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I’ve worked in the healthcare industry for the past 17 years, specializing in emergency, rehabilitation and end of life care at facilities ranging from large universities to local community hospitals. It wasn’t until the past 7 years in the long term acute care setting that I started noticing an alarming trend: patients starving to death, literally. Whether the starvation stemmed from cancer and its treatment or just old age, it almost always took on the same symptoms: lack of appetite or severe nausea. As healthcare workers, we try to coerce patients to eat by hand-feeding the unwilling. We pump liquid nutrients through their Ivs, and we even place tubes in their stomach to force enteral nutrition. I’ve seen patients receive prescribed medications such as Marinol (synthetic delta-9-THC) as well as other appetite stimulants, but most of the time it’s with the same outcomes: more Cachexia (wasting syndrome) and then ultimately, death.
For years I’ve watched patient after patient roll through our doors, readmission after readmission, until there is basically nothing left. Starvation leaves them shells of their former selves, not even half the men and women these once vibrant souls used to be. Skin and bones, covered in wounds and all because there is no more adipose(fat) tissue left in their bodies to protect their skin from the hardness of their bones pressing against the hospital beds to which they are now confined. Pressure sores turn into open wounds, open wounds leave the patient more susceptible to infection, breakdown of protein and muscle fibers cause multisystem organ failure, targeting the kidneys, heart, liver and eventually the lungs. Modern medicine isn’t helping, because no matter how hard we try to get them to eat, no matter what we pump into these increasingly lifeless bodies, in the long run, it does not matter.
Within the past year I’ve witnessed two impactful events that led me to pursue other alternative therapies, to become educated on natural medication, including medicinal cannabis. The first event happened late one night when I was called to help a friend with her father who was dying from cancer at his home with hospice. The struggle in those last 2 days of his life, not only his but his family’s, was hard for me to experience. As a respiratory therapist I was there to help him breathe easier in his final moments, bearing witness to his daughters caring for him as tears of utter sadness rolled quietly down their cheeks. He had been prescribed morphine to help him through the excruciating pain, but it made him sleep. Although the medication temporarily took the pain away, it also made him too dazed to eat. The daughters talked of how much weight their father had lost just in the past 5 months since his diagnosis of lung cancer, how quickly his body wasted. Outside on the porch, the daughters talked about the unspoken issues between them and their father, things that would never be resolved. As I watched this unfold I felt so much empathy for what they would be left with, holding on to unresolved matters.
The second event was a patient on life support dying from laryngeal cancer (cancer of the throat). As I went through his medical and surgical history I noted he had surgery about 2 years prior on his throat to remove a tumor. At that time he was walking, eating and living. The surgical notes state the radiation therapy done prior to surgery to shrink the tumor also damaged this man’s esophagus by hardening it. That, in turn, interferedwith his normal eating habits. The cancer came back some time later, this time in a man who was malnourished, in a weakened state, I’m sure physically but one can only surmise mentally as well.
So, as I am in this man’s room taking care of him, I can’t help but notice his emaciated frame and wonder what if things had been different? What if he were in a state that allowed medical marijuana? What if he had access to specific strains to treat loss of appetite and nausea? What if he had the desire to eat and the chance to medicate, just feel better, to escape the fact that he had a mass growing inside of his body? And I wondered could this man have made it through another bout of chemo/radiation with a healthy body? Could he have perhaps survived another surgery? What if surgery and chemo/radiation weren’t necessary? Could the cancer cells in his body have been stopped or put into remission by high doses of medicinal cannabis oil to possibly kill the cancer cells? Unfortunately, I will never know as my state does not recognize medicinal marijuana as a legitimate medicine.
And for my friend who lost her Dad, I wonder if her father could have benefited from medicinal marijuana. Could he have been helped to feel more at ease during his last months and not lethargic from the prescribed morphine? Could the family have had more time, more time to talk out many of their family issues, to hear the things they needed to hear from their father, or for them to say the things they needed to say? I don’t know.
What I do know is this: I can do what is within my power, to stand up and fight for legalization of medicinal cannabis, to become more educated, to educate and become more vocal in this fight for my patients and their loved ones rights. I hope one day in the future I will never see patients like this again because our state will wake up and realize this isn’t an issue of marijuana, that it is a human rights issue. No being should have to die like this, to waste away to absolutely nothing before they pass. It is an ugly truth, but one that needs to be told.
Photo Credit: Coleen Whitfield under (CC BY-SA 2.0) via Flickr