Dying with dignity

(First of four parts)

In 2016, Dennis Ang, who ran a stock brokerage business with spouse Ramona, was diagnosed with stage four liver cancer. A few months previously, the gastroenterologist had pronounced his liver problems to be over, so it was a shock to know that the tumors were inoperable. Medication caused blisters to form on the soles of his feet, and had to be abandoned.

Dennis’ cousin, oncologist Dr. Marina Chua-Tan, suggested that the couple’s children, all professionals based in the US, fly back to be with their father while he was still lucid.

I know of heirs who find it hard to return, which complicates succession and inheritance issues in business families. Marina agrees, citing children who for one reason or another, prioritize work over family.

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The Ang family has strong bonds. The children returned and spent months of quality time with their father, a blessing that Ramona is thankful for. The couple, who met in high school, also renewed their wedding vows.

Dennis enrolled in a clinical trial abroad and flew back and forth for infusions. But in early 2017, “Dennis was not responding to treatment,” says Ramona, 78. “Doctors had to stop the trial before they ended up doing more harm.”

Liver cancer causes fluid to build up in the body, and a pigtail catheter makes it easier to drain at home. But “what was supposed to be a few days in the hospital turned longer, because Dennis got pneumonia. In the end, he did not go for the catheter, because he was getting weaker. Then Marina suggested palliative care.”

“Palliative care was a totally new concept for us,” Ramona continues. They were worried about the pain, having to endure unnecessary suffering. “Marina also told me to discuss final measures, but I did not think I could do that [yet]. Dennis and I had talked about that years ago, when we were both healthy, but when he got sick, it was hard to bring it up.

“When the palliative care doctor came, Dennis stated clearly that he did not want tubes or whatnot [as much as possible]. I was so relieved, because things (like the living will, the crypt, etc.) just fell into place.”

Peace of mind is paramount. Dennis had deep and loving conversations with his children, and while still in hospital, he told Ramona, “I am so happy,” something she treasures to this day.

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At home, palliative care nurses provided round-the-clock care, including pain medication.

“Sedation was hard for me,” says Ramona. “I wanted to talk more but he was sleeping more. I prayed whether we were doing the right thing. Dennis’ mind was also clear; he asked for the dose to be reduced to minimize diarrhea.”

“On the positive side, Dennis had the comfort of home. In the hospital, visitors and visiting hours were limited, but at home, the children and I were there. Palliative care gave us peace of mind, because professionals were taking over the medical part, and we could focus on the emotional part. He was sleeping a lot, but when he was awake, he had one-on-one talks with each child. Friends visited and took turns talking with him. He was able to say goodbye.”

Since his diagnosis, a priest had been visiting Dennis regularly, and they had lengthy conversations. “He was prepared, he was at peace.”

Palliative care at home lasted a week. When Dennis’ blood pressure dropped, he was brought back to the hospital, where he passed away before his 72nd birthday, surrounded by his wife and children who were praying with him.

Nine months had elapsed since Dennis’ diagnosis.

“At first we were praying for a miracle cure,” says Ramona. “But then we realized how fortunate Dennis was—not for getting the cancer, of course—but to have quality of life with family and friends.”

“Dying with dignity,” Ramona says. Palliative care was integral to the process.

(Next week: Palliative care enhances quality of life)

Queena N. Lee-Chua is with the board of directors of Ateneo’s Family Business Center. Get her book “All in the Family Business” at Lazada or Shopee, or the ebook at Amazon, Google Play, Apple iBooks. Contact the author at [email protected].