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Published On June 17, 2019

TECHNOLOGY

How to Get Home

A man with cancer faces the logistics of dying at home.

The EMTs strapped my husband into the gurney. He didn’t look like a man dying of cancer. Tired and heartbroken, yes. But still ruddy and robust. He sat upright, long legs outstretched, beefy hands resting in his lap. I grabbed one of them and squeezed. “I’ll see you at home,” I said.

I didn’t think I would get to say those words again. The oxygen tube in his nose was a reminder of the absurdly complicated task we had set ourselves—managing his final few weeks in our home, rather than at the state-of-the-art oncology ward we had come to know by heart.

The ambulance doors slammed shut and the vehicle sped off with Greg, sirens blaring. I set out to the hospital pharmacy to load up a shopping cart’s worth of supplies and medications, including the Ativan, codeine, morphine and oxycodone that would help Greg manage the end-of-life pain and anxiety.

Two years ago Greg’s cancer was just an ache, something his doctor suspected was a case of kidney stones. That ache turned out to be a renal tumor, which spread to his lungs a year later. A constant assault of targeted and immune therapies had done nothing to stop the cancer. Soon it was also a tumor on his spine, then tumors on his lungs that required an oxygen tank for rapidly escalating breathing trouble.

Two days ago Greg’s oncologist had broken the news that death was our next stop. He estimated that we had two weeks and gave us the choice of staying in the hospital or moving to a hospice facility. Home was our dream situation, but it wasn’t an option. Greg required a high flow of oxygen to breathe—12 to 14 liters per minute—which couldn’t be managed by a home oxygen concentrator.

We resigned ourselves to Greg dying at a nearby hospice facility. By 9 a.m. four members of the hospital pulmonology team came by for rounds. As they explained how the next two weeks would go—weakness, drowsiness, withdrawal, coma—I was surprised to see that their eyes were welling up, too.

“So, Greg. We understand you’d like very much to go home,” one of them said.

Greg and I looked at each other in disbelief. The team had a plan, which was apparently a common home-hospice hack for getting around the limited oxygen flow of the concentrators. They would send us home with two concentrators and link them, allowing for a continuous flow of up to 20 liters per minute. Long story short, we could go home again. In the bleary hospital morning, it felt like winning the death lottery.

Greg’s bedside quickly turned into a hospice war room. As the day wore on, a social worker walked us through the physical stages of death, including what to expect in the final days and hours. The medical equipment company called to ask where they should put the hospital bed. A nurse stopped by to give us a crash course in managing high-flow oxygen equipment.

Every so often a doctor would return with an announcement: They’d gotten approval from our insurance company. The three-page list of medicines Greg needed would be ready by the next morning. They’d secured the ambulance to get Greg home. Finally, we were good to go.

I arrived home to find our TV room humming with the familiar, frenetic energy of men talking late-season college football. Propped up in the hospital bed was Greg, surrounded by his history books and movie collection, with our black Labrador, Josie, at his feet.

I squeezed in the bed alongside him. He grinned and kissed my cheek.

“Hi, honey,” he said. “I’m home.”

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