On Feb. 8, Sue and Jim Markham were poring over their dad's medical file like confused calculus students, trying to understand how the VA had come out with a different answer. Meanwhile, back in Building 51, another vet was just hearing bad news: His cancer was back, he was not a candidate for surgery, he was too weak for chemo -- did he want to be DNR?
John Schellhase was 48, a Vietnam vet who'd returned an alcoholic and spent the rest of his life struggling to pull off civilian adulthood. On July 21, he was told he might have cancer. The next day, he found one of his brothers dead. A few days after that, still reeling from the first two shocks, he underwent a 19-hour surgery to remove his tongue, larynx and lymph nodes. (Apparently if the cancer had been on his larynx instead of right next to it, he would have been eligible for Agent Orange benefits. Instead, he kept worrying about getting back to his minimum-wage job.)
Radiation didn't start for four months. Every time John's brother, Mike Schellhase, asked about it, he was told John wasn't strong enough yet. "His spirits were pretty good, though," recalls Mike. "He was doing OK. And he wanted a fresh chance." Then, during radiation, he started having pain on his right side. "I kept saying, 'This ain't normal -- radiation doesn't cause this much pain,'" recalls Mike. "They finally scheduled an MRI for Thursday, Feb. 4."
On Mon., Feb. 8, John Schellhase was informed that the cancer was back and that no further treatment would be possible. Alone, daunted, he signed the DNR and sank into depression. The next day, the VA told his family what had happened. By the time his sister, Mary Jo Wyatt, arrived, John was groggy with pain and morphine. At one point he opened his eyes and asked for a pen and pad of paper, but by the time she'd fetched them, he was out of it again.
By 5:45 the next morning, he was dead.
Wyatt had suspected the cancer's return: "I smelled an odor from his trach(eotomy), and it was similar to the odor I recall prior to his operation," she says simply. "What hurts the most is that nobody called us so we could be with him when he heard." She visited, regular as clockwork, every Tuesday evening (once after a flat tire in a rainstorm, because she knew he counted on it), but she'd also given the VA her work and home phone numbers. "I said, 'You call me at work; they will let me leave.'"
That didn't happen. John was alone, and he made that final decision alone, in a state of shock and depression. Wyatt's not surprised he signed: He'd just learned there was no hope, he was in pain, he couldn't speak, there were no family members there to discuss the issue, and the piece of paper was there, an urgent physical presence waiting for his agreement.
It's not that his family would have dissuaded him. "I would have left the decision up to him; it was his right," Wyatt says firmly. "I just wish I could have been there to hug him and hold him and tell him we'd pray for him."
In the end, we all die alone. But the cold isolation of VA procedure is driving the point home with a vengeance.