.  

Cancer robbed him of his breath and his strength, it took his dignity and then it took his life.  

He never made peace with his death. He clung to hope for a miracle cure, until the bitter end.  

For months, I silently watched my father die. I didn’t have the heart to tell him there would be no miracle, at least not for him. Hope was all he had left. And I couldn’t take that away from him.  

I knew he would never have chemo. His cancer was far too advanced, and he was far too weak. Chemotherapy would shorten his life, not lengthen it. 

  

At his last appointment, his oncologist explained to him why he couldn't have chemotherapy. She outlined the side effects of chemo as she told him how ill it would make him and then asked him what he thought.  

 “It sounds to me like I don’t want to have chemo." 

  

His shoulders slumped as he said it, his voice barely a whisper. He was exhausted. I knew he was nearing the end. I wondered if he knew it too.  

If he did, he never said it out loud. 

"We don't have to worry about that for quite a while yet," he told me, two weeks before he died.

  

He adamantly refused to speak of his death. 

  

The week before he died, my mother had to call the EMT's three times. The palliative care nurse called me the morning after the third visit and told me it was time, we had to move him to the hospital. At that point, my father was refusing to go. As his medical guardian, it was up to me to sign the papers. 

  

It was a position I'd never wanted to be in. I knew my father wanted to die at home, but I had to do what was best for him, and for my mother. 

Fortunately, I never had to sign those papers. By the time, I arrived, he had relented and agreed to go. On his terms, of course.  

"I'll go, but just for a week until I feel better. Remember what the doc said, I can come home whenever I feel up to it. A deal’s a deal. Right, Lib?" (Lib was his childhood nickname for me.)  

Right, Daddy.

He would never get to make that trip home.

He died the next day.

  

I started composing his eulogy in my head months before he died. 

"My father died of lung cancer. I would like to say he died after a courageous battle, but the truth is he never had a chance to fight. The war was over before the battle even started. Lung cancer was the victor, as it all too often tragically is.” 

The other day, as I was stopped at a stop sign, a man with his little girl crossed the crosswalk in front of me. She had dark curly hair and was talking a mile a minute. He held her little hand in his. With his other hand, he took a drag off of a cigarette. 

I could feel the tears welling in my eyes. She reminded me so much of a little girl I used to know. 

As I wiped away a tear, I couldn't help but wonder if she would be holding her father's hand in his doctor's office one day.  

Lung cancer is the leading cause of death from cancer for both men and women in Canada. Lung cancer kills more Canadians then breast cancer, colorectal cancer, and prostate cancer combined. Despite the large numbers of Canadians dying from lung cancer, lung cancer research is the least funded in the country. There are no national or provincial screening programs for high-risk populations. Partially because of this lack of screening, most lung cancer patients are diagnosed in late stages.

  

The five-year survival rate for lung cancer is a dismal 17%.

  

More than 85% of lung cancer cases in Canada are related to smoking tobacco. The risk of developing lung cancer increases with how lung you have smoked, how old you were when you started smoking and the number of cigarettes you smoke each day. The risk is also higher if you smoke tobacco and have other risk factors such as exposure to asbestos, radon, certain chemicals, and air pollution.

  

For more information on lung cancer and lung cancer prevention please see the Canadian Cancer Society

To learn more about grief, resiliency, and life after loss, follow Monica Bobbitt on Facebook:https://www.facebook.com/agoatrodeo/