♪♪♪ ♪♪♪ ♪♪♪ ♪♪♪ [phones ringing] [crosstalk] [phone rings] Dad: Hello?

Doug: Hola.

Dad: ¿Como estas?

Doug: Bien, bien.

You too?

Dad: Uh, yeah.

Whatever.

Doug: Ran out already, huh?

Dad: Ran out.

Well, late in the day.

My gosh.

Doug: You gotta get past the "¿como esta?

", Pop.

Come on.

Dad: Uh, well, late in the day.

Doug: Yeah, I guess I'll forgive you this time.

See to it-- Dad: Okay, I'll be sharper tomorrow.

Doug: See to it it doesn't happen again.

Dad: Okay.

Doug: What's up?

Dad: They came back with the needle biopsy results, or at least in part.

Doug: Mm-hmm.

Dad: The tumor--that is, the adrenal gland tumor-- tests positive.

It is malignant.

Doug: Okay, that's the one above her kidney?

Dad: Yeah.

Doug: Okay, gee, I didn't even realize there was a tumor there.

I mean, I knew she had a problem, but I thought it was-- Dad: Maybe I'm not saying it right.

I don't know that there is a tumor there.

They needle biopsied the adrenal gland.

Doug: Okay.

Dad: I guess that's what I should say, and that one came back testing positive.

They did double needle biopsy of the lung.

That one they do not have the results on.

Doug: Jesus.

Dr. Wayne Beach: In 1990, a graduate student that I had been working with walked into my office, handed me this box of audio cassettes, and told me a story.

When living in San Diego as part of his graduate studies in conversation analysis, he'd hooked up a recording device to his telephone.

And when his dad called informing him of his mother's cancer diagnosis, he had no idea that the conversation was actually being recorded.

Dad: So, the doctor was in there tonight about 7-ish, and he said--he basically--that it has gone from the lung to the adrenal gland.

Now, they do not know what kind.

They do not know what they will do as a course of treatment.

I did ask.

I said, you know, in cases like this would they expect to do surgery on this?

And he said no for several reasons.

Doug: Is this for chemotherapy?

Dad: Yeah, they would--he said they would choose to do radiation and chemotherapy.

Dr. Beach: After the first call with his dad and the second with his mom about her cancer diagnosis, which we will hear in a few minutes, the son realized that the phone device had actually recorded the calls without his knowledge.

And he knew that these were very important conversations.

Son then told me that all family members had agreed that he should continue recording their phone calls.

Later, and together, he also decided to donate these recordings to me, conversations that captured a significant portion of their family cancer journey.

Doug: How did she fare through these processes?

Dad: Think she did pretty well.

She has been saying all along that this is too bad to be something simple, and she was-- Doug: Mm-hmm.

She's never wrong, is she?

Dad: Yeah, she's never wrong.

Dr. Beach: The family made two requests.

First, that I make all recordings anonymous so that their personal privacy would be protected.

Dad: And she was falling apart the early part of the week.

That was the fear, anger, resignation.

I'm sure this will go from state to state for a while, between rage and despair and all the rest of it.

Dr. Beach: And the second, that I wait for a few years if I chose to analyze these calls.

Doug: Yeah, having no course of action.

This has just been a nightmare of not knowing.

Dad: Oh, yeah.

Doug: You know, the inactivity and the inability to know what's going on has gotta be the most frustrating part of all this, because, you know, all you do is you sit and you stew.

Dr. Beach: Well, as you might imagine, I was very honored that the family had entrusted me with their recordings, and I assured the son that I would keep the recordings safe and protect their confidentiality.

But wait a few years?

Huh.

I have to admit the shoebox sat with the rest of my recorded materials for another eight years, mostly untouched, simply not a priority.

Dad: Right, and you can conjure up all these horrible nightmares, some of which turn out to be true, but you're right, you know?

You feel so damnably impotent.

Doug: Yeah.

Dad: Exactly, basically she said she just hurt too bad to be anything else, you know?

It had to be something drastic.

And she was really having some problems with pain today.

She had 1 1/2 Percodans in her and wasn't hardly slowing it down.

Doug: Hmm, wow.

Dr. Beach: So, you might ask, why did I finally start listening to these recordings?

Well, eight years after Doug walked into my office with these cassette tapes, I got a long-distance phone call from Iowa.

My mother had been diagnosed with lung cancer.

During these next few months, I had countless phone calls with family members and doctors and friends.

At some point, I realized that I, too, was now a son in the midst of my--our own cancer journey.

No longer just a communication researcher who had the option and privilege to study one set of recordings over the next.

I was relying heavily on phone calls to manage as best I could our cancer journey, so somehow we were getting through it, coping just.

But how so?

Each call, it became more and more clear to me that all cancer patients and family members, they get caught up in a journey that they don't ask for, they don't fully understand, and they can't fully control.

Each phone call I more fully realized that here I was, a son talking to his mother and other significant calls, and I wondered, "So, this is what that graduate student must have been going through with his mom's cancer diagnosis."

Gradually, I came to realize that maybe it wasn't a coincidence that these family cancer calls had come my way, you know?

It's funny how it works like that, isn't it?

Here I was having allowed these materials to gather dust in my office for eight years and now I'm being able to call-- to examine what is extremely timely and rich.

Available family conversation?

Ah.

Well, my mom died four months after her cancer diagnosis, and when I came home I got to work on these phone conversations.

I applied for and received a grant from the American Cancer Society to do my research and my writing about cancer communication on the telephone.

I soon realized that this collection of recordings, 61 calls over 13 months, was the first natural history and the social and medical sciences of a family talking about and through cancer on the telephone.

These are real conversations.

They're not artificial or hypothetical versions of how family members might talk about the way that cancer converges and often clashes with daily circumstances.

More and more, I came to realize just how rare and extraordinary these phone conversations are, our first opportunity to hear and respond to how communication organizes and is organized by actual family cancer journey.

So let's take a closer look at how delicately the communication is organized.

Consider one quick example during the opening of this phone call when dad seems unable to speak further Spanish.

Doug: Ran out already, huh?

Dad: Ran out.

Well, late in the day.

My gosh.

Doug: You gotta get past the "¿como esta?

", Pop.

Come on.

Dad: Uh, well, late in the day.

Dr. Beach: In dad's first-- Dad: Well, late in the day.

Dr. Beach: And then his second.

Dad: Uh, well, late in the day.

Dr. Beach: A critical difference can be heard.

The vocal cues in dad's second "uh, well, late in the day" accomplishes a very important social action.

He forecasts the son that the upcoming news not yet delivered will be bad rather than good.

From that moment, dad and son no longer play, but they become more serious.

They work together to move towards what dad knows and son now anticipates will be bad cancer news.

And as we'll see in these phone calls, they reveal so much more about the human social condition than most of us can imagine.

Not just insights about how cancer news gets delivered and received, but how we manage inherently uncertain futures in the face of illness, adjust to challenges in lifestyle and relationships, describe and assess what doctors have reported, and critically, how or if we remain hopeful and loving in the midst of fearful events.

From these descriptions thus far by dad and son, cancer triggers a wide array of emotions: fear, anger, resignation, rage, despair, frustration, uncertainty.

And as we will see in subsequent phone calls, hope, love, and playfulness emerge as critical resources for balancing these often challenging emotions.

Earlier, dad said living--he described living in a nightmare that, as dad stated so well, can leave you damnably impotent.

Dad: As you said, the unknowing is so damnably frustrating.

And maybe you don't wanna know, but I don't wanna not know either.

Doug: Right?

Dad: 'Cause, boy, I could conjure up some real, wild nightmares.

Doug: Yeah, really.

Dad: So, I probably won't have a lot more information until Monday night.

Doug: Well, you think Mom will be up for a call in the morning?

Dad: Oh, I would--yeah, yeah, I would think so.

Doug: I thought I'd call her from work.

Dad: Yeah, sure.

