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Cancer Care Chronicles
September 2015

Terminal Life

Author Affiliations
  • 1Hematology and Oncology Fellow, Yale Cancer Center, New Haven, Connecticut
JAMA Oncol. 2015;1(6):731. doi:10.1001/jamaoncol.2015.1533

Terminal. The end of the line. This classic train metaphor is what physicians have adopted to convey to our patients with euphemistic tidiness that they are going to die. One of my patients, a 44-year-old woman, took her prognosis literally. “My illness has been one long train ride.” She reflected on her diagnosis of acute myelomonocytic leukemia (AML) during a follow-up visit in clinic. “I was prepared for the ride. Not the destination.”

Before leukemia, she was a mother, wife, successful career woman—so many words to define her and so much to fight for. Now, a patient, she did not accept our hospital vocabulary, nor did she let it define her. Not patient. Not terminal. “I vowed to fight for my life,” she said. But as we’d come to find, no one tells you what life will look like when you survive your own prognosis of death.

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