Psychology, recent

She Did Not Go Gently

In August 2017, my wife Buffy was diagnosed with early onset colon cancer. She was 41 years old. In April 2019, she passed away. Our five-year-old daughter and seven-year-old son lost their mother. I lost my best friend. She and I were together half of our lives, married 18 of them. She did not want to die.

She was an amazingly accomplished woman. Girl Scout Gold at 16, national first vice president of the Children of the American Revolution, and president of the university chapter of the Society of Women Engineers in undergrad. Bachelors in civil engineering from Georgia Tech, masters in construction management from Stanford, certified construction estimator.

She built buildings. Big ones. Cool ones, that everybody loves. She was a talented woman in a male dominated industry. To my knowledge, she succeeded at every single thing she ever set her mind to, save beating cancer. Her face lives in the Atlanta skyline.

There was never any hope, if we’re being objective. Her first CT scan showed a major obstruction of the colon, twenty spots on her liver, two the size of tangerines, and several on her lungs. She was deep into stage four cancer before she ever got checked out. The first scan was a death sentence, and she knew it. She wasn’t dumb.

Elizabeth ‘Buffy’ Thomas Campbell, 1975–2019

She carried a lot of anger for not getting evaluated sooner, but it probably wouldn’t have mattered. She noticed major symptoms in July of 2017, but pushed the doctor’s visit for professional reasons. In retrospect, she probably had signs as early as May, but she did what every early 40s person does—she wrote them off to aging. She thought she had irritable bowel syndrome and was going in to get some pills. The only reasonable way to catch the cancer would have been a routine colonoscopy, but nobody gets those until they’re 50. It was unavoidable, and incredibly rare at her age. And incredibly unfair.

Buffy deserved this less than anyone I’ve ever met. She was kind, warm, friendly, astoundingly intelligent, and incredibly strong. Everyone loved her. She was rarely critical, but when she was, she was always right. In the days after her passing, many different people said to me that their behaviors in the past decades have been influenced by the mere thought that Buffy might disapprove. They loved her that much.

It was unfair to her, to our kids, and to me.

My first task was to get over how unfair it was to me. My next was to mitigate how unfair it was to the kids. And my last and most important task was to beat her cancer. An unbeatable cancer. This diagnosis is the sort that will remain a death sentence five decades from now.

So the project definition shifted.

The actual project was not to survive the cancer at all. The actual project was to squeeze out as many remaining days with our kids as we could. For that, she needed hope.

Hope and Denial Are Linked

The placebo effect is real. It’s measurable. It’s why we have placebo trials in medical research—because the hope buried inside that sugar pill has a measurable medical benefit. Hope is literally medicine, and it’s powerful stuff. But in hopeless situations, hope is in short supply.

If you’re in a hopeless situation, the only way to get hope is to deny the situation. Hope and denial are linked. She told me early on, “I’m just going to be hopeful that this chemotherapy treatment will work,” which was at once bullshit and also the obviously correct thing to do, and I went along with the masquerade. But I didn’t hope and I didn’t deny, because doing either wouldn’t have done me any good. I didn’t need the placebo, she did. I needed to hold everything together, and her hope was part of the treatment plan, not the action plan. Which meant I did a lot of my grieving alone, while holding her hopeful hand.

After the colectomy, we went through three different flavors of chemotherapy cocktails, two of which worked for a bit before they didn’t, followed by a shot-in-the-dark clinical trial. I made graphs, because that’s a classic coping mechanism for engineering nerds.

Here we see Carcinoembryonic Antigen count, which is a blood marker that indicates the presence and growth of tumors, over time. In healthy people, this marker is down around “5” or lower. We started at 831.

Chemotherapy: a three-day long infusion of chemical poison, every other week for 14 months, beating the cancer back. Buying another day with the kids. You haven’t lived until you buzz your wife’s head with your beard trimmer. She smiled her infectious smile while the hair fell into the shower drain.

I moved viciously through the stages of grief in early-to-middle 2018, while Buffy remained hopeful. The chemo turned out to be a very good training platform for the future, because every other week I was a single dad of two kids caring for a cancer patient and running a small business.

I took on a spirit animal. I needed a guiding force that dealt with tragedy while still getting things done. I chose “Oklahoma Dustbowl Farmer.” Those guys would bury their son in the morning and plant corn in the afternoon.

Buffy did the harder part. The chemo.

Hope expired the day she was pulled from the clinical trial. Her liver became too weak to tolerate the medicine, the tumors too prevalent. It was the second most emotional day for us of the entire stretch, behind Day One. The doctor’s visit was a shitshow. In the car on the way back from Emory Hospital, I told her, “I know you’re in a tremendous free fall right now, but I need you to know this. This was never beatable, and I’ve already fallen down this hole. You’re falling towards me, down at the bottom of this pit, and I’ve done everything I can to make for a comfortable landing.” That exchange was in the Arby’s drive-thru, waiting for a Jamocha shake. She wanted one.