I called you, so I'm sure she's gonna be interested in your reaction, to at least be sure you're all right.

Doug: Sure.

Well, I'll give her a call tomorrow and all that.

I'm gonna turn into a pumpkin here in a minute, so.

Dad: Okay, go rest up for you daty at the salt mines.

Doug: Okay, well, I appreciate the call.

Dad: Okay.

Doug: Thanks.

Dad: Talk to you tomorrow, Doug.

Doug: Bye-bye.

Dad: Bye.

Dr. Beach: Their story continues the very next morning with son's call to his mother, the first time he's had the opportunity to speak with her since her cancer diagnosis.

[phone ringing] Mom: Hello.

Doug: Hi.

Mom: Hi.

Doug: How you doing?

Mom: Oh, I'm doing okay.

I gotta--I think I'm radioactive.

[laughing] Doug: Why is that?

Mom: Well, you know, when you get that bone scan.

Dad: Oh, did they do it already?

Mom: Yeah, they give you a shot.

Then you have to drink water, coffee, tea.

Whatever the hell you want, but volumes of it.

And I'll go down at about 10:30.

Doug: Okay.

Mom: So, anyway.

But Pop--I realized that I was told after you left here yesterday that you had not already heard the verdict we had, so.

Doug: Yeah, that's what I was calling to talk about.

[coughing] Yeah, I think maybe we were a little bit glib and all that.

Mom: No, no, no, no, that felt good.

Doug: Well, good, 'cause, you know, we were both-- we kinda walked out and said, "Geez," you know?

We both realize how serious this all is, but it seemed like everyone was being awfully down.

And we weren't entirely sure why, and we both thought, "Well--" Mom: Well.

Doug: "Maybe they're just stilling themselves for the worst."

And I guess we'd already heard it.

Mom: No, it was the worst.

It was the worst.

Yeah, the large-cell cancer is--there is only one worse.

Doug: It's already being dead, perhaps?

Mom: Ha!

[laughing] There's an adenoma type that is worse, but this is very fast, very rapid.

Very difficult to treat.

There's a very small percentage of people that do respond, and we're talking at that maybe five years.

Doug: Hmm.

Mom: So, it's real bad.

Doug: I guess.

Mom: And I don't know what else to tell you.

Doug: Yeah, I don't know what to say either.

Mom: No, there's nothing to say.

I'll wait to talk to Dr. Ledon today.

He's the cancer man and see what he has to say and just keep going forward.

I mean, I might be real lucky in five years.

It might just be six months.

Doug: Yeah.

Mom: Who knows?

Doug: Whew!

Mom: Yeah.

Doug: What do you do with this kinda thing?

I mean-- Mom: Radiation.

Chemotherapy.

Doug: Oh boy.

Mom: Yeah, my only hope.

I mean, my only choice.

Doug: Yeah.

Mom: It's either that or just let it--lay here and let it kill me, and that's not the human condition.

Doug: No, I guess not.

Mom: No, so that's all I can tell you, sweetie.

Doug: Oh.

Mom: Yeah, I'm sorry.

Doug: Well, I should think.

Me too.

Mom: Yeah, see, it's already metastasized.

It's already gone someplace else even.

That's what makes it--that's partially what makes it so very serious.

Doug: Mm-hmm.

Whew!

-- Mom: Yeah, I know.

I know.

Doug: Where's the magic wand Mom?

Mom: Beats the hell outta me.

I guess the only thing I can do is after I'm done reeling from this is find a reason to keep fighting and keep being hopeful.

You know, that that's about all you can do.

That's all a person can do.

Doug: How can you do that?

It's gotta be tough.

I mean, I didn't mean to say that.

It sounded like-- Mom: Ah, here comes your papa, and he has brought me the magic elixir called coffee.

Doug: Oh.

Well, good.

Mom: Because I gotta pour all that stuff through me, I might as well.

Doug: Well, you guys can sip some coffee with me.

Mom: Yeah.

Doug: I just poured myself a pot--a cup.

Tell Pop good morning.

Mom: Your son says good morning.

Doug: I'm glad you're both there.

Mom: Yeah.

Wait a minute.

Hold on.

Hold on.

Let me see.

Yeah.

Dad: Good morning.

Doug: Hi.

How you doing?

Dad: Okay, hey, what do you wanna do about your car?

You mentioned that the other day.

What's the matter with the Datsun again?

Same thing?

Doug: Same thing.

Dad: You wanna try and jump-start it?

Doug: I'm gonna trade it for an '88 BMW 735.

Dad: Right.

Doug: Even swap.

You think they'll take it?

Dad: Throw in 35,000 cash, maybe.

Doug: Can I borrow some money?

Dad: I got $1.70.

Doug: Hey, we're gonna cook you dinner.

Dad: Oh, okay.

Doug: We're making chili.

So, what I thought we'd do is we'd come up and take care of some things and go spend some time with Mom, and then come over and have some dinner.

Dad: Okay.

Doug: All right?

Let me talk to Mom for another minute, and then I'll let you two visit.

Dad: Okay, okay.

Hang on a second.

Mom: Oh.

Dad: Yeah.

Mom: Yeah.

Doug: I was telling Pop we're gonna come up on Tuesday and visit you with a big pot of chili and have some chili together.

Mom: Okay.

Doug: So, where are you gonna be?

Mom: Well, I might be home by then.

Doug: Do you think?

Mom: I have no idea.

By the way, your sign for the nurse, "do not take me," really worked.

Doug: Did it?

Mom: Totally confused one girl.

She looked, and she looked, and she looked.

She brought in a liter of clear water to set there.

Doug: Oh, really?

Mom: She couldn't quite figure that whole thing out, but she wasn't gonna touch it.

Doug: Good.

Mom: So, that was kinda funny.

Doug: See, there's a small battle that we've won.

Mom: Right, right, right.

Doug: And it's all you can do is just rack up the small battles.

Mom: Right, right.

Well, okay, I'm gonna let you go.

Doug: Okay.

Mom: We'll tell you what we learn when we learn it.

Doug: Okay, I'll talk to you or Dad or both later tonight.

Mom: Yeah, okay.

Doug: I'm probably home by 9:00, 9:30.

You're not usually asleep yet, are you?

Mom: No, I'll have dad call you.

Doug: Okay.

Mom: Okay, sweetheart.

Doug: I'll talk to you later.

Mom: Okay.

Doug: Bye-bye.

Mom: Bye-bye.

Dr. Beach: In these first two calls, son was living in San Diego.

Ten months have now passed.

Son is divorced and living in Austin, Texas, to continue his graduate studies.

He is managing mom's illness and his family relationships from long distance.

Doug: Life support or not, huh?

Mom: Now, I have up until this point.

Doug: Uh-huh.

Mom: I mean, I have done it in my will.

I have given that paper to Dr. Wiley and one to Dr. Peters, and it has been my issue all along.

I don't want to be put on life support.

My mother was, and I didn't like it.

Doug: Mm-hmm, okay?

Mom: However, if I get there and they are not-- I don't know how to say it.

Doug: How about just the quickest way?

Mom: It's hard for me to talk.

The pain is just unreal.

Doug: Okay.

Mom: There's no way I can go on, so I said to Dad, "Maybe I'm being terribly naive, but I want them to stop the pain."

Now, if they can do that, you know, I can sit there for five or ten days and--I don't know.

I mean, I just don't know.

I've not done it before, so I don't know.

Doug: Okay.

Mom: I could sit there, and they can-- they'll jam me with morphine.

Doug: And you could float for a while.

Mom: Yeah.

And I have trouble talking.

Doug: Okay.

Mom: Ah, now I'm being nutty too.

[laughing] I've been--I have had several periods of not being coherent.

I mean, I even talked to my mother this morning.

Doug: How's she doing?

Mom: She's doing fine, but she didn't answer.

Doug: Probably looking forward to seeing you, huh?

Mom: Looking forward to it, yeah.

