Last Thoughts

By Greg Tuck

Everybody dies. That’s the cold hard reality of life. Not everyone gets forewarning and time to think about it, and what, if anything, comes next. After undergoing treatment for brain cancer, a patient finds that accepting his inevitable mortality is very difficult. His brain is whirling out of control and he has difficulty controlling his anxiety after treatment fails and palliative care is all that there is left. He has moments of clarity though where he seeks larger truths. Without the ability to communicate any more, he faces his remaining days, trying to deal with something we all will face.

• Language: English
• Publisher: Greg Tuck
• Release date: Apr 11, 2024
• ISBN: 9798322464631

Greg Tuck

I am a former primary teacher and principal, landscape designer and gardener and now a full time author living in Gippsland in the state of Victoria in Australia. Although I write mainly fictional novels, I regularly contribute to political blogs and have letters regularly published in local and Victorian newspapers. I write parodies of songs and am in the process of writing music for the large number of poems that I have written.

Book preview

Warm sun beats down on my wispy grey-haired head. The sand and water mix squelch between my toes as tiny ripples eat away at the seashore. It seems a hopeless contest. The power of the ocean against the tiny grain of sand, but such battles have waged throughout time and there was still no victor. One day all the land would be swallowed by the sea and the sea would become a sluggish mix of mud and lose power too. None would surrender, none would raise a flag of triumph. It was as inevitable as the final breath of a human life. It was all about time.

In years to come people will still complain about being old, only to be rebuffed by the same reply, The alternative is being dead. Would you prefer that? I don't complain anymore. It doesn't do you any good.

I know that my mind is wandering. That is the outcome of the treatment that has gone on before. I lie in the bed and hear everything – the shuffle of nurses as they come and go, the beeping of the monitors, the incessant hum of everyday life in this cancer ward. I am resigned to my fate but I can’t communicate that. I am just a shell and at times that is how I am treated. They don’t mean it, I know, but that is what they do. They have to remain dispassionate because caring too much will crush them and drain their energy. I have become dispassionate too, although no-one can sense it. Two weeks ago, I spoke my last words. The growth in my head had reached the area of the brain that controlled my speech. It had made my speech slurry and almost unintelligible for the past two months and in a way, it was a blessing for everyone. I had been trying to articulate, Why me? No-one had answers to that question, so, even if they had understood it, their compassionate replies would have been less than the honest truth. It was strange. When I could no longer utter those words, the question for me became moot.

People thought I couldn’t hear either and I kept up that illusion. Even if they spoke directly to me, what could they say that was comforting, and I had no way of responding anyway. A shell, an empty vessel, a vegetable that merely breathed and consumed the liquids that were fed through tubes. There were other tubes that drained things out of me. One day they would drain my willpower and my inner being.

I could see the clock with its second hand laboriously moving from one marker to the next. It was to my mind, no longer measuring time, but counting down what time I had left. My eldest daughter was in a week ago. Yes, I was still cognisant enough to know the days of the week still. The oncologist had given her the news that everyone had been expecting. He talked as if I wasn’t there. He spoke to her and the words palliative care were chilling. No-one saw the single tear that flowed down my cheek. Those words are a death sentence, finally uttered. He had done his best. I had done my best, radio-therapy, chemo and more chemo until my body could take no more. I just wished his bedside manner had been much better. He was correct in his assessment and I was correct in my assessment of him. You don’t want someone pussy-footing about when bad news needs to be delivered, but you do want someone with some sensitivity to the feelings of others. My single tear was not for me, but for my daughter. She didn’t burst into tears, she just sat down on the end of my bed, stoic but ashen faced.

Even now as death draws closer, among other things, I am still the non-conformist, I have always been. As my body changed and deteriorated, I still did not leave my childish attitude behind. There was no fun left if I did. Life was too short to be always serious.

I am not an intellectual. I merely see things differently; through a different prism, and that confuses others. I’d always lived from day to day. Days, weeks and even years were irrelevant. For me, time wasn’t something like many thought as being the interaction between bodies in the solar system. That is just a human construct based on some mathematical and astronomical calculations. It is artificial. Adult mayflies don’t count their days. Females only live five minutes and males if they were lucky, live just over one day. That is their whole lifetime. We as humans put too much emphasis on measuring life in terms of years and not in terms of experience. We can focus too much on legacies and death and miss out on the joy of living. Humans conform to expectations of the society they find themselves in and we slip into the predetermined phases about how to act, think and even dress as we age.

Chapter 2

Is this what life has come to? They pump chemicals into a dying body to keep it alive for what purpose? My organs will be harvested and my brain examined in a detailed post mortem. I had authorised that long before I had the final pronouncement of my imminent death. Someone should benefit from all this. They wouldn't be desecrating my body as it was just a vessel that contained my thoughts and memories of my experiences. They couldn't harvest those, much to my despair. 

We claim to be very advanced creatures, but flesh and blood are limiting factors. Perhaps on other planets these been dispensed with. Perhaps the embodiment of an individual in those places is indeed thoughts and ideas communicating across the ether. That way immortality would be a real prospect.

Here on Earth, we have been conned into believing that immortality exists, but only if you follow certain rules. Rules made by primitive flesh and blood creatures who rate themselves as the smartest on Earth, and transpose that assumption to mean the whole universe. Our eyes and vision improving mechanical devices can barely see much beyond our own galaxy, so such an assumption is doubtful at the very best.

I do not fear what lies ahead. I have resigned myself to my fate. People die. That is a fact and one in my earlier years, I thought didn't apply to me. I think that we are programmed that way lest we cocoon ourselves away and do nothing with our lives. Before me lies a darkness and a nothingness and I must be content with that.

