It was several decades ago when my father, not long retired from a lifetime of denominational service as a chemistry professor, noticed pain in his abdomen.  Initially attributing this to ingestion of some excessively hot tea, he ignored it for a time, hoping that, like many ailments, it would dissipate on its own.  When it did not, he sought medical attention.

He ended up at the hospital where I worked, and his workup proceeded apace.  A CT abdominal scan revealed a tangerine-size mass in the tail of his pancreas that, upon needle biopsy, showed malignancy.  Angiography demonstrated encasement of the splenic artery and occlusion of the splenic vein.

A well-intentioned surgeon with normally impeccable judgment convinced him to undergo surgery, which offered the only curative option.  The angiographic findings indicated nonresectability, and I was dubious, but my father, whose options were limited, elected to have the operation, hoping, as many of us undoubtedly do in such situations, against hope.  Perhaps the surgeon’s optimism was justified and his judgment not clouded by hubris.

Later, much later, I would relive those moments and, feeling as if I’d let my father down, wish that I’d discouraged him from undergoing the knife or, failing that, to push for his not being awakened in the event the tumor indeed proved to be unresectable.  In California (and, indeed anywhere in the USA at the time), the latter scenario was likely impossible in that, unlike certain limited places such as the Netherlands, no physician would be persuaded to participate in such action.  I chided myself that I had not sought a second opinion preoperatively, which was certainly an option that I considered but briefly.

At surgery, the tumor was indeed proven to be unresectable, and the surgeon, after confirming such, merely closed him.  But postoperatively my father was worse off than before.  He developed ARDS (adult respiratory distress syndrome) and nearly succumbed.  A skillful internist brought him through that, and he was sent home, where his cancer would work its inexorable, inimical, opportunistic destruction.

My father was a stoic man who complained little, but, during the time he spent in my home, I witnessed his anorexia, inability to eat, the pain that nothing could ameliorate, the suffering.

More than anyone, the one who was there for him was my mother, his companion of nearly five decades.  When he shed tears (mostly silent and internal), she tasted salt.  She was the flickering light in his darkness.

Not insignificantly, despite lacking any obvious serious illness, she went to join him within a year of his passing.  My eldest sister, with whom she lived after my father died, said that my mother seemed to lack the will to live.  I think this happens at times with certain individuals: their what the Chinese call “qi” (vital life force) dissipates when they no longer feel needed.

Pretty much all her adult life my mother had been a caretaker and nurturer, first as a wife, then mother, then grandmother.  The bulk of her adulthood had been spent as a homemaker.  When my father died, she lost her best friend, and her reason for living, her raison d’être.  So she chose to go be with him and, although that choice may have been passive rather than active, the end result was the same.

Perhaps she succumbed to Takotsubo cardiomyopathy, or “broken heart syndrome,” a condition unknown until the 1990s.  We will never know.

My father departed in expected fashion, although I cannot say his, unlike that of protagonist Tristan Ludlow of Jim Harrison’s novella, Legends of the Fall, was a “good death.”

But he had been blessed with a good life.  A loving wife and children, all of whom were reasonably educated, largely because of my father’s belief in the value of education, a satisfying, distinguished career, and many outside interests, the breadth of which is impressive considering how busy a man he was (he published thirteen books, as well as numerous articles, mainly scientific; was a member of various scientific societies; built a freestanding garage at one domicile and tilled the soil of a half-acre garden which largely provided the provender for a family of eight; had a photographic darkroom, carved animals from soap; popularized origami before the word became part of ordinary parlance; made root beer and pickled cucumbers; canned and froze produce; and had time to take the family on outings to various parts of the country.  He once modestly characterized himself as a jack of all trades but master of none; I do not believe this to be an accurate description, in that he was accomplished at many things, including magic tricks, with which he loved to regale audiences, particularly the young.)

And, although I believe he was taken too soon, he lived the sort of life Alan Watts, British speaker, writer, and philosopher, would have advised.  I think he loved his life and had few, if any regrets.  As my eldest brother opined at his eulogy, he was a great man.  Not necessarily as the world counts greatness, but that, too.

Samuel M. Chen is a radiologist.