Has my title scared you off yet? The topic of death, especially for anyone who has lived through hearing the words, “you have cancer”, can make even the most resilient of us squirm in our chairs. With a chalky mouth and a thready pulse, we look for an exit from the room, the conversation, and the risk that one day we will wake up with a unexplained pain and a doctor will pull an x-ray out of it’s sterile envelope, slide it onto a lit surface, and show us a colony of little metastases hunkered down deep in our bones.

In some ways, the deluge of pink ribbons and announcements of bright and shiny 5-year survival statistics has lulled us (or maybe it’s just me) into a fairytale land where we can almost convince ourselves that surgeons dressed in crisp scrubs and oncologists packing an arsenal of chemotherapy drugs will protect ALL of us from the risk of eventual death. But, if you heard the buzz on February 4th about World Cancer Day, you might know the truth. “More people die from cancer than from AIDS, malaria, and tuberculosis combined. Each year globally, 12.7 million people learn they have cancer, and 7.6 million people die from the disease. Even more alarming, the World Health Organization projects that without immediate action, the global number of deaths from cancer will increase by nearly 80% by 2030, with most occurring in low- and middle-income countries.”

I know – intense information to read while sipping your morning coffee. Often I shield you (and maybe myself) from the darker side of the story. I find ways to inject humour and soften the edges of the harsh realities I sometimes experience while on the road. But, before your eyes glaze over and you click on the little x at the top of this post, in search of the latest news or celebrity gossip, stay with me…because today, I want to share with you a story about compassion and HOPE.

If you have read A Fresh Chapter for awhile, you might know about my good friend and coping mechanism, DENIAL. Typically, I avoid thinking or reading or focusing on a world involving words like metastatic or palliative (Palliative Care, Fluorescent “Sky” Lights & Gratitude) because of my *incredibly rational* logic that if I think too much about this terrifying world, the universe will hand me a one-way ticket into it.

For any of you other avoid-thoughts-of-death-at-all-costs kind of people, maybe you can imagine the duelling butterflies in my stomach as I wove up a crumbling staircase, crowded with forty to fifty squatting people, in search of the first floor and office of Dr. Quach Thanh Khanh, Vice Director of the brand new Palliative Care Unit at HCM City Cancer Hospital. Looking every inch, the only lost, white, foreigner in a Vietnamese hospital, I stared at the characters on the sign and tried to gauge whether I had arrived in the right place or not. Luckily, my cheap Nokia mobile phone buzzed and I saw Dr. Khanh waving at me through the crowd.

He led me through an onslaught of patients, caregivers, and nursing staff and then gestured for me to take a seat on one of the mismatched chairs scattered around the long boardroom table. The room, the heat, and the noise faded away as he asked about my story and then finally gave me the chance to hear his.

After eight years as a Radio-Oncologist, specializing in head and neck cancers, a chance meeting with Dr. Eric L. Kraukauer of the Harvard Medical School Centre for Palliative Care shifted the course of Dr. Khanh’s life forever.

As recently as a year ago, in hospitals across Vietnam, if an oncologist had exhausted all known treatment for a person, that patient was sent home to die with with no drugs to manage the pain and no emotional support for either the patient or their caregivers. Now, after an intensive course in Palliative Care, Dr. Khanh and his team use Dr. Krakauer’s model to run the first Palliative Care Program in HCM City.

As we wrapped up our conversation about cancer survival rates, hospital policies around spiritual support, and the protocols of palliative care, Dr. Khanh paused to look down at the ground for a moment.

When his eyes next met mine, he softly said, “I have a big dream too.”

The quiet intensity in his words and the hope shining in his eyes made my eyes fill and a lump form in my throat.

“What is your dream?” My voice trembled as I asked the question.

“I dream that one day, no cancer patient in HCM City will ever have to die in pain or to die alone.” His voice resonated with such conviction that I now had to bite down hard on my bottom lip in an attempt to reign in the tears threatening to tip over onto my cheeks.

His sincerity and dedication to alleviating the suffering of others inspired me more than I can articulate in this little post. For the next hour, I had the privilege of seeing the Palliative Program in action as we visited the home of a woman dying from metastatic breast cancer. Throughout our time with her, Dr. Khanh spoke to the patient (and her daughter) as if they were the only people who existed in the world. Even though I couldn’t understand the words, I did not feel even an ounce of pity in the exchange, but instead saw only genuine kinship and compassion. Even though Dr. Khanh will not save this woman’s life, he and his team will ensure she dies with dignity and in as little pain as possible. As I write these words, four days later, the screen blurs and I am still surprised by how much the feeling of connection and hope impacted me when I had braced myself to witness only sadness and fear.

Unfortunately, the reality of cancer and palliative care hit even closer to home today when I heard the news about the passing of two of my favourite Breast Cancer Bloggers. Susan Niebur of Toddler Planet and Rachel Cheetham Moro of The Cancer Culture Chronicles both died this week and my inbox and my heart will never be the same. Both of these women shared their beautiful writing, their quick wit(s), and their truest selves with a large community of readers both inside and outside the cancer world.

As I witness the devastating affects of cancer both here in Vietnam and among my tight knit group of breast cancer friends, I can’t help but notice that even across different continents, languages, and cultures, we are all united by our compassion for each other and by our grief. Whether we come from Vietnam, or a city in North America or Europe, we all experience sadness over the loss of loved ones, hope for a cancer-free future, and a desire to live meaningful lives.

The work of Dr. Khanh, and the writings of Susan and Rachel will continue to touch the lives of so many people. I hope their stories inspire you to think about how you can live a life filled with even more compassion and purpose. I know each of them will continue to inspire me.