LIVING WITH DYING
Chapter Three, "...so many undone things"

Photo Essay, Carroll County Times, December 21, 1998

By Ken Koons


treatment
Dale gazes up at the nurse who is preparing him for a chemotherapy treatment. "For the first time, the needle of the connecting tube goes into the port of the catheter implanted in my chest," he said. "The chemotherapy is about to start."




marching
David Braune drove Dale and daughters Maren and Miriam to a peace march at the Pentagon in December 1996.


ruth crying
As she waits at the hospital, Ruth Aukerman feels the strain of dealing with her husband's illness.



mail
Ruth couldn't believe how many people wrote to Dale wishing him well in his fight against cancer in the months following the November 1996 diagnosis.



hospital
"In such a time, the Bible, much more than anything else, is what I want to read," said Dale, shown above hooked up to a chemotherapy pump. "It nurtures my spirit."




CAT
Dale prepares to undergo a CT scan as part of his participation in a study conducted by the National Cancer Institutie.




Article, Carroll County Times, December 21, 1998

By Scott Blanchard

Daniel Aukerman took a one-month leave from his medical residency in Maine and returned to Maryland after learning that his father Dale had lung cancer in November 1996.

He took his father to Suburban Hospital November 21 for tests on spots in Dale's liver to see how bad it was. If the cancer hadn't spread, there was a chance doctors could get rid of it by removing Dale's left lung. After the tests Daniel spoke to the doctor, then went to Dale's room. Dale asked Daniel whether the cancer had spread. Daniel nodded. Dale lay there for two hours, crying at times, reciting Bible verses from memory, praying.

Dale told his wife Ruth that afternoon, then daughters Miriam and Maren. Miriam canceled job interviews in Russia and was home within a week. Maren flew in from Arizona. Daniel eventually moved his residency to Lancaster, Pa.

Their 66-year-old father, who had never smoked, could expect to die from lung cancer in between two and six months, the average expectancy for stage IV patients. Statistics showed 40 percent made it to one year; about 10 to 12 percent lived two years or more. The cancer already had spread, and doctors could not surgically remove the lung tumor. The family didn't know if he'd make it to Christmas.

He wasn't sure he wanted medical help to try.

A friend of Ruth's had undergone chemotherapy and suffered before dying. Dale's mother died in 1983 of bone cancer after she refused further chemotherapy treatments.

In the mid-1950s, Dale's parents chose not to put Dale's 14-year-old sister Jane through chemotherapy or radiation to treat her fast-growing cancer. Doctors said Jane had a one-in-1,000 chance of surviving. Her parents took her to New York and Dallas to try alternative therapies such as diets and herbal drinks. Jane lived for three months after the diagnosis.

Dale, Ruth and their children weighed the quality of a life extended by what one doctor reminded them was toxic medicine.

Dale and the family made arrangements for his death. He didn't want money spent on the funeral, so he checked and discovered Maryland law permitted burial without embalming if it is done promptly after death - as the Brethren of Reuel Pritchett's generation had done.

``It made my day to find out about the burial possibilities,'' he said at lunch one day.

``That sentence has probably never been said in the English language before,'' Miriam responded.

Dale planned to make lists of household chores that he had always taken care of, like what needed doing in the gardens in late fall. The family talked about where to put Dale's bed when he became too weak to climb the twisted, narrow staircase to his and Ruth's second-floor bedroom.

The phone rang constantly with calls and prayers from friends, and the mailbox kept filling up with well wishes - even some from church members who opposed Dale's peace work. Ruth figured they got about 350 cards and letters in the two months after the diagnosis.

On November 30, the family gathered in the living room with its low, wood-beamed ceiling, foot-wide floorboards and heavy wood furniture. Dale sat in his recliner; Ruth, Daniel, Maren, Miriam and Miriam's husband Chuck filled the couch and the two wooden rocking chairs surrounding the glass-topped metal table.

Dale opened Dostoyevsky's The Idiot and read a passage he'd discovered while studying at the University of Chicago.

In the scene, Prince Myshkin tells of a man who has been sentenced to death and is being led to the scaffold. He has just five minutes left to live.

``He told me that those five minutes seemed to him an infinite time, a vast wealth; he felt that he had so many lives left in those five minutes that there was no need yet to think of the last moment. ...'' Dale read in his patient, measured monotone.