But I don't know if I say no life support and I get in there and it's real, real quick--which, of course, I have no way of knowing--then maybe you can't get here.

And maybe you don't want to get here.

Doug: Yeah, I wanna get there.

Mom: Yeah?

I said to Dad, you know, or Dad said to me, you wanna be here for this or the memorial service?

'Cause now we're talking money, which we know you have little of.

You're not wealthy, and we're talking your job and your school and all that.

Doug: Yeah, well, frankly-- Mom: I couldn't have picked a better time to die.

If you tell me that-- Doug: No, no, no, no, no, no, no.

I'm not gonna tell you any of that.

I was gonna say just, if you want my opinion, I'd rather be there for this than the memorial service, because the memorial service is strictly for me, 'cause you aren't gonna be there.

And I can take care of me here or there, whatever, but I think that this is a time when you need everybody to be together, around you, and I would just as soon be there when you're still there.

Mom: Okay, tell Dad this, okay?

Doug: Okay.

[Mom breathing heavily] Dad: All right.

Dad: Hello.

Doug: You all right, Pop?

Dad: Hmm, relatively speaking.

Dough: Anything I could do for you right now?

Dad: No, there is nothing you can do at this point.

Doug: Okay, well, what I told Mom is, as far as I'm concerned, if the question is do I wanna be there for this or the memorial service, there's no question in my mind.

The memorial service is something that-- you know, that's for the people who are still alive.

And I can mourn here, I can mourn there, I can mourn a lot of places, but I kinda feel like now would be a good time to be there with Mom, when she's still got any time left.

And to be there together, you know, with everybody.

Now, I think it would make more sense.

I mean, yes, I can't come for an indefinite period, and I certainly can't come back and forth a couple of times 'cause I know sure as hell I can't afford it.

And I can't imagine you can with everything else going on either, but given my druthers I'd come home now.

Dad: Okay, let me talk to Auntie Carol and see about a plane ticket.

Now, don't drive to the airport yet, but pack your bags.

Doug: No, but I'll be here.

I'll stay home.

Call me, tell me what to do, when to do it.

As soon as I know what and when, I'll make the arrangements on this end and take care of it.

Dad: Okay, I'll find out what I can do about a plane ticket.

Doug: Well, yeah, you can call-- there's a couple of different airlines.

They have something called compassion fares, which means that they waive all the restrictions and basically give you the best deal that's possible without all the restrictions.

Dad: All right.

Let me talk to her and find out how I do it from here.

Doug: Yeah, and just I'll stay here.

I'm by the phone, you know?

Maybe what you can do is just order me the plane ticket, and I could pick it up here.

Dad: Mm-hmm, okay.

I don't see that as a problem.

Doug: Okay, I've got a day at least I hope, okay?

Dad: Yep.

I would think so.

Doug: All right.

I'll stay by the phone.

Dad: Okay.

Doug: Tell Mom I'm irritated, because I was just about to send you a recipe for fake guacamole that I've heard is really good.

And so, now she's not gonna get to try it, and it's a bummer.

Dad: We found all your cookbooks.

Doug: Okay, well, this wasn't how I wanted to come and get 'em, Dad.

Dad: No, true.

Doug: All right.

Well, call me.

Dad: Okay.

Doug: All right, bye.

Dad: Bye.

Dr. Beach: Did you hear how son did his best to accommodate mom's wishes about no life support, to understand her pain and the impacts of medication and how difficult it is to make choices about when to travel to see a dying loved one?

Money, time, work, the need to be together or apart, all these factors influence the kinds of decisions and plans made by family members.

Did you also hear how dad and son are now resigned to mom's dying?

It's time for the son to pack his bags to get on a plane and to come see mom one last time before she dies.

[phone ringing] Susan Gaines: American Airlines, Susan Gaines.

Doug: Hi, I got a question for you.

Susan: Yes.

Doug: I'm a graduate student here at the University of Texas.

Susan: Yes.

Doug: I just got a phone call and apparently my mother is going to die, and I need to get back to San Diego.

I'm told there's such a thing as a compassion fare for poor folks like me who need to go somewhere in a hurry.

Do you have such a thing?

Susan: Okay, let me check for one second, please.

Dallas to San Diego?

Doug: Yes, ma'am.

Susan: Okay, now, for these situations, sir, what we do is we waive the advance purchase and we authorize a $328 round-trip fare.

Doug: Okay, $328.

When's the--do you have something tomorrow afternoon at any point?

Susan: And just one traveling?

Doug: Yes, it will be.

Susan: And when did you want to return, sir?

Doug: When she dies.

How's that?

Susan: Well, what we do is, just so you won't have to do this again, we just, you know, pick a date, say seven days out.

Doug: Uh-huh.

Okay, at this point don't actually book this.

Like I said, I'm waiting for one more phone call before I'm sure I have to go tomorrow.

Susan: Well, if you like, I can, you know, just hold this for you, or you can call us back when you get more information.

Doug: Well, I wish I was traveling under better circumstances.

Susan: Well, we do too, sir.

Doug: Well, thanks very much for your help.

Susan: Thank you for calling American.

[phone ringing] Monica: US reservations, this is Monica.

Doug: Question for you.

I understand that there is something called a compassion fare.

I just found out that I need to get home.

My mother is about to die, and I'm a graduate student and have not got much money.

Monica: We don't really have a compassionate fare.

We have what's called a bereavement fare, and unfortunately, that's when somebody has already passed away.

Doug: All right.

Monica: We do offer that for people who are going to a funeral.

Doug: Okay, well, funeral won't happen till after I get there, I suppose, but thank you anyway.

Monica: I'm sorry I couldn't help you.

Doug: It's all right.

Bye.

[phone ringing] Jessica: Good evening.

Thank you for calling Southwest Airlines.

This is Jessica.

How may I help you?

Doug: Hi, do you have such a thing as what they call a compassion fare?

I just found out it looks like my mother is gonna die, and I need to get back to San Diego from Austin, Texas.

And I'm a graduate student and do not have a lot of money.

Jessica: Well, let me see exactly what that fare would be.

Now, I know we don't have anything like that.

Our fares are usually much less, though, than America, Delta, people like that.

Doug: All right.

Jessica: The normal fare, sir, is 133 one way.

You might wanna try America West.

They may have that passion or berevance fare, something like that.

Doug: Yeah, there's a couple airlines that will do this when-- if I wanna go for a funeral, but I'd just as soon get there before she dies, and that's a matter of days at this point.

Jessica: Right, you wanna be there as soon as possible.

Doug: Well, I really appreciate your help, and you know, with any luck, I won't have to call you back.

I'd rather travel under much better circumstances than this.

Jessica: Oh, I imagine.

Doug: All right.

Thanks very much for your help.

Jessica: Well, thank you for choosing Southwest.

Doug: All right.

Bye-bye.

Jessica: Good evening.

Doug: All right.

What's the scoop?

Dad: Well, stay there.

Doug: Stay here?

Dad: Stay there.

Doug: Oy, okay?

Dad: Yeah, I know it's been a damn up and down and up and down.

You don't know whether to be pleased or not pleased.

I don't know yet.

You know, the trip is gonna come about.

It's just that, you know, if you wanna come this week, it's not gonna be an end week kinda thing.

Doug: Mm-hmm, okay?

Dad: She's mobile, et cetera, so.

You know, as I said, her answer is to stay there for the time being.

Doug: Ah.

You guys gotta stop doing this to me.

Dad: I can feel for you.

Believe me.

Doug: Yeah, well-- Dad: Oh, keep your list.

Keep it as current as practical, 'cause I'm sure I'm gonna call you in the near future and say, "This is a good time."

But you know, your guess is not gonna be a hell of a lot different than mine as to when is a good time.

Doug: Okay, oh, this is weird.

Oy vey.

Dad: Yeah, it's tough.

I mean, you know, you go home at night.

You cry yourself to sleep thinking, "Well, this is the end of it."

Then you come back the next day, and she says, "Jesus Christ.

