On Valor and Vitality
8.27.18
Senator John McCain’s “maverick” politics placed him among the most intriguing contemporary legislators. His policies and feud with the current president continue to inspire support and criticism from the partisan masses. But Senator McCain’s last year of life also inspired conversations about how we cope with illness, both individually and collectively.
In July of 2017, it was revealed that Senator John McCain had a particularly aggressive brain tumor, glioblastoma multiforme (GBM). In the medical world, GBM is an acronym that evokes a sense of dread and resignation. Of the many different shades of tumors, GBM is of a merciless ilk. Long-term survivors are rare.
His family’s announcement that he had “chosen to discontinue medical treatment” set off a new wave of commentary and sympathy.
Since last July, Senator McCain’s diagnosis had elicited a host of reactions in the public sphere and provoked meaningful conversations on illness and healthcare. Our understanding on these issues is ever evolving and, hopefully, maturing.
Here are three lessons to be learned from Senator McCain’s diagnosis and our collective response.
- Cancer is not a test of valiance.
Shortly after news broke of Senator McCain’s diagnosis, President Barack Obama tweeted: “John McCain is an American hero & one of the bravest fighters I’ve ever known. Cancer doesn’t know what it’s up against. Give it hell, John.” His well-intentioned tweet utilized the language we have learned to turn to when we hear someone has cancer. Fight. Brave. Battle. We turn people into soldiers because we want them to win, to beat the odds, defeat cancer. But as screenwriter/producer Josh Friedman described with raw and personal eloquence, “it’s okay to be a coward about cancer.” Some will be overwhelmed with fear and uncertainty. Those who do not survive were not weak.
Candidate Trump callously declared McCain earned his “war hero” title simply because he was captured. “I like people that weren’t captured,” he said. But heroes can be captured in war. And in life, even the strong can fall to disease. While valor is admirable in the face of illness or combat, it should not be demanded.
- Medical treatment does not always seek to cure.
Every day we are one step closer to understanding that a cure should not always be the goal of medical treatment. Hospice care and palliative care are vital branches of modern medicine that seek to improve quality of life in whatever remaining time a person has in this world. They can maximize mobility, comfort and quality of time with loved ones.
Some disease processes are simply evasive of curative therapy, especially in the context of advanced age. The scenario is common – at the behest of family, invasive procedures are performed on people who are overwhelmingly unlikely to benefit from them. Why? Because death and dying are difficult to discuss. We are suspended in denial about our mortality and the limits of modern medicine. We become vulnerable to politicized threats of “death panels,” fearing that life-saving treatment will be withheld from us when we are still viable.
Death and dying are normal. Functionally, financially and emotionally, it behooves us to make space for the tough conversations about end of life expectations. Dr. Atul Gawande explores this urgent need gracefully in Being Mortal.
- Healthcare must not be a partisan issue.
McCain’s eleventh hour thumbs down vote, just two weeks after brain surgery, on the repeal of Obamacare came with a flurry of speculation. Did his diagnosis and surgery bring him to cross party lines with his vote? McCain had been a vocal critic of Obamacare, as many are. High premiums and deductibles made the Affordable Care Act far from ideal for many Americans. But in the end, McCain took a more nuanced and practical view than many of his colleagues, insisting that any replacement not pull the rug out from under those with the greatest need. And John McCain, who had his share of medical scars, understood that our inescapable mortality makes meaningful healthcare a necessity for us all.
Rest in peace, Senator McCain.