``... But he said that nothing was so dreadful at that time as the continual thought, `What if I were not to die! What if I could go back to life - what eternity! And it would all be mine! I would turn every minute into an age; I would lose nothing, I would count every minute as it passed, I would not waste one!' ''

The five minutes pass, and the man is given a reprieve. But Myshkin's friend does not keep his promise. Dale was living in those five minutes.

``I felt sort of a new connection with that passage,'' he said. ``There was a lot in my experience in the first weeks [of] living very intently, very purposefully.''

From Dale Aukerman's journal: Tuesday, March 18 [1997]. An insect was crawling over the back of my neck. I tried to remove it. Then it was on the back of my hand, and I flicked it onto the table and crushed it. The body had yellow and black stripes. I felt bad right afterward that I had not taken it alive outside. I am being given an opportunity to live longer, but I had not given that to the insect. Several more of the same unfamiliar species has appeared in the house since then, and I have taken them outside.

As family members arranged their lives around Dale's impending death, they investigated ways to help him live. They considered chemo and radiation therapy, and homeopathic remedies popular in Ruth's native Germany.

One doctor advised against chemotherapy.

Two others, Maren said, were ready to hook Dale up to chemo right away, as if any side effects would be only a nuisance.

Another met with Dale, Daniel and Maren for about two hours and laid out the good and bad of chemo, medicine that poisons cells - healthy and cancerous - and can make hair fall out, damage the stomach lining or wipe out red blood cells, which carry oxygen and carbon dioxide in and out of the body.

Dale knew the line from Matthew 16:25: He who seeks to save his life shall lose it. But in the winter of 1996 he kept thinking about Ruth, and what he would leave her with. Their friends were thinking the same thing.

``I always felt that he had so many undone things,'' said Frauke Westphal, a longtime friend. ``He felt that he could finish some of the things if he could get more time. If six months could stretch into a year, he could better the land for Ruth.

``He wanted a garage for his wife for when it snowed ... the house to be more winterized ... a new car so Ruth could go to work.''

As the family investigated chemo, Daniel said, Dale learned that for most people chemo might extend a patient's life by only a couple months, and at what quality?

``The reason for treatment was because there was a small minority of people for which getting that treatment may mean significant time,'' Daniel said. ``In a way it's kind of a gambling type thing, which is odd because my father's not the gambling type.''

Friday, August 29 [1997]. The little rows of seedlings in my late garden are peeping through - a delight to see.

About a month after the initial diagnosis, Dale decided to undergo chemotherapy. Frauke and Heiner Westphal, family friends for almost 25 years, gave him literature on a National Cancer Institute study that was testing a new way to give patients two standard cancer drugs. Heiner, a genetic researcher at the National Institutes of Health, checked to see whether Dale would qualify. A couple of Frauke Westphal's patients had been in the study and had survived longer than expected.

The NCI study accepted Dale, which meant the federal government would pay for his treatment. A man who'd been arrested four times during peace protests, whose 1981 book ``Darkening Valley'' called on Christians to resist militarism, was to be treated at the U.S. Naval Hospital.

``During my life I was opposing the military in the taking of life, or preparing to take life in war-making,'' Dale said. ``This was something the military was doing that I found good. This was something that was serving life, was helping to preserve life.''

Doctors first had to irradiate his hip, liver and lower spine to get rid of cancerous spots. On December 30, Dale had radiation, then friend David Braune drove Dale, Maren and Miriam to the Pentagon, where they joined a march protesting nuclear weapons.

``He was more maybe at peace and really quiet, clearly feeling like it was the right place for him to be,'' Maren said.

He had begun to buy time. He would take in his hands his Bible - the one his parents bought him about 45 years ago, the one that has been rebound twice, is covered now with black masking tape and filled with notes and underlines - and read it intently, trying to unlock the mystery that had come with the cancer.

``Before the diagnosis I was doing interim pastoral work but I probably wasn't making as good a use of my time ... how should I put it? ... I wasn't really as focused toward living my life fully toward God,'' he said. ``Through the diagnosis it was just sort of like shaking up a child. I came to my senses much more and did become more focused, working toward the question: I may not have very much time. What does God want me to do?''



Go forward to Chapter Four, "Each day is precious"

Go back to Chapter Two, "Walking the right way"

Go to the Living with Dying page