Bioethics lessons in life (and they hurt)

I mentioned last week that my Mama was ill. My family and I were dealing with very real, very painful real-life bioethics questions.

Mama passed away Monday night, while in or on the way back from Magnetic Resonance Arteriography. I was with her, and I'm not sure whether she stopped breathing in the MRA and had some rigorous breaths after we took her off the table or whether she died over the next few minutes. Hopefully, the report on the MRA will shed some light on the strokes she'd had over the last 2 weeks and answer my questions about the immediate cause of her death. But, even this incredibly high-tech test may not give us all the answers we need.

Thankfully, I am sure that she had been unconscious and unaware for a few hours prior to the test.

My mother has been in pain for most of the last 2 years, since just before she was diagnosed with thymic carcinoma. The cancer is very rare - two or three a year in the US. It's also usually virulent and most patients are diagnosed after local invasion by the tumor.

Mama was diagnosed after the tumor was found during evaluation of a respiratory crisis,when she became unconscious. The loss of consciousness and severe muscle weakness that caused it were most likely due to the antibodies her body made to fight the cancer. While it looked as though this response had saved her life, the side effects of weakness, pain, and personality changes weren't ended by complete removal of the cancer (proven by a ton of tests in the last two weeks), radiation and steroids.

Medicine today is a combination of fantastic tests and medicines, protocols from best experience and insurance guidelines, and the experience, prejudices and guesses of the doctors. Tests that can show blood flow to regenerating bone, glucose uptake in cells, and images of the brain and other organs that look like photographs of the actual tissue cannot tell the doctor what to do next or what will happen if he or she follows a given pathway.

If you ever find yourself making the decision between making a loved one pain free (when she experiences a draft as a pain at a level of 10 out of 10) or doctors who don't seem to be listening to your questions, much less be able to answer those questions, remember that there are times when no one can give us all those answers.