Bone China

pexels-photo-209438.jpegThis story was relayed to me by an acquaintance:

On a bright sunny spring day, Katie watched as her elderly neighbor walked solemnly into her house.  Her neighbor’s husband had been fighting cancer for a couple of years, and his condition had declined greatly over the winter.  Katie suspected the worse.

“Hey, Marge,” she said, tilting her head a little.  “How are things…”  She was hesitant to finish the sentence, hoping it wasn’t bringing up a subject she wasn’t ready to discuss with the neighbors, “you know, with Joe?”

“Oh, he’s doing much better.  He’s going to hospice today.”  She smiled and invited Katie in for tea.  Katie started the kettle while Marge got out her bone china cups and saucers.  They made small talk about the weather and old man Nichol’s with his knee socks, and Katie waited for Marge to give information about Joe.  By the time the kettle blew, Marge had set a beautiful table.  The candles were lit, cloth napkins folded just so, a dish was filled with pecan crisps, and real cream in the pitcher.  Her china set was elegant with dainty flowers and gold trim.  The dining table looked like it was set for royal guests.

“Wow, Marge, this is beautiful,” Katie said.  That is when she noticed Marge’s red-rimmed eyes.  Instinctively, she put her arm around Marge’s shoulders as she sobbed.  Neither said anything – there was no words that could be said at that moment.  Marge lifted her head, sighed deeply, and grabbed a nearby box of tissues.  She was petite and gentle, but was the type of woman to take the bull by the horns when confronted with difficulties.  Except today, and Katie noticed a particular frailty to her she had never seen before.  They sat down and Katie poured the tea.

“You know, Joe and I rarely used our good china.  We saved it for special occasions, and over the years I think maybe three or four times I’ve brought it out.” 

“It’s beautiful, Marge.”

“He’s dying, you know.”  She stirred her tea and took a sip, not looking up from the dishes on the table.  “We’ve just run out of time and now he’s going to hospice.”

Katie was not familiar with hospice, but understood it’s where people go to die.  Marge explained that so many things happened to Joe over the past two weeks, starting with a fall in the bathroom and four stitches on his scalp.  Most recently he had a series of blood clots, and yesterday Joe had a massive stroke.  He was not responsive, unable to eat or drink, and connected to many monitors and tubes.  Today, his oxygen levels dropped and the doctors talked to Marge about intubation, but she said no.  Marge and Joe had living wills made decades ago, and when he was first diagnosed with cancer they had confirmed the choices made.  No feeding tubes, no heroic measures, and if there was no hope for a full recovery, no intubation.  She asked if it was time for hospice, and the doctor made a referral. 

“When we had these living wills made, we said letting go would be the greatest act of love for one another.”  Marge sipped her tea, and setting her shoulders square said, “And I love him to death.”

Katie drove Marge back to the hospice later that day, and Joe passed peacefully a few days later.  It’s been nearly a year since Joe passed and Marge has taken up painting, something she had never tried before.  The women have tea regularly now, usually with cookies or pie, and always on the bone china.   

Having a living will or advance directive is a way to make sure others know what your wishes, should the situation arise where you are unable to speak for yourself.  A living will can be prepared by your attorney, but there are several types of advance directives available online.  For more information about advance directives, please see the links below:









Medical Marijuana

This is a controversial subject, so please keep an open mind as you read.

Disclosure: I do not use marijuana. I smoked a little in high school and during college, but like a lot of things I did when I was young, I out grew it. Getting high is not fun to me. I do not like the way drugs or alcohol make me feel and I do not condone recreational use of any drug.

Another Disclosure: I have worked with patients who used medicinal marijuana, legally prescribed and obtained in the state of California or Oregon. I support the legalization for medicinal purposes only – not recreational. Please, if this treatment is desired, do so legally and let your doctors know. This is a drug, and it may react with other medications.

Okay, now with that out of the way, I hope you understand I would not publicly support the use of medicinal marijuana unless I knew it would benefit my patients, other patients, and babies. Yes, babies, adults, senior citizens. Terminal conditions, chronic conditions, and temporary conditions. It is not for everyone, and does not treat all conditions. I am most familiar with cancers, seizures, nausea, anxiety, and pain.

Kentucky Senator Morgan McGarvey filed a bill in the 2017 legislative session, and he recently spoke in front of the Interim Joint Committee on Health and Welfare and Family Services. If passed, medicinal marijuana will be available through physician recommendations and only for extreme end of life cases. Some believe the bill is too restrictive and the much needed drug should be more accessible for chronic conditions and for those going through cancer treatment, not just at the end of life. Any legislation is better than no legislation, I believe, because it initiates discussions about the therapeutic effects of cannabis. It would also prevent the arrest of dying patients who buy weed from the neighbor’s kids so he can eat a meal without vomiting.

Cannabis plants have over 300 identified cannabinoids. Hemp cannabis contains very few cannabinoids and those that are present have nearly no medicinal properties. Medicinal marijuana comes mainly from two types of cannabis plants: sativa and indica. Each strain, or unique breed, has a different ratio of cannabinoids (see links below for more information). I can attest that patients do benefit from use of THC, CBD, CBC, or a hybrid, but the CBD oils and tinctures do not have the “high” that most people associate with marijuana as that comes from the THC.  Clinical trials support the use of CBD oil to control seizures in children and adults.

I will not disclose the identity of any patients, but here are some of my experiences of those using medicinal marijuana:

A 92 year old female, stomach cancer spread to bones in hospice. She couldn’t tolerate narcotics, so she smoked a joint every morning and ate a brownie at night.

A 75 year old woman with colon cancer in hospice developed severe abdominal pain with intractable vomiting and pharmacy prescriptions didn’t work.  The family begged for another option. I said I’d call the doctor for a recommendation, but they had their own plan. I never asked where they got it but within 24 hours her pain and vomiting was gone. She was sitting up eating tapioca pudding, smile on her face.

A 50-something year old man, had never used marijuana until diagnosed with brain cancer. Used it to control seizures by inhaling nebulizer tincture of CBD. He was a physicist, and felt the CBD kept his mind more clear than narcotics.

A very ill 6 year old boy, on hospice due to a genetic disorder that caused multiple seizures daily, as many as 200 a day…nearly constant seizures. He took multiple medications, all given through a tube in his belly. The family moved from their life-long home to a state with legalized CBD oil and a clinical trial.  A month later, he talked for the first time and started eating real food. Three months later, he discharged from hospice and the feeding tube removed. Six months later, he went to school for the first time. Today he takes CBD oil three times a day and just a couple other medications. Best happy ending I’ve seen.


Check out these links:

Senator pushes to legalize medical marijuana in Kentucky

THC, THCA, CBD, CBC, CBN: Medical Marijuana Composition, The Chemicals in Cannabis

The ‘nuns’ that grow medical marijuana

Why I changed my mind about medicinal cannabis | Hugh Hempel | TEDxUniversityofNevada

Cannabis oil treatments are helping children with seizures

Marijuana saves father’s son