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Published on October 23, 2017

Planning for the unexpected guides journey through cancer carePlanning  for the unexpected guides journey through cancer care

300To this day, Jim McGrath of Chatham tells anyone who may be concerned about oncology care on Cape Cod, “Be not afraid. You don’t have to go to Boston. The doctors and staff here at Cape Cod Healthcare are simply superb.”

He lives by the philosophy that planning for the future is an essential part of life, whether it’s planning investments, retirement and vacations, or healthcare, in the event of a serious illness like cancer. He and his late wife, Patricia, took the time to discuss their decisions about their end-of-life journey, realizing that knowing what medical care each other wanted in their final days was important.

[RELATED: Plan your life…all the way to the end]

Jim is a retired executive with an international consumer products company and she was an executive with a major communications company in the U.S. The McGraths were fortunate to have traveled  throughout the nation and abroad.

When Patricia decided to retire from corporate life, she studied to become a master gardener, and the couple enjoyed spending their vacations visiting and admiring East Coast gardens. During those trips, Jim developed a fondness for the Raleigh-Durham area of North Carolina., because of its readily accessible medical, cultural and educational facilities, and formulated a plan for them to retire there.

But Patricia had another plan; to retire in Chatham, where she spent every summer during her childhood since she was three years old.

She won, and they designed and built their dream home with all the amenities carefully planned out.  Patricia then designed and oversaw elaborate landscape plantings around their home.

Twelve years after moving into their home, Patricia developed a cancerous tumor. Her doctors advised that she go to a Boston specialist. One of their neighbors, a well-respected surgeon off Cape Cod, recommended a surgery chief at a highly regarded Boston medical center. As they were preparing for surgery, another problem was discovered:  spindle cell sarcoma, a rare form of cancer in the U.S. Spindle-shaped cells are the hallmark of this type of cancer. Jim described it as a “bowl of spaghetti sitting in her abdomen.”

Unable to operate, the Boston surgeon referred Patricia to Basia McAnaw, MD a radiation oncologist with Cape Cod and Falmouth hospitals. Dr. McAnaw introduced the McGraths to her colleague, Frank Basile, MD a medical oncologist formerly at Cape Cod Hospital’s Davenport-Mugar Cancer Center. Together, the two doctors developed a treatment protocol that included radiation and chemotherapy.

“The cooperation between Brigham and Women’s Hospital, Dana-Farber Cancer Institute, where we began this journey, and Cape Cod Hospital was seamless,” said Jim.

During the time of Patricia’s treatment at Cape Cod Hospital, Jim noticed the degree of compassion and kindness they received at every level  –  from doctors, nurses and technicians to parking attendants –  surpassed every expectation.

“Even walking through the halls, if we didn’t look like we knew where we were going someone always offered to help,” he remarked.

While traveling back and forth many weeks to the hospital for treatments, the McGraths became familiar with the ebb and flow of the departments.

“The courtesy of the front office staff in the chemotherapy and radiation departments as well as the nursing and technical personnel was extraordinary,” said Jim. “Every day they face people who are frightened, who may not know what is happening to them, have many questions or they’re anxiously waiting for their appointments. Everyone was treated with absolute patience and respect.  How the staff and caregivers maintain their calmness and commitment to their patients amid the chaos is beyond expectation.  How they do it every day is beyond comprehension.”

Dr. McAnaw’s treatment eliminated the tumor and the chemotherapy treatment was bringing the spindle cell cancer under control when the unplanned happened.  Patricia developed complications and things took a turn for the worse very quickly. She was hospitalized in Cape Cod Hospital’s Intensive Care Unit (ICU) and needed immediate extensive abdominal surgery.

While Patricia was sedated, Jim was called in as her healthcare agent for approval of the surgery.

When he arrived at the ICU, Jim met the on-call surgeon, Daniel Gorin, MD. “I have great respect for him because of my prior association with him,” Jim said.

After hearing Dr. Gorin’s evaluation, Jim knew that Patricia would never agree to surgery.

“We both had healthcare proxies and living wills,” he noted. “We understood exactly what the other one wanted.”

Jim asked Dr. Gorin to bring Patricia back to consciousness and to convene a consultation with her, Dr. McAnaw, Dr. Basile and himself to outline the course of surgery.

“We weren’t just patient or family and they weren’t just doctors,” said Jim. “All three were kind, generous and compassionate people coping with the transformation of Patricia’s life as we know it, which made our experience the best it could be under the circumstances. For their affection, concern and support, I will be forever thankful.”

Surrounded by her husband and her doctors, Patricia stated emphatically that she would not have surgery. Jim wanted her transferred to hospice care at Liberty Commons in Chatham so she could spend her final days in the town she loved, and the hospital staff worked out the arrangements to transfer her the next morning.

It would seem that God and Patricia had a different plan. She died peacefully in the hospital that night.

Reflecting on those final difficult days, Jim offers this advice to others.

“While our death is inevitable and the timing is impossible to predict, formalizing your wishes will make life much easier for your survivors.  And in their grief they will at least have the peace of mind knowing they did what you wanted.”