You forgot my cigarettes."

Gimme a break.

Doug: And in the meantime we just sit here with the clock ticking, huh?

Dad: That's right, you know?

With a knot in your stomach.

And every phone call you dread and all the rest of it.

Doug: Exactly.

Dad: And how do you stay prepared without getting an ulcer and all the rest of the insanity that goes with it?

I'll call work, and I'll say, "I won't be in today," and then I show up.

Doug: Yeah.

Well, tell Mom that I think this is very inconvenient of her, 'cause if ever there was a good week, this was a good week.

I could get away from things this week.

Next week, she better damn well not die next week, okay?

'Cause next week will be a lousy week for me to be gone.

You know, this week is not a big deal.

Next week will be a problem.

Yeah, if you call me on Wednesday I'm gonna be really mad, so, you know, tell her to wait a couple of weeks now.

Dad: Okay, we'll make an appointment.

Doug: Yeah, yeah.

Dad: You pick a good week, and we'll try and accommodate.

Doug: Yeah, okay.

Well, I'll look in my calendar and see what I can come up with.

Yeah, as soon as I got a good answer as to when.

Dad: Okay.

Doug: How are you?

Dad: Better this morning than I was yesterday.

Doug: I guess.

Dad: Yeah, you know, yesterday was tough.

Doug: How bad?

Dad: Trying to get her outta bed and moved around, you know?

The mental part as well as the physical, but you know, you don't have a lot of choice.

Well, you just do the best you can.

Other than that I'm doing reasonably well.

Doug: Well, good.

Dad: Only one ulcer hurts today.

Doug: Yeah.

So, should I expect a phone call, like, in a matter of a day or two, or a week or two?

Dad: No, no, if I had to give you an uneducated guess-- Doug: The only kind you can give me.

Dad: Yeah, 'cause that's the best I can do.

I'll say month to six weeks.

Doug: Okay, well, yeah, and I know Dr. Wiley will never say anything in particular, right?

Dad: Well, you know, she's only got an educated crystal ball.

She looks, and she said, "Well, okay, so we got a few more tumors here.

We can radiate those.

That will slow those down."

Then the next ones pop up, you know?

It's just like trying to squash mushrooms in a rainstorm.

Ah!

You know?

Those suckers just keep popping up.

Eventually, you're gonna lose, but who knows what eventually is?

Doug: Well, we'll work with that, then.

I will unpack my bag, and I'll keep my lesson plans current.

Dad: Yeah, keep your list up to date, but leave the bag where it is.

Doug: Yeah, okay.

Dad: That's the best I can tell you at the moment.

I told you life's a -- Doug: Yeah, right.

Huh.

Dad: No rose garden.

Doug: No, no rose garden.

Dr. Beach: Guessing the time of another's death is ambiguous, tiring work and involves balancing many different possibilities.

If mom is dying, at least her suffering is minimized, and the family has some closure on their cancer journey.

If mom continues to live, her condition will likely worsen, and the lives of the family members remain volatile and in flux, yet there is more time to be spent with her and other family members.

And in the midst of dealing with cancer many other events occur in life.

Life decisions simply come to a halt, you know, though at times we all wish we could just push the pause button so that we could better manage our own problems with our own-- or someone else's illness.

Many different kinds of relationships need to be balanced and managed.

With this next call, son talks with his recently divorced wife about mom's condition and delicate issues about visiting her.

[phone ringing] Doug: Hello, Doug here.

female: I love you.

Doug: Hi.

female: I just wanted to tell you that.

Doug: Well, thanks.

female: You're the one.

Doug: Thanks.

Oh, well, there's the possibility I might not be coming now.

female: Why?

She's pulling through?

Doug: Not pulling through but at least stabilized.

And of course, I can only be gone so long, so if it looks like she's gonna hang in for another couple of weeks, then I wanna wait a couple of weeks.

female: Oh my god.

Doug: Yeah, right.

So, I was--in fact, that's what I thought this phone call was.

I'm waiting to hear from-- female: Oh, I know you must probably panic every time the phone rings.

Doug: Yes, I do.

female: Did they call you last night?

Doug: Yeah, she's got a doctor who's gonna see her this morning, but you know, the time difference and everything.

They won't know anything for a little while yet, so it kinda puts me in an awkward spot here, 'cause, geez, you know, I got everything arranged to go.

I'm packed, and I'm ready.

I emptied the garbage.

I cleaned out the butter dish.

I used up the lunch meat.

I got somebody to take my classes and pick up the mail, dah-dah-dah-dah, and if I end up staying I'll feel a little weird.

female: Fine, stay, take the day.

Doug: Well, yeah, I told them that no matter what happens I'm taking today off, because the problem is, based on when the doctor is gonna be there and everything, I probably won't even know for sure if I'm leaving until noon.

female: Gosh.

If this stretches out, it will be really hard.

Doug: Yeah, well, it's been stretching out, and it's been hard.

It just keeps going and going.

And if--she signed one of those things that says no heroic measures, you know, they're not gonna do too much other than just ease her pain at this point.

female: I was befuddled again last night, and I'm trying to figure out what that feeling is, and I think it's just the additional stress of your mom.

It just kinda flew me off the handle, you know?

And I don't know if I should tell her or not what's going on with us.

I need to sort this out and talk to you about what I'm gonna say to your parents.

Doug: Yeah, I mean, you know, certainly it's up to both of us, but it's also a matter of if you wanna see my mother or not.

female: I'm fighting so hard to hear what you need, and I have to-- Doug: Well, what I need doesn't necessarily have anything to do with telling them.

I mean, it's really a matter of if you want to see my mother or not.

female: You really don't care?

You would just go through this whole thing without letting 'em know that I'm here, and then just disappear if you wanted to see me?

Doug: Huh, yeah.

female: Doesn't matter to you?

Doug: Not particularly.

female: I don't need to burden you with that.

Just I wanted to call and see how you were doing, but I think a part of the problem is just that I'm hiding.

And so, at this point, I don't need to hide anymore.

I need to be honest, so I think I'm gonna tell 'em.

But the truth is I'm scared to death, scared to death they're not gonna wanna associate with me anymore.

That's the truth.

It's why I'm afraid to go up there.

And if I go to be with your family and they reject me-- just I'm so fragile right now.

I know that, but I don't know which is worse, you know?

Hiding because I'm afraid at this time of facing that, and I don't know if they're gonna want me there, 'cause it's kind of a awkward time.

I wanna honor the family's needs, you know, and I guess it's just kinda screwing me up a little bit.

What do you think?

Doug: I think that they've gone out of their way to express to me that they really miss you, and that they really wish you hadn't gone, and that they still love you.

And I think you have to expect that they're gonna feel a little funny around you.

female: Yeah, I'm sure.

Doug: And I'm sure that they'll react a little peculiarly, but I don't know that that means that they're gonna reject you.

Will that work for you?

female: Unless you don't want me to be there.

Doug: Yeah, I just think it's funny that you keep going around in a circle.

female: Well, no, I wanna honor your needs.

Doug: What I keep saying is I can't know from here.

I think it would be nice if you were there, but I have to get a better feel for it when I get there and see how things are going.

female: Okay.

Doug: Does that work all right for you?

female: Well, you mean you might not tell them that I'm here?

Doug: No!

I just mean I don't wanna talk about it now.

I can't think about it right now.

female: I know that you don't wanna talk about it.

Doug: Yeah, well, I don't think it's gonna be anything like a big deal.

I don't think they'll even have time to notice.

female: No, it'll only be a big deal for me.

Doug: Yeah, it certainly will be that, and I don't wanna take away from that, but I mean, I don't think that they're all gonna go off worrying about it, about us and what's happening with you, 'cause I think that they're all gonna be just worrying about my parents.

female: Sure.

No, I know.

I know, and I could be there to support.

Doug: Don't worry about it.