We stopped at a bar on the way home. We have a local brewery called Scofflaw, which has a seasonal brew called “F*ck Cancer.” I ordered one with our lunch. It was good. I ordered another. They brought me a Hefeweizen. I hate Hefeweizen. I complained. They told me “Sometimes the bottom of the keg on IPAs gets cloudy. We didn’t pour you the wrong beer.” But they did. I asked for a Sweetwater 420. A couple minutes later I said to Buffy, “We just witnessed a metaphor, didn’t we? You order ‘Fuck Cancer,’ and they bring you a Hefeweizen.”

That was March 1, 2019. I’d had a year and a half to emotionally process her coming death, and she was just getting started with it. This was the price she paid for our shared denial. She had to come to grips with her own death on a short fuse. I tried to help her. She had other ideas.

The Fortune Cookie

I would have probably reacted differently to the cancer than Buffy did. I would have been flying around, checking bucket list items, building memorabilia for people, making whatever mark I could before I passed away. I offered her support in that, and she simply wasn’t interested. She wanted things to just be as normal as possible. The best way for her to fight it was to not think about it.

It frustrated me some, and for a long time I thought that she was simply not capable of coming to grips with her death. It was too big. But looking back, especially on the final months, I think I was wrong. She could have come to grips with it if she wanted to. She chose not to, and my job as a husband was not to push her towards an epiphany she didn’t want to have. She wanted to fight, and my job was to help her.

We did no funeral planning. She chose not to finish many of her projects, such as knitting the kids’ Christmas stockings, because choosing to finish would be admitting why she was finishing. We only got onto hospice care six days before she died. I don’t know where the wedding ring is. Going through her belongings after she passed on, looking for that wedding ring, I found these three cookie fortunes in her purse:

She kept the first two intact, ripped the third one, and then kept it ripped in her purse. It was her ‘fuck you’ to the situation. She was the most talented planner I’ve ever met, professionally or otherwise, saying, “No, I will not prepare.”

Last Words

In the final days, Buffy was very averse to anyone wanting to say “last words.” She cancelled all her friend visits. She told me she didn’t want people talking to her like she was going to die. She told the social worker on Tuesday, the day before she died, that she figured she had another week or two if she could just get the pain under control. Later that day, she told me the pain was about like Pitocin-induced labor contractions with no painkillers. She would know. She was on a 60mg OxyContin time release and 20mg of Oxycodone at the time. She could barely eat and had no weight left to lose. Nevertheless, she persisted.

In those final days, I abandoned my spirit animal for a better one. The Oklahoma dustbowl farmer paled in comparison to Buffy.

There was a moment on the Tuesday when we had a scare. Her breathing slowed tremendously from some of the breakthrough pain meds we had administered, and I held her hand, stimulating it. I didn’t know if she was gone or not. When she came out of it, I said this:

If you see a tunnel, go to that tunnel. If you see a light, go to that light. If that light is a benevolent force that reviews your life, know that your life was wonderful. If you see anything I did that was hurtful to you, please forgive me, and know that I forgive you. You go to that light, and you wait for me. I’ll meet you there, just not today. I have to stay and finish what we started.

And I freaking lost it. All that stoicism came crashing down. Couldn’t say another word. She fought one more day.

After

It seems to me that stoicism is, in its purest form, nothing more than “keeping it together when shit needs to get done.” My wife taught me there are different ways to do that. While I accepted, grieved, and planned, she denied, hoped, and fought.

What do we learn from death, and from our choices in trying to deal with it? How do we know we did the right thing? Maybe I did everything wrong. Maybe we did everything wrong. That’s the problem with terminal cancer—there are no do-overs. No learning from your mistakes. Nobody gets good at this. But I think our decision to leverage that denial-hope link was the right one, because I don’t think Buffy knew how to do anything else but fight anyway.

She did not go gently.


B.J. Campbell is a professional civil engineer in Atlanta and a single father. He writes about gun policy and culture analysis at medium.com/handwaving-freakoutery and freakoutery.com, has an album on Spotify, and will one day buy another sailboat.

53 Comments

  1. Joel Gladman says

    I have a 5yo daughter and 7yo son too. My heart aches for you and your children. Unfair is the right word.

  2. Name Withheld says

    So sorry for this, for your loss and your family’s.

    My spouse made a serious attempt at suicide last fall, was hospitalized for several days. It was Oklahoma dust bowl farmer stoicism, punctuated by involuntary sobbing for a minute, and then back to folding laundry and cooking dinner for the kids. She’d done her homework; it was only a fluke, an accident that she wasn’t dead. Your descriptions of stoicism–and its fragility–hit home for me.

  3. Stephen Lane says

    A beautifully written article, packed with wisdom, humanity and love.

  4. Rob Hamer says

    I wish you and your daughter and son strength and peace.

  5. Grant says

    I’m horrified by your family’s great loss.

    Both of you did, of course, the right thing, because there’s no ‘right’ way to cope with it. I’m sure she wanted to fight it because being a mother demands you fight no matter the odds.
    Last night I learned a friend, a woman, has 3 months or so. She’s doing chemo so that she can hopefully attend her daughter’s high school graduation.

    My best wishes for you and your children, and your continued endeavor to complete what you both started.