What I fear is pain. I am grateful for my palliative care. Boost the medication up and don't let me suffer. Stop with the other chemicals because they don't achieve anything except to appease the consciences of the doctors and my family. The intravenous drops make me feel nauseous and the pain inside is awful as they battle away at an enemy that cannot be defeated. It is hard to communicate the level of pain that I am forced to endure.

Although the cancer is in my brain, I am not slipping into dementia. That might be a blessing if I did. The reverse is happening and the pressure in my brain is forcing the cognitive areas to work faster and my brain’s functioning is far more effective in thinking than it ever has been. It is overstimulated and sees patterns and solutions like it never could before. I'm not just talking about mathematics and logic, but also being able to analyse, predict and rationalise human behaviour, particularly my own. My life is not flashing before my eyes, but gliding past and I'm capable now of understanding the choices I made, both good and bad. I have watched how my ethics have developed and am learning to forgive myself for straying from them at times.

I don't sleep, although I pretend to in order not to have extra medicines to promote that. Learning to work the system proved to be relatively easy. To prove that I am sleeping, I meditate thus lowering my heart rate. As long as their machines tell them what they expect, their lives are less complicated. My eyelids are down, my breathing is relaxed, but I don't need to see anything. The room barely changes and all my senses are heightened so I can tell who is in the room, by the voice, the distinct sounds of an individual's movement. I am also strangely, and much to my surprise, able to gauge their moods and sometimes accurately predict what may be causing these. I needed that skill much more in my own relationships that I had in the past; many of which I screwed up because of my self-centredness and ignorance of the human condition.

I share a room with no-one. Having been a loner all my life, I haven't the requisite skills to fit in with others. What do you say to someone else who is also in palliative care? A lot of them are doing last minute conversions to religion, imploring to their chosen god to be lenient for all the morally reprehensible things they have done in the past. I don’t need to hear their sudden move to religious fervour and them trying to convert me. It is another reason for pretending deafness. I am sure that if I was in a shared ward, my ethics would be severely challenged and someone would end up having a Bible lodged into whatever orifice was available.

It is incredible how the mind works, well, mine in particular. One thought triggers another, and often goes off a complete tangent for no conscious reason. I guess it works like the paths we take in our lives; some of which are pretty straightforward and mundane and others are based on gut reactions when faced with choices. Different choices take you through different paths through the labyrinth of life.

Chapter 3

One of the side effects of the pain relief they give me is that it gives me less control of what my brain thinks about. I go off on tangents and often my memories activate all sorts of, what at times, seem totally disconnected insights. For some reason, I find that whole process amusing. Physically, I can't tell whether I smile or not, although a couple of times a nurse has said, totally oblivious to the fact I can hear her, that I looked more relaxed and happier. 

I used to be so much more in control of my mind. I was skilled in the art of meditation and used it to relieve physical pain and mental anguish. Now, whatever is in the drug cocktail sees me not needing to meditate much at all.

I miss having choices. For there is no choice. I am on a drug regimen that I have no say in. Stuff gets pumped in by well-meaning doctors and nurses. I have no voice to object with, no means of communicating my approval or otherwise. Based on other cases, they are making decisions that they believe they are in my best interests. I am no longer unique, merely just a stat that will fit into someone's thesis one day. It won't be properly verified because no-one has verified what the actual effect is on me.

But in the long run, aren't we all just stats, if that? How much is your life valued beyond your immediate friends and family? You have a name, but soon even that will be lost in time. Most of us are not in a position to change the world, let alone the universe. Does that mean we have little value? Given that the human race seems intent on destroying itself along with the planet it lives on, the question is probably debatable. Which brings me back to religion. If there really is a God, why does he/she/it not intervene to stop us doing that? We have fought wars in God's name, sacrificed babies and children to prove that love is the most important thing in the world. We have demeaned and debased our fellow humans, slaughtering them by the millions in the name of an ideology that may be based on a lie. Maybe I am better off out of it.

These thoughts are depressing and come at the end of the pain relief cycle. Just up my medications and get it all over with.

Chapter 4

Every person's brain is individual and extraordinary. That was the opening line of the neurologist. I had come to see him not for a university lecture, but for a diagnosis and a resolution to a problem. If I have a problem with my laptop, I get it serviced. I don't need to understand the intricacies of how it works, just that it works. The neurologist was right though, as I was to find out. I had bouts of forgetfulness, migraines and nausea that my regular doctor couldn't explain. In a way, I wished I had remained ignorant because the unspoken and unanswered question of how long I had hung in the air around us.

It was terminal. It was inoperable and things would get worse. Treatment was to be reducing the effects of symptoms rather than working on the cause. It was a slow growth one. It was not in the area that affected basic body functions, luckily, I was told. Although a long lingering death as a vegetable was not what I considered a lucky alternative. I learnt different names and locations of my brain, but I didn't need a zoomed in Google Maps detailed version. Just the location of and what each suburb was known for would suffice.

We are programmed to believe that other people die, but we never will. It makes us foolhardy and wasteful of our most precious of commodities, time.

For a whole lot of reasons, most people in poorer, less developed countries don't live as long as us we in the western world. I am not sure whether they live a happier or fuller life, but I know the people like me are considered fortunate. Leaving the oncologist’s office that day, I had never felt less fortunate. A person's mortality is something that rarely gets discussed even by oneself to oneself. My cancerous growths were a ticking timebomb. There would be swelling around these as the body tried to fight back. How that extra pressure affected the neural pathways would be the drivers as to what my brain was capable of still doing. To operate, use radiation or chemo may see me lose functions of my body, and I would die on the operating table if any procedure was done. Was it better to die in a bed recovering from the poisons used in an attempt to stop or reduce the spread. Location really didn’t matter. Once placed in the hospital, I wasn’t leaving and a bed is a bed, is a bed.

I was unlikely to lose my