Ask Mary Jo

On death and dying

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Q. My gram is real sick. She has a bad cancer, and I heard my mom say it’s all through her. The medicine they’re giving her makes her sick a lot. I don’t understand a couple of things. Why do they keep giving her medicine if she’s dying? And the other thing is, why won’t my parents tell me she’s dying? My gram is a real good woman. She always took me to church with her, and I know she would say that she’s right with God. And another thing is that I want to know how I can show her how much she means to me. I love her. Thank you for letting me talk with you.


12-year-old male


Mary Jo’s response:


I often tell other adults that young people are wise. To me, wisdom means a person has knowledge and good judgment. Some adults argue that children and teens aren’t experienced enough to be wise. Your questions show wisdom, regardless of your age. The experience of seeing your gram sick is a true life challenge, but it is helping you grow strong. I can almost feel your love for your gram through your words. I think she’ll be very proud of you if she reads this column.


Instead of answering your questions about medicine myself, I decided to go to an expert. My daughter, Lisa, always had a lot of wisdom, even when she was your age. Her title now is Lisa Podgurski, M.D., UPMC Palliative & Supportive Care Fellow. Her response to you follows and gives you the point of view of a doctor who serves people like your gram:



First of all I want to say that from just reading your questions, I can tell you care a lot about your gram. I’ll bet she can tell that, too, but it never hurts to say it. When you tell her you love her, I’ll bet it means a lot to her. If she’s in the hospital a lot, you could make her a card or a picture to keep in her room to remind her of you. I can also tell that you understand a lot about the world around you, that you seem to be “wise beyond your years.”


I don’t know enough about your gram’s cancer to give you a medical opinion about how she’s doing, but you said it seems like she’s dying. I want to tell you how brave you are for asking this question, and for using the “D” word. A lot of people – grownups especially – are afraid of using that word and afraid of talking about death. If your gram is dying, it may be that your parents are scared to talk about it with you because they want to protect you from the sadness of it. It may or may not be something that your gram has talked about with her doctors, because sometimes even doctors are afraid to bring up death.


Doctors usually give people medicine in the hope that it will help them feel better. You’re right, though, that sometimes that medicine ends up really making people feel worse. In the case of cancer, it can be really hard to tell when that line has been crossed. There is a fairly new specialty in medicine called palliative care which deals with these issues. It sounds like it would be helpful for your gram to see one of these doctors, a doctor like me. We work on “palliating” (fancy doctor-talk for easing or making better) the things that are making people feel sick. If your gram is having pain, we can use medicine for that. If she’s feeling sick to her stomach, we have medicine for that, too. Palliative care doctors can try to help her feel less sick, even while she’s continuing to get medicine to try to treat her cancer. If your gram might be wondering whether or not she should stop these cancer treatments, palliative care doctors can help her (and your family) think through those decisions. Because we’re kind of new, lots of people don’t really understand what we do and might think we’re only useful once someone’s decided to stop cancer treatments, but that’s not true. We focus on improving how someone feels when they have a serious illness, whether that means giving medicine for physical pains, or talking about emotions, or helping support the patient’s family. It sounds like your gram has a supportive church community, which is also great to hear. It also sounds like she’s very lucky to have you for a grandchild.


I wonder if you’ve tried to bring any of this up with your parents or your gram. They might feel more comfortable talking about these things with you if they knew that it’s already on your mind. If they need a little help talking about these big questions together, I suggest asking her cancer doctors to refer her to a palliative care doctor for help.


- Dr. Lisa Podgurski



My daughter is pretty wise, right? Please, let me add one more thought to her wise words. When my father was very sick with cancer, our children were 20, 15 and 11. Losing him was very difficult for me, but I wasn’t alone. Our family talked about his illness. My husband, my children and my faith made something sad easier to handle. I think your parents will be happy to know that you understand what’s happening. I think your gram will be relieved to know that you’re OK. I think that you will feel much better when you talk about your feelings with the people you love.


You’re a person of great worth. Thank you for your insightful questions. I send you my respect and my prayers.


Youth Champions:


A huge shout-out to Michael Passalacqua, the owner of Angelo’s Restaurant in North Franklin Township, for teaching our young parents the fine art of preparing healthy, nutritious meals on a budget. His pasta primavera, chicken piccata and shrimp scampi were outstanding. Thanks as well to our staff, especially to Amy Podgurski-Gough for organizing the Live, Laugh, Learn conference last week. Our PPT team of Heather Crowe, Karen McFedries, Farrah Doman and Amy provide one-on-one educational mentoring to pregnant and parenting teens from three counties. They are youth champions 24/7, 365 days a year.


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