You just take care of you, and I'll take care of me.

female: You can lean on me, because, you know, I mean, I know what--I mean, it's like your whole family is gonna be in really terrible upheaval, and it's gonna be hard to lean on each other.

And I'm here for you, okay?

Doug: Okay.

female: I could be your secret hideaway, if you're interested.

Doug: Okay.

female: I mean, I could be there for you.

You've been there for me for so much.

Doug: Well, thanks.

female: 'Cause we're buds.

Doug: Yeah, I know.

I know we're good buds.

female: Yeah.

Well, you just-- you keep me posted.

Doug: Okay.

female: Thinking about you.

Doug: Thanks.

female: Okay.

Doug: Talk to you later.

female: Bye.

Doug: Bye.

Dr. Beach: Mom's sister, son's aunt, is also a part of these calls.

She lives in San Diego and is able to be with mom, dad, and son who is in Austin through this journey.

[phone ringing] Aunt: Hello.

Doug: Hi there.

You would call earlier, right, when I'm out walking the dog, wouldn't you?

Aunt: Oh, well, what can I tell ya?

Your dad just came home from the hospital, he and I, and I know your mother called to say goodbye.

I can't really blame her for her attitude, Dougie.

And you thought you'd be coming home to see her for the last time.

Doug: Well, Jesus.

This is yucky, isn't it?

Aunt: Yeah, it is.

Doug: Ah!

Aunt: It's a real Russian roulette.

Doug: Yeah, it sure is.

Aunt: It's devastating.

I mean, no matter how you cut it it's devastating, all this guesswork.

Doug: Yeah, it sucks Aunt: Yeah, well, that's a real sweet way of putting it.

Doug: Yeah, I know.

Aunt: Come on.

Doug: Yeah, I'm known for my tact, you know?

Aunt: Yeah, me too.

It's genetic.

Well, neither your dad or I believe she'll be here for Christmas.

Doug: Yeah, well, I keep wondering if we can even realistically think about Thanksgiving.

Aunt: I don't know.

All I can say is that tomorrow morning we'll talk to Dr. Wiley.

She should be able to give us some path.

It could be a very short path.

Just don't know.

Doug: Well, hang in there.

Aunt: I'm hanging.

Doug: Okay.

Aunt: I have no choice.

Dr. Beach: Aunt and son describe their experience as yuck and devastating, it sucks, like a real Russian roulette.

During other moments in these phone calls, family members describe themselves as being caught up in a-- Doug: Confusing roller-coaster ride.

Dr. Beach: Their experiences are-- Dad: All part of the game.

Dr. Beach: And the need to face challenges as a family is a priority.

Aunt: We're all gonna have to pull together, 'cause this is just gonna knock us for a loop.

Dr. Beach: At times, the family pulls together by talking about the journey that they're navigating, yet at times we are alone.

[phone ringing] recorded message: Hi, this is Lorraine.

Rich and I are unable to come to the phone right now.

If you leave your name and number, we'll get back to you as soon as we can.

Thanks for calling, bye.

Doug: Hello to my little family.

It's Thursday evening.

It's about 9 o'clock my time, so I guess that will make it about 7 o'clock yours.

I'm gonna go walk the dog for about 10 or 15 minutes, but otherwise I'm here and I was just wondering what's going on.

I think Mom was gonna come home today, and if she has, hello.

And if she hasn't, what's happening?

Either give me a holler tonight, or you can give me a ring tomorrow morning sometime.

Let me know what's going on.

Thanks, bye.

Dr. Beach: Some conversations we have are uplifting and others interactions that are difficult.

At times they're even uncomfortable, but heartfelt and supportive.

Mom: Well, so anyway, nothing else new here except I'm just very tired and very hurt-y today.

Doug: Mmm.

Yuck, huh?

Mom: I can't seem to break the cycle of yuck and hurt.

I asked him for a pain pill this morning, and he gave me one, only I forgot about it.

So, I asked him for a pain pill, and Dad came in, and he said, "You already had one."

I said, "Well, whoops."

[laughing] Doug: Had it not kicked in yet, or did you just need two?

Mom: Well, I guess-- I guess it hadn't kicked in, and I needed two.

Doug: Oh, boy.

Can you get through the night?

Mom: Yeah.

Yeah, I can.

Not real well, but I can.

Doug: Yuck.

I really don't envy where you're at, Mom, I gotta tell you.

Mom: Yeah, sometimes it's really, really-- it's just so painful.

I don't know what to do, and I just-- I don't even know what to do.

Doug: Huh.

Yeah, it's gotta be weird, 'cause there really isn't a hell of a lot you can do, is there?

Mom: Nope.

Doug: Oh, boy.

Well, I am thinking about you.

Mom: Thanks.

Doug: Dad said they found some stuff in your spine.

Mom: Well, they did.

Doug: That's not very fun.

Mom: No, it's very painful.

Doug: Yuck, huh?

Mom: You're right.

It's yuck.

Doug: Well, I'll let you get back to-- Mom: To whatever I'm doing.

Doug: I will probably send you a letter here in the next day or two.

Mom: I did enjoy the letter, by the way.

Doug: Oh, that's good.

I'll send you another one this week.

Mom: You won't get any letters from me because I can't do it.

Doug: That's okay.

All right, well, I love you, Mom.

Mom: I love you too, sweetie.

Doug: Okay, take care.

Mom: See you later.

Doug: Bye-bye.

Mom: Bye.

Dr. Beach: When families go through cancer, there comes a time when even though the illness may progress, life seems to take on a new rhythm.

Something like a new normal emerges, where even though we live with the illness and its problems the bright side of life begins to emerge again, where humor, play, and teasing, even glimpses of joy, bubble up even in the midst of uncertainty and suffering.

At times, you know, the sun's rays, they begin to shine through the clouds, but how does this family do being hopeful?

Well, some beams of hope radiated from where you might least expect them during these curious and funny stories about dogs, hair, furniture, old and new relationships, and much, much more.

[phone ringing] Doug: So, what's the story?

Dad: I hooked up the phone yesterday.

Your mother was feeling a little better.

Doug: Okay.

Dad: She said sure she'd be delighted to talk to you.

I should pick a time, see if you could match it.

She'll make sure she's in the room someplace so she can grab the phone, so I said, okay, between 9:30 and 10 o'clock our time.

Doug: Okay, by then Charles should have forgiven me for giving him a bath this morning.

Dad: Uh-huh.

Doug: Yeah, yeah, he's not happy with me.

Dad: Oh, so he's now a soggy camper, huh?

Doug: That's right.

Well, you know giving Clinger a bath is a challenge, I'm sure, but you can pick him up and you can put him in the sink.

Dad: No, I do.

Doug: And you can hold him down.

Dad: Yeah, I do that too.

Doug: Charles, on the other hand, you can't do that with.

Dad: Oh, he's a little larger.

Doug: Yeah, he's a little larger.

Dad: We're up to bathtub size, yeah.

Doug: We're up to bathtub size, but even that is very difficult, particularly if there's only one of you.

But I have figured it out.

Dad: Put the shower on.

Doug: Yes!

And get in.

Dad: Oh, okay.

Doug: Really, it works.

It's the quickest, and it's the most thorough.

Yeah, and it seems to be--it's-- I mean, it's a thoroughly demoralizing experience for young Charles.

You know, if the two of us get right in there, I just strip right down and climb in with him, and we get him thoroughly soaked down.

Then we just turn it off, lather him up, let him soak for a few minutes, and this actually works like a charm.

Dad: Hmm.

Mm-hmm.

Doug: Yeah, but we survived it this morning.

Dad: He's clean for another week or two.

Doug: Yeah, and he's clean for another couple weeks.

Yeah, so it's been a traumatic morning already.

Dad: Yep, I had a cute one last night.

You'll appreciate this.

We got home last night after the hospital, and we stopped to eat and that kinda business.

So, Clinger and I were in our bed, my bedroom, and you know, I'm reading the paper and he's laying-- I guess he was laying on your mother's bed at that point.

