When I was young, one of my favorite stories was O. Henry’s “The Gift of the Magi.” Originally published in 1905, the short story became standard fare in public school reading classes and I doubt that there are any of you out there who have not read it. But just in case– the story is about a young couple, poor and deeply in love. At Christmas, they have no money to buy each other gifts. She cuts off her long golden hair, her prized possession, to buy him a watch chain for his own treasure, the pocket watch his grandfather left him. He sells the watch to buy ornamental combs for her beautiful tresses. In a classic example of cosmic irony, the two are bereft of everything except their enduring love for one another.
Yesterday, an eighty five year old man was crying in my office. A month ago, he completed a grueling seven weeks of treatment for head and neck cancer. Otherwise healthy, he endured the side effects of treatment with great equanimity—the loss of taste, the sore throat, the dry mouth, the hoarseness, the skin reaction, the fatigue and the weight loss associated with treatment. His reward is great—he is free of disease and very likely to remain so. He drove himself to every treatment, clearly motivated to complete his therapy despite his advanced age. I never had to cajole him into continuing and finishing the treatment—he was clear that he was doing this for his wife of sixty three years, and for his family. He wanted more time, and more healthy time with them.
When I saw him in follow up, I asked him how his post treatment time had been. Many times for radiation therapy patients, the week or weeks following treatment are even more difficult than the treatments themselves—the side effects may worsen before they improve. So I was not surprised when he said, “It’s been TERRIBLE.” I patted his arm and said, “Tell me about it.” He replied, “Right after I finished, my wife was hospitalized and now she is in kidney failure. She started dialysis on Wednesday.” Somewhat surprised that an eighty five year old woman would choose to go on dialysis, I asked him, “Do they expect her kidney function to improve?” He said, “No, the doctors said there is no chance of improvement. The hospital doctor said that under no circumstances would he recommend dialysis for her. But the kidney doctor said it was her choice—to have dialysis and live, or to be made comfortable and die. She chose to live, for me.” And then he wept.
We can all be cynics or pragmatists if we choose. We can talk about the escalating cost of healthcare, and the wisdom or folly of treating eighty five year olds with intensity modulated radiation therapy and daily image guidance and their wives with hemodialysis. But what I saw yesterday was an affirmation of enduring love, in two elderly people, who gave one another a gift not unlike “The Gift of the Magi”—the gift of sacrificing self to continue to live. It’s hard to be cynical about that.