Ask Dr. Giles: I don't know what to expect

Anjie asks:

My brother was recently given his “expiration” date and it is really the elephant in the room disease.  It is very difficult to talk about which is the way our family has always been.  My question is more medical in nature, but don’t know who to go to.  He is beginning to be jaundiced and I don’t know if that means we are close to the end…I don’t know what to expect.  The anxiety of facing everyday not knowing seems to be so painful.  Since you experienced this first hand, can you tell me what to expect?

I’m so sorry to hear about your brother’s worsening condition.  I’m not a medical doctor, so I don’t have the expertise to tell you what to expect physically, but I can describe to you something to expect psychologically.

It is normal, when facing death and dying, to disengage emotionally from the event and the people involved.  In your brother’s case, he may seem increasingly aloof or emotionally distant.  This would be his way of preparing for the separation of death.  His family and friends may be doing the same thing–to prepare for the time when he is no longer with them.  The looming prospect of death and the unknown timetable for its arrival can create anxiety and listlessness for all involved.

While this transition to emotional separation is normal, Anjie, it also has the potential to leave the survivors with some regret about not having said or done more to express their feelings to that departed one while they were still alive.  Regardless of his demeanor, I would encourage you to share with him your feelings about him and about your relationship with him.  Reflect on the good times and tell him what he has meant to you.  In this way you can deal with his passing–whether it is soon or on his hundredth birthday–with the peace which comes from having no regrets regarding what was left unsaid.

When my best friend died from cholangiocarcinoma, I felt satisfied that he knew how much I loved and respected him.  I feel very fortunate to have a minimum of regrets in this area, and hope you will be able to say the same about your relationship with you brother.