Of course, he lays right smack between the television set and me.

So, I flip on the news, and I can't see because I'm laying down.

He's laying down.

He's a lump right in my line of sight, so I say, "Get down," so he gets down, you know?

Gives me this indignant look.

Gets on the floor.

"What a hell of a place for a dog, on the floor."

Doug: Right, imagine that, huh?

Dad: Yeah, yeah, imagine that.

Talk about deprivation.

But anyway, got to the end of the news, so I shut the thing off and I roll over.

About five minutes later, I hear this bam!

"What the hell is that?"

Old dummy here decided he was gonna jump back up on the bed, but he didn't pay any attention to where he was relative to the bed.

So, he makes this flying leap, doesn't get far enough, and plowed right into the sideboard of the bed.

Doug: Oh, geez.

Dad: I flip on the light.

He's over there shaking his head, looking at the bed, you know?

And then when I got the light on he jumps up on there again, looks at it, and lays down.

God.

Doug: Dogs, huh?

Boys and their dogs.

That's what we've come to, both of us, huh?

Dad: Yeah.

Oh, I don't remember that being part of the original plan.

Seems to have digressed to that point though.

Doug: Huh.

So, how is everything else going?

All right?

Dad: Yeah, seems to be.

Yeah, things around here are doing fine.

It's all under control.

Doctor did say yesterday that she seems to have some kind of infection.

They're periodically giving her intravenous antibiotics for it.

Dr. Beach: And then there is grandma, dad's mom.

God bless her.

She also lives in San Diego and closely monitors not only how mom and the family are doing, but son as well.

[phone ringing] Grandma: Ah.

[phone ringing] Doug: Hello, Doug here.

Grandma: Oh, you are really home already.

How are you?

Doug: Oh, pretty good.

[inaudá*] Grandma: Well, I'm just sitting here trying to get my energy up.

I'm drinking my second cup of coffee, thinking about when to clean up the house.

Doug: Yeah, without your sweet baby grandson to come vacuum it for you.

Grandma: Right.

Doug: Is something up?

Grandma: Well, your mother came home yesterday.

Oh, Friday.

Doug: Wow.

Well, that's good.

Grandma: Well, she said, "I don't know," but-- Doug: She doesn't know that it's good?

Grandma: Well, no, she says "I don't know" because she's afraid that pain will start up again.

Doug: Mmm.

Grandma: And the other night she farted, and she said, "Oh, I'm so embarrassed when I go..." [blowing raspberries] But you know, she's gassy, so.

And oh, I'm taking her in for her GI series the day before Thanksgiving, you know?

That means when they give her enemas and stuff, you know?

Yeah.

And you said you needed a recipe for some cookies.

Doug: Yeah.

Grandma: Well, I wrote some down on a card, and I sent it to you yesterday with some of my sour cream cookies.

Doug: Great.

Grandma: Well, I decided to wrap them up in some soft cloth, you know, the kind you can also dust with.

Doug: Well, you know I don't have a good dustcloth, and I got a couple of nice pieces of nice wood furniture, like that dresser from Aunt Esther and you know, those little side tables and all that.

Grandma: Well, now you can dust with some soft underpants from your grandmother 'cause I sent 'em your way.

Doug: Well, wouldn't those be just perfect?

You're giving me something to look forward to, and I can explain that to everybody that comes over.

"You wanna see my grandmother's underwear?"

Grandma: Yeah, I even sewed 'em together a little bit, you know, so they don't look bad, and I cut off all the wrong parts and the rubber there and everything so it stays a nice soft cloth for you.

Doug: Okay.

Grandma: But you know, I haven't had very many wear out lately, so I've got an oversupply of 'em.

I'm gonna have to wear some more out.

Doug: Yeah, well, the thing to do is just sit on the floor and scooch around a lot.

Grandma: Oh, yeah, all I need is just one tiny tear, and then I'll say, "Oh, well, this is no good anymore."

Doug: Uh-huh.

"Yeah, make a cloth outta this one."

Grandma: "Yeah, make a cloth outta this one."

Well, anyway, I think that's enough for this morning.

Doug: Okay.

Grandma: But things are going along about the same.

Well, I'm anxious to--I think we'll probably go over and see your mother and father tomorrow.

Doug: Mm-hmm.

Well, thanks for calling.

Grandma: Mmm.

Take care.

And now, don't get too involved with anybody.

There's not a lot of nice people out there, but just don't get yourself a reputation.

Doug: Okay, I'll behave.

Grandma: Well, not just behave, but be cautious about who you go out with.

Doug: Sure.

Not to fear.

Grandma: Not to fear.

Okay, honey.

Doug: All right.

Bye, grandma.

Grandma: Bye-bye.

Dr. Beach: As these phone calls unfold, there's often an intricate balance and tension between these serious, troubling matters and simply playing together.

Despite the many challenges associated with cancer, funny, good, and hopeful possibilities arise out of otherwise troubling topics.

Doug: Is her hair grown back yet?

Dad: No, she does have a little stubble up there, 'cause I kissed her goodbye last night, and I got whisker burns.

Doug: Oh, well, tell her she should shave.

You gotta get her one of those electric-- like, Norelco or something.

Dad: Yeah.

Doug: Yeah, she could meeeee over her head.

Dad: Remington.

Doug: Yeah, yeah, there you go.

Or an Epilady for your head, huh?

Dad: Right.

Doug: Okay, well, I should scoot.

I'm gonna be paying for my phone bill until June, but I wanted to see what was going on 'cause I was just, you know, just wondering.

Dad: Well, not a lot yet, but if anything comes out of the meeting with the doctor this morning or whatever, I'll give you a buzz tomorrow morning.

Doug: Okay, well, if there's anything to tell me let me know.

Dad: You'll know.

I'll keep you apprised.

[phone ringing] Doug: Hello, Doug here.

Dad: Good morning.

Doug: Morning.

How are you?

Dad: Fine, you?

Doug: I'm pretty good.

Grandma called this morning, and I had a good chat with her.

I understand mother is home.

Dad: Yes, she is.

Doug: How's that going?

Dad: Uh, tough.

Doug: On everybody?

On her?

On you?

On who?

Dad: All of the above.

Doug: Okay, you know, this sounds terrible to say, but is it worth it?

Dad: It's not a choice.

They discharged her.

They will not just warehouse her.

Doug: Oh, okay.

Dad: Doctor said, "You know, take her home.

Handle her with hospice.

She can be there and probably like the surroundings better, et cetera."

She wasn't overly thrilled, but you know, but I brought her home on Friday.

They have elected to do radiation on both the upper and lower spine to try and reduce the tumors there and see if they can make it any less painful for her.

Then we came home and she spends a lot of time sleeping, or at least dozing partially because of the medication, et cetera.

Doug: Sure.

Dad: I kinda screwed up the medication on Friday.

Doctor wrote out the whole set of instructions and all the pills that she takes, how often and all that stuff.

I don't know.

I guess in my mind I hadn't thought it through too well, but she said that particular pain medicine should be three times a day, fine, breakfast, lunch, and supper.

Doug: Oh, so you didn't have anything to go through the night with.

Dad: Yeah, right.

Doug: Oops.

Dad: Took, like, the best shot at it and missed.

Doug: Mm-hmm.

Dad: Four, five o'clock in the morning everything hurt like hell, and she's frantic and all that kinda business, so I gave her a couple of pain pills.

And that calmed her down a little bit, but it still hurt.

So, this gal brought me three different dishes of things: meatloaf and chicken and-- Doug: Casserole stuff.

Dad: Yeah, enchiladas.

Doug: That's nice.

Dad: Yeah, it was great.

Your mother was busy looking at 'em, and you know she-- Doug: I'm sure she's not up to cooking, huh?

Dad: No, no, no.

You know, very much like Aunt Esther, she gets kinda flustered.

But she was looking at 'em and geez, your mom thought this was great, so she takes all the tin foil off all three of 'em, all in the metal pans, and she wants 'em all put in the microwave.

