My mother passed away in September 2024. I didn’t post anything about her battle with pancreatic cancer as it was underway out of respect for her privacy. Recently, I came across a handful of writings I forgot. I had intended to keep notes for my own sanity and to reinforce certain conversations. I’m going to go through those I have – and share them as I can.

Fall 2023

It’s never going to be good news when you get a call from your mother and she says, “The doctor wants to see you and me both in her office at 3:30 Wednesday.”

My mother had just recently decided to start seeing my concierge doctor. At 85, she was feeling less than impressed with her longtime doctor who always seemed to substitute in his PA and often didn’t spend more than 15 minutes with her. Heck, I know from experience it takes more time than that to get her around to talking about what ails her and to weed through the side paths to start to see any sort of pattern. My doctor will sit with me for an hour as I hypothesize various diagnosis and never once indicate that I should hurry.

When I learned Mom had a chest x-ray, then a second chest x-ray, then a CT scan, I knew something was up. My doctor is nothing if not thorough.

Upon arrival I was surprised to be handed one copy of the CT report while we sat together in the waiting room. Each holding one side of the stapled pages, we began perusing. My stomach sank. There were lots of terms and measurements and way too much medical jargon, but I began to see one word, “metastatic.” Likely metastatic. Concerning for metastatic, Almost certainly metastatic. I think my eyes began to cross. We finished our review and I held onto the pages, silently fuming that they would hand us that report without someone to guide us through it immediately. For an office I typically trust, I was doing quite a bit of screaming at people in my head.

When we did get called back to see Dr. T, we sat in an exam room and she gestured to the document in my hands. “You’ve read it?” she asked.

“Yes,” we nodded, and I added, “It’s a lot.”

“It is a lot.” she agreed. The doctor went on to backtrack through how this all came about. My mother had come to her complaining about occasional hives, and telling her she would wake up sometimes with her tongue swollen on one side. Dr. T considered this troubling (as one will when your tongue is so swollen you feel like you can’t even talk until you’ve held an ice cube in your mouth for a while). Suspecting some sort of allergy, perhaps related to my mother’s apartment of two years, the doctor listened to my mother’s chest and detected wheezing. Thus the chest x-ray. But there was something odd in the x-ray and they hadn’t used markers so they went back and did it again. This time it picked up just the top of her pancreas – where another anomaly was spotted. So, the next move was an abdominal CT scan. Those results were the ones in my hand. The ones telling us the small 1.5 cm spot on my mother’s pancreas that the previous doctor had been watching for any signs of change over the past several years had, over the past 5 months, grown to 3.7 cm. And then there were all the other locations where scary things were visible. Liver, pancreas, kidneys, retroperitoneum.

Dr. T went on to tell us the main concern: Pancreatic cancer has spread throughout her abdomen. She walked us through the next steps of finding an oncologist and determining if a biopsy is needed or not. From there we would discuss treatment options, or not. She explained the situation of the pancreas, how difficult surgery is, and additionally, how chemo for this is a hard road. She was preparing us to consider all the how’s and what’s that were running through our minds. During that discussion and my mother’s questions and comments, I sat calmly, trying to make my mind stop squirreling around. I wanted to run out of the room and drive straight home to bed where I could cry. In fact, my need to cry kept distracting me from my need to listen. To pull myself away from the abyss, I would pinch myself and try harder to focus on what was being said. I didn’t want my mother to break down if she saw me breaking down so I nodded sagely and re-doubled my efforts to think of something intelligent to ask. After the doctor said, “We don’t know if this is something that is a matter of months or a matter of years,” my mother shrugged and declared, “Well, I’ve had a good life.”

Thinking I must have heard wrong, my head swiveled to see her expression. She looked perfectly serious. I could hear my brother’s voice in my head snort and say, “Since when does she think that?” But she meant it; I could tell. I just didn’t always think she knew what a nice life she’d had – especially after marrying my stepfather, when things like country club memberships, expensive dinners, a big house and yearly trips to Colorado to get away from the Texas heat for a month were a way of life. Not that “things” make life good or bad – but they certainly take the sting out of some of the other disappointments. And frankly, I don’t even know if those are the things she was picturing in her mind at the moment. Maybe she was thinking about her kids, and granddaughter.

We left the doctor with all sorts of plans to hear from her office regarding a contact and appointment at two hospitals. I thought she could get into Presbyterian faster – and it’s very close to both our homes. But she prefers UTSW and has more faith in their doctors so both plans were set in motion. We could always choose later, once she’d met the oncologists.

We have received confirmation that we are in at UTSW for Wednesday.

In the meantime, I understand she has talked to her sister and brother. Her sister believes there is no way they could tell any of that from a scan and says she won’t believe it until there is a biopsy. I am trying to walk a fine line myself. I want her to have hope and to feel like the worst is not a foregone conclusion, but I also have to keep the train on the rails a bit. This is not fake news.