  6. Barney Doran says

    Please, people, start getting colonoscopies when you are forty not, repeat not, starting at fifty. I did, and it saved my life and probably the lives of some of my friends and relatives who I bugged l ilke hell to do it. If I had waited until fifty, I would not be writing this. Colon cancer is one of the biggest killer cancers yet the most preventable. Just get a colonoscopy, and if you are forty plus and haven’t done so, do it now!

    • A lot of this comes down to doctor’s recommendations, and insurance coverages, which in turn comes down to the actuarial science of death. Colonoscopies are not trivial. This is a topic unto itself that I couldn’t fit into this article, nor would I want to because it’s too much of a departure from the subject.

      One day I might sit down and do that math, but quite honestly I’m afraid of what it might tell me.

      If the math breaks one way, then I might discover that the age 50 (or 45 or whatever) recommendation is the correct one, because the number of early onset colon cancers identified by a colonoscopy at 40 or 35 would not offset the costs, both in money and in the potential for botched procedures, of the additional colonoscopy recommendation.

      That would mean that Buffy was sacrificed on the altar of efficiency.

      Or the math could say that earlier colonoscopy recommendations make sense, and that doctors and insurance companies should absolutely be pushing their patients to have them in their early 40s or 30s.

      That would mean that Buffy was sacrificed on the altar of institutional inertia.

      I’m not sure I want to know that answer. In the end, seeking the answer out would simply be looking for someone to blame, and I don’t think blame in this case is the appropriate or mature response. Because the blame doesn’t matter.

      • C. G. says

        Knowing a healthy person who died from a perforated colon caused by a colonoscopy, I agree. There are other tests now that are non-invasive and just as effective if you have average risk (i.e., none in the family–which unfortunately wouldn’t apply to Mr. Doran’s first degree relatives.)

        https://www.sciencedaily.com/releases/2019/02/190225175921.htm

  7. Heraklion says

    This was a beautifully written article. I am sorry for your loss.

  8. I am sorry for your loss, sir. Thank you for writing this. You’re not alone.

  9. Sean Leith says

    How hard it is to solve a problem that was discovered 100 years? Something is wrong in medical research community. whenever I say this, someone would say: you know nothing about research. I think I do. Doing research is what I do. But it is illogical after so many years no cure has been found. Don’t tell me how much progress has been made, I don’t need that.

    • Heraklion says

      It’s not like too high a dose of chemotherapy (i.e. highly toxic cellular poison) could kill the patient before it kills the tumor, hey ? Or increase the risk of chemotherapy-induced leukemia years later, hum ?

      For your information, if Mrs. Campbell had been diagnosed earlier (during stage one), she could probably have been cured.

      My mom has been diagnosed last November with a stage 1 B lymphoma, and was cured after 4 rounds of chemotherapy. A few years ago, the word “lymphoma” only would have been a death sentence.

      Please share with us your deep insights about cancer treatment my dear.

    • FuckCancer says

      Then go solve it if you thi k you can do better.

  10. Nox says

    You got me Sir. This report helpful in mysterious way.

  11. Stephanie says

    What a heartbreaking story, I’m so sorry for your loss. Those poor children who will have to grow up without their mother…

  12. Myra says

    There simply aren’t words to tell you my heart breaks for you and the children.

  13. James Pelton says

    I waited until sixty. I thought it was the beets. I got off the can and turned around to flush and the water was pink. That was November 2017 and I still don’t know if I’ll make it through. LESSON ONE: like the person above said: get your colonoscopies. Cancer may be listed as my cause-of-death, but to be honest, it will be stupidity.

  14. mary delaney says

    I was 5, my brother 9 when our Mom died age 42, heart attack. Im 64 now and still realizing new insights into the trauma her death was on all of us.. She was a gentle, intelligent , loving Mother and my fathers best friend. He was a longshoreman supervisor in nyc and not intellectually prepared to cope well. My brother and I were thrown into a whirlwind of chaos needing to be watched so our father could go to work.

  15. Buffy sounds like a wonderful person, and this is a beautiful tribute to her. I’m so sorry for your loss.

  16. Andrew says

    Cancer is a bitch-kitty, and plays no favourites. Condolences from the grateful husband of a survivor.

  17. One of my best friends died from breast cancer in December. She too did not go quietly. At the time I didn’t understand, or perhaps didn’t want to, and spent the last few months trying to make sense of it. Your article has helped me better understand her choices in those final months and days. Thank you sir. I wish you and your children well.

  18. MarySue Foster says

    I’m reading this on a Sunday morning. My 47 year old daughter died January 3 from leukemia, diagnosed in February 2018. Our journey was similar. I appreciate your clarity about the hope/denial couplet. Her diagnosis was a death sentence. No one escapes her form of leukemia, especially with the mutation she had plus some ineptitude on the part of the hospital. We were all hopeful and optimistic as hell. Only in the last 6 days when she lapsed into a coma from liver failure did we see cancer won. Cancer sucks.

    Thank you for writing this.

  19. My wife died in Feb 2019 due to stomach cancer… when she was diagnosed and began chemo, I quit my job (easiest decision I ever made) to