She's gonna cook 'em.

Doug: Uh, okay.

Dad: You can't cook 'em with the metal pans.

Doug: Ah.

Dad: So then she fell yesterday morning here in the kitchen.

Doug: Oh, you're kidding.

Dad: Came 'round the corner.

I said, "Okay, wait a minute.

I have to go to the bathroom," but I went the other way.

And she was gonna walk around here and get a cigarette.

Halfway across the kitchen floor, between the two counters, her leg gave out.

Down she went.

Doug: Oh, Jesus.

She's still smoking?

Dad: Yeah, she's still smoking.

Doug: God.

Dad: Yeah, it's my life's fight.

Doug: Yeah, I guess.

Dad: Kinda, yeah.

Doug: Well, it's kinda morbid way of looking at it, but what the hell, huh?

Dad: Yeah.

And when the funeral directors do the cremation and I give 'em a carton of cigarettes and say, "Lay 'em on top," they're gonna -- Well, I won't really do that, but I will seriously think about it.

Doug: Yeah.

Dad: You gotta watch, because -- you know, when she fell, she had a cigarette in her hand.

Doug: Uh-huh, and the way she falls asleep, you gotta watch that, too, huh?

Dad: Yeah, and I won't give her a cigarette unless I'm sitting right there looking at her, 'cause she could go to sleep and it would burn her hand or something.

Doug: Right, so she's not thinking real straight?

Dad: Not even close.

Not too sweetly, either.

Doug: Hey, that's gotta be tough on you too.

I know you were saying that she was getting snarkier and snarkier.

Dad: Yep.

Well, she's frustrated, you know?

Doug: Sure.

Dad: If she understands on the inside, she sure doesn't say it verbally.

It's gonna be like Aunt Esther.

You don't know how much is truly going on accurately in her mind.

You listen to what comes out of her mouth, you know, and that gets confused.

She'll be standing here saying, "Well, okay.

Get some flour and sugar, and I'm gonna make breakfast, okay?"

Thursday morning, she came out, poured herself a cup of coffee, put orange juice in it, and started drinking.

Said, "Boy, you make lousy coffee."

[Doug laughing] I guess I shouldn't laugh, but that is kinda funny.

Dad: Yeah.

Doug: But that's like Aunt Esther putting the plastic pot on the stove and trying to cook it, right?

Dad: Mm-hmm.

Same thing.

Doug: How are you gonna be able to go to work?

Dad: Well, we're gonna trade off, 'cause I'm gonna have to take her in to continue the radiation.

So, I have to take her in every morning at 8:30.

Doug: Mmm, geez.

So, are you doing all right under the circumstances?

Dad: Most of the time.

You can't dwell on it because you drive yourself crazy, so you say, "Okay, it's under control for now.

I will do what I have to do, and that is to keep her comfortable, keep her fed and warm, and all that kinda stuff."

It makes it easier, and I'm trying to make it as easy as I can.

Doug: And that's really about it, huh?

Dad: Yeah.

This is just killing me, you know?

Hell of a lot of life isn't a choice, and you do this for the ones you love.

And so, you know, it's bill-paying time.

Doug: Hmm.

Whew.

Dad: And yes, it gets tough at times, 'cause you're trying to be nice and then you get hell because you hover or you're not doing what she wants.

She asks for something, I say, "Okay, I'll go do that."

And by the time I get back, that's not what she wants.

That's the way it goes.

Doug: Yeah.

Dad: It's not rational behavior, so you gotta stop and think, "Wait a minute.

Stay pleasant overall.

Don't get all bent outta shape over it."

And I don't always do that too gracefully.

Doug: That's right.

This is gonna teach you tolerance like nothing else in the world, huh?

Dad: Oh, yeah.

Yeah, I guess it does.

[mother coughing] Dad: Just heard your mother.

Maybe she woke up.

Hang on.

Doug: Okay.

Mom: Hello.

Doug: Hi.

How are you?

Mom: Oh, better.

Doug: It's nice to have you home.

Mom: Well, it's pretty good to be here.

Doug: Dad said you're not walking real well, though.

Mom: Not hardly.

I don't know what to say.

All I know is it's nuts around here.

Doug: Mm-hmm.

So, are you mostly sleeping during the day?

Mom: Yeah.

Oh, geez.

It just hurts when I do things like lay down, and it hurts when I do this.

It hurts when I do that.

Nothing I can do.

Doug: Huh.

Just everything hurts, huh?

Mom: Yeah.

Doug: Have they got you on something that keeps that down, I hope?

Mom: Oh, yeah.

Oh, yeah.

Doug: That's good.

Mom: Yeah, for sure.

Doug: Well, otherwise it would probably drive you nuts, huh?

Mom: It would certainly.

Doug: I understand you have someone coming by now, like a hospice nurse or something.

Mom: Yep.

Doug: What does she do?

Mom: Yesterday she kinda talked a lot.

Doug: Oh!

Well, sure, you could get a lot of people to do that.

Just turn on the radio, huh?

Mom: Right, and we just sit there and talk.

Doug: Mm-hmm.

I suppose it's nice to have somebody to talk to.

Mom: Yeah, and they help me a lot.

Doug: Good.

Part of the plan.

Mom: Yeah, part of the plan.

Doug: Hey, I met a girl, Sharon, and you can tell this to Dad.

He'll appreciate this.

And it made me feel good.

I thought, "Ah-ha," you know?

I'm feeling all this terror and panic about how would I ever meet anybody, 'cause, you know, I don't like to go to bars.

Mom: Yeah.

Doug: But I met this woman, and I thought, "I could ask her out.

Yeah, and I think maybe she'd go."

Mom: Mm-hmm.

Doug: So, there.

You can know that at some point there's hope for me yet.

As unnerving as the thought is of having to ask somebody out, I think I could do it.

Mom: I'm sure you can.

Doug: Well, but you know I never really have.

Mom: I know.

Doug: Mom, it's nice to know that you have confidence in me.

Mom: Mm-hmm.

Doug: But I don't always know that I have confidence in me, you know?

Mom: Sure.

I understand that.

I'm not worried so much, and I can have daddy-- I'll have him call you, and he can tell you that you'll be all right.

Doug: Okay.

Mom: Well, okay, sweetie.

Doug: All right.

Well, it's sure good to talk to you.

I'm glad you're home.

Mom: I feel better.

Doug: That's good.

Now watch for a letter from me in the mail.

Mom: All right.

Doug: All right.

Well, it's nice to talk to you, Mom.

Mom: Okay.

Doug: Okay, bye-bye.

Mom: Bye-bye.

Dr. Beach: Cancer.

It changes daily routines and responsibilities, reshapes your character and your philosophy about living.

Doug: So, what's up?

Dad: Nothing.

I just called to say good morning, see how you were doing, all that kinda stuff.

Doug: Ah, well, good.

It's better than finding out that there's something up, I guess, huh?

Dad: Yeah.

No, no, nothing's up, but she's still-- I'm gaining new appreciation for hospital orderlies and home healthcare people.

Doug: Oh.

Dad: That's what I'm doing.

Let me tell you just trying to give her a bath yesterday wore me out.

Doug: I bet.

Dad: Get your shoes and socks off and you know, roll your pants up 'cause you gotta get her in and out.

Doug: Mm-hmm.

Dad: And fortunately, washing her hair is easy.

Doug: That's right.

That's right, no hair.

Dad: I catch myself doing that every once in a while.

It's dumb because, I mean, it's been like this for so long.

But you know, I got her in the tub, and she had soap and a washcloth, and she was doing a little washing, so I said, "Okay, hang on a minute.

I'll go get the shampoo."

And I walked out the door, and I said, "What a dumb thing."

So, I went back, and I got the washcloth and soap and said, "Oh, god."

Doug: You need a bowling ball washer, huh?

Don't tell her I said that, okay?

Dad: No, I won't tell.

