What my patients have taught me about dealth—and life—by permitting me to be with them at the end.

Mrs. Anna Velosian’s daughter calls me to say that the cancer on her mother’s neck is bleeding heavily. I leave my office to make a house call on the 88-year-old Armenian woman. Her daughter meets me in the kitchen, and her mother is sitting on the sofa. Mrs. Velosian stands to greet me; she is four feet eight inches and now weighs 85 pounds. Ten years ago, she decided that she didn’t want us to treat the slow-growing cancer on her thyroid. But Mrs. Velosian’s cancer has recently grown into a tumor the size of a billiard ball. I remove the bandage and see that the white, glistening tumor has grown right through the skin. There is a red, open patch the size of a quarter. There are no visible bleeding vessels.

Mrs. Velosian’s daughter shows me the bedroom. Blood stains the pillows, the sheets, even the mattress. I return to Mrs. Velosian. She gives me a big smile. “How are you?” I ask. She is hard of hearing, but she knows what to say. She always says the same thing to her doctor. “Fine,” she says. “Fine.” And I see the cross on her wall and I remember her life story and I think, yes, you will be fine. You are fine now and you will be finer. And I call the home hospice nurse, and I tell the daughter to call relatives, because it will not be long before Mrs. Anna Velosian will be going home to be with Jesus.

In many ways, my patient’s stories are more interesting than my own—more poignant, more dangerous. Their stories have been full of lessons for me.

Seeing Mrs. Velosian reminds me that life has a tenacious dignity. Despite the cynicism with which we doctors guard ourselves, this dignity often takes us aback. The Down’s syndrome ...

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