Payge Barnard
I huffed and puffed as I ran along the dirt trail through the woods, slowing to a stop as I approached the river’s edge. Suddenly, my chest grew heavier. “Has medical school deconditioned me this much?” I thought. It was then that I realized my feet were standing in the exact spot my father had stood just months before. The sunlight peered in through the leaves, and I felt an overwhelming presence with me. Tears suddenly flowed down my face, and it felt as though I was standing between heaven and earth.
Payge Barnard and her father
Since my junior year of college, my father had carried the burden of a stage 4 prostate cancer diagnosis. For years, I lived in fear that my father would call me and tell me his cancer had spread. Milestones suddenly became more than their inherent celebrations. When he saw me graduate college, it wasn’t my degree I was proud of. It was the knowledge that I now have a photo of him standing with me in my cap and gown to show my children someday. When I called to tell him I had been accepted into medical school, his joy far outweighed my relief from a successful admissions cycle. Although I knew he would not live to see my wedding day or the birth of my first child, I was determined to reach as many milestones as possible.
That all changed in October 2022. He began experiencing new symptoms, and my family felt completely defeated when we learned he had been diagnosed with a new primary pancreatic adenocarcinoma. Two cancers in one lifetime? Different emotions began to arise: anger, disappointment, and acceptance that this cancer was going to take him. I stopped living for the big milestones and began living for the everyday moments that make life so precious and worth living. I was lucky I was in my third year of medical school, which had allowed me to take online electives to be home in Wisconsin with him as he transitioned to hospice care. These were some of the most precious weeks with him, especially watching him feel stronger as he discontinued his chemotherapy and began to feel like himself again.
It was a Thursday morning in March when he called me. I was rotating on an inpatient cancer rehabilitation service during my physical medicine and rehabilitation month. I was already home for the day, using my scissors to cut off the loose strings on the couch that my cats had ripped up. I saw him calling and picked up the phone. There was a lump in the back of his throat when he said hello, and I could tell he had been crying.
“I’m at the hospital, and they said I’m going to die in five days,” he said to me.
The six-hour drive to Wisconsin was a blur, probably because tears filled my eyes the entire time.
What I still find incredibly ironic to this day was that only three days prior to his phone call, I had sat around a table in the team room with my residents. Although we’d just met each other, we were sharing stories of our parents and realized we had a common experience. One resident had lost his dad to pancreatic cancer. Another had lost her dad at 16 to a cancer of unknown origin. And the other’s mom was currently living with breast cancer. We laughed and cried together, and it was a beautiful reminder that I wasn’t alone. Little did I know that days later I’d receive the worst news of my life and that their words of kindness were what I unknowingly needed.
My family and I quite literally moved into the hospice facility. We cooked in their kitchen, slept in their spare beds, and showered in their patient showers. To the nursing staff and physician’s surprise, my father lived almost three weeks, much longer than the anticipated five days. My dad has always pushed the limits, and it wasn’t surprising to us in the slightest that he was holding on. There was even a point where his physician thought he might be able to receive surgery and live a few more weeks. But having rotated through the hospitals in medical school, I started seeing the signs that death was near. I helped his nurses shower him, and I cried softly as we cleaned the soap off his bones. That’s all that really was left of him at that point: bones. His skin was changing color, and he slept the majority of the time. His face was flat, and his eyes lost their beautiful blue, softly fading to gray.
I was sitting at his bedside doing homework one night—ironically an online course on hospice and palliative care—when I noted his breathing became rapid. He started using his accessory muscles to breathe, and his fingertips turned purple. I woke my sleeping siblings and mother and told them I wasn’t sure he had much time left. Only 15 minutes later, he took his last breath with his family’s hands placed gently on his earthly body. I have never known true heartbreak until I saw my siblings shatter into pieces at that moment. He passed away on April 11, 2023, at 2:21am.
My father was a fighter, and I still don’t quite know how to live in a world where he does not exist. I’ll carry him with me until I see him again, and I now see him in the patients I care for at the hospital. Everything about medicine is different for me now. Everything. On my first week back in the hospital since he died, we told a patient that his cancer had spread, and he only had a few days to weeks to live. My heart dropped into my stomach as I saw the agony on his face as he thought about his own mortality. His wife and I locked eyes as tears flowed down both our faces. I had been told throughout medical school what the “appropriate” amount of tears to cry in front of patients was, but that didn’t quite matter to me anymore. I felt for these people. Their pain is real, and my bruised heart could not watch another family go through what I had just seen weeks prior.
When I apply into physical medicine and rehabilitation as a fourth-year, I know that my patients are going to be looking to become whole again. What’s beautiful about the field is the focus on functionality and quality of life. At first, I didn’t think I would be able to return to medicine after losing my father, but now I look forward to listening to patients talk about their own experiences. I’m so grateful I found a specialty where I feel I can truly make a difference. I know now that there is beauty in both daily life and the milestones we reach, and I am thankful to have a father that I will continue to make proud.