Doug: Yeah, you could just get a little Pledge and a kinda dustcloth and you know, tch-tch-tch, right?

Dad: Polish it up.

Doug: Buff it up.

Dad: Uncle Tom's car buffer.

Few of those and boy, it'd be shiny.

Doug: I like it.

So, what's she doing?

I mean-- Dad: Uh, less and less.

Doug: Less and less, okay?

Dad: Uh-huh.

She got up for a while yesterday.

She fell--oh, hell-- Friday morning.

Doug: Grandma mentioned that Mom had a fall.

She didn't tell me much about it.

Just that she had.

Dad: Well, once in a while she decides to get up in the middle of the night to go to the bathroom, and I sleep pretty sound, so I don't always hear, you know?

Apparently got herself up outta bed, tried to stand up and all.

I remember hearing--well, she said something about, "Uh-oh, here I go," and I hear this god-awful crash, you know?

You come outta bed like you've been shot.

She banged the back of her head on the door, just crumbled over, went over backwards.

There's a goose egg in the back of her head, big, red, raised lump.

Doug: Wow.

No hair to cover it.

Dad: Nope.

No hair, but anyway, I suspect those tumors are growing and time has just taken its toll.

She does very little.

Every now and then you get an answer back or you get some smile like she's pulling your leg, so part of her is still working fine.

Doug: That's good.

Well, there isn't anything you can do other than just keep doing what you're doing.

I'm just making sure that you're at least dealing with this as it happens, you know?

It's really easy to kinda put your head down and plow and not think about it, and you can't do that, you know?

Dad: No, but you can't get too caught up in it either.

The emotionality destroys your need to just keep going.

Doug: Right, right.

Dad: Somewhere in there is a medium.

Doug: Yeah, I just wanna make sure that you're trying to stay towards the medium, 'cause I've known you for a little while, and I know you'll tend towards one side.

And that won't do anybody any good and you know, the last thing we need to do is have you explode in the middle of all this.

Dad: No.

Doug: I have to say that from what I've been able to tell, I think that you're doing really well with this, frankly better than I would have expected.

Dad: Oh?

Doug: And I don't mean to say that in any way that's disparaging at all, but well, you know, during the last year I would say that it's really made me happy to see how you and Mom talk a lot more and get more in touch with a lot of things about how you're feeling about stuff.

And it's kinda more you than Mom, I think, but you've opened yourself up to a lot of things that, you know, maybe were always there and I just never saw it.

But it kinda gave me the impression like, if nothing else, this whole process has forced you to get in touch with a lot of things that you put on hold for a long time.

Dad: Mm-hmm.

Doug: And it's kinda neat, you know?

Dad: Well, somehow your priorities seem to change.

Things that were such a big deal before become less significant.

Some of the rest of this stuff becomes more significant, so hell, you know, life is a learning process whether you're 15 or 50, so I'm still learning.

Doug: Yeah, yeah.

Well, that's good.

Dad: Oh, yeah.

Doug: I mean, the day you quit you can just pack it in at that point, because then you're not alive anymore.

Dad: Well, you can't quit, because it still boils down to you gotta keep trying.

You gotta deal with the imperfections in yourself and everybody around you, try not to make it some life-or-death kinda battle.

It always has to be a confrontation.

And I don't always remember that, you know?

Doug: Mm-hmm.

Yeah, I understand.

Okay, Pop.

Take care of yourself, okay?

Dad: Yeah, don't worry about me.

Bye now.

Doug: I love you, Pop.

Dad: Okay.

Dr. Beach: These final two phone calls occur between son and his girlfriend Sharon.

In the first call son is getting ready to travel back to San Diego, having been informed that his mom is near death.

And the final call takes place only a few hours before mom's death.

Son has arrived in San Diego to be with his family.

Sharon is house sitting.

He reaches out to her, someone close yet far away who represents another life in his other home.

Doug: Hello, Doug here.

Sharon: Hi there.

Doug: Hi, Sharon.

Sharon: What are you doing?

Doug: Packing.

Sharon: Packing?

Doug: Uh-huh.

Sharon: Oh no.

Doug: Yep.

Sharon: Oh.

Doug, I'm sorry.

Doug: Yeah.

Me too.

Sharon: You want me to come over?

Doug: Well, whenever you get a chance I certainly wouldn't object.

Sharon: What time's your plane leaving?

Doug: Tomorrow morning, 7 o'clock.

Sharon: Tomorrow morning.

Oh, hon, I'm so sorry.

Doug: Yeah, well, I'm not entirely convinced based on the phone call that I had that I'm even gonna make it, but we'll see.

I guess this is as good a time as any.

Mom's always been so nice that way, you know?

Sharon: Oh, god.

Doug: Yeah, I'm frazzled.

Sharon: Are you?

Doug: And I don't know if I can even think straight enough to reason my way through it.

Sharon: Well, all right.

You know, I think I'm just gonna go ahead and come over in a little bit.

Doug: Okay.

Sharon: Okay.

Doug: I'll see you in a bit, then.

Sharon: Okay, bye.

Doug: Bye.

♪♪♪ ♪♪♪ [phone ringing] Sharon: Hello.

Doug: Hi, sweetie.

Sharon: Hi.

Doug: How you doing?

Sharon: Mmm, I'm fine.

I'm sleeping.

Doug: Oh, I'm sorry.

Sharon: No, no, it's okay.

Doug: What time is it there?

Oh, I forgot about the time difference.

Sharon: I think it's, like, midnight.

Doug: Oh, geez.

I'm sorry.

I was thinking it was earlier.

Sharon: No, it's all right.

So, what's going on there?

Doug: Oh, I guess nothing other than what I expected.

You know, she's-- boy, she's terrible.

Sharon: Is she, hon?

Doug: You know, she's just about as gone as a person can be and still be alive.

Sharon: Oh, god.

Doug: She doesn't respond at all.

She can't eat anymore.

You know, she rattles when she breathes.

You gotta put water in her mouth so her lips don't crack.

Sharon: Oh, lord.

Doug: But everybody else seems to be doing, you know, reasonably okay, I guess.

You know, mostly, I guess, I was just thinking about you, and I wanted to call and talk.

Sharon: I'm glad you did.

I was-- Doug: I didn't mean to wake you up, but I really did wanna talk.

I was thinking it was earlier, and I forgot which way the-- direction the time went and-- Sharon: Mmm, I know.

It's okay.

I don't care.

I don't care.

We miss you.

Doug: I miss you too.

Dr. Beach: After 13 months and 61 phone calls, cancer took mom's life just hours after this last call was recorded.

That was this family's journey, but of course, not all cancer diagnosis results in death.

Fortunately, more than half of all cancer patients are survivors, moving forward with their friends and family to live healthy and productive lives, yet the ongoing challenges of facing cancer together--the fears, the hopes, and dealing with uncertain futures--are much more similar than different.

Imagine how many phone calls about cancer were made today in San Diego or California or the United States or the world, and these phone calls are the first recorded natural history, calls that could not have been recorded by the son or might not have been investigated if it wasn't for my own mother's cancer affecting me so deeply.

I have learned so much from these family cancer conversations that communication between family members and friends can be a source of strength and resilience when facing life's most difficult challenges, that hope softens the blow of despair, good news arises out of bad, living is more important than dying, and that families-- well, families endure forever.

Thanks to this family a natural history has been provided for me and now for us to study and to more fully appreciate how family members rely on telephone conversations to navigate their way through cancer.

It has been my good fortune to work with this collection of phone calls, an experience similar to harvesting grain from such fertile fields that I did not plant.

In the end, what we have heard are interactions produced by ordinary people.

By relying on each other and talking on the telephone, these family members have reminded us to not take for granted how extraordinary and also how beautiful the dance of communication can be whenever we gather together in conversation to share our experiences about the trials and tribulations, hopes and triumphs of everyday living.

Dad: Hello?

Doug: Hola.

Dad: ¿Como estas?

Doug: Bien, bien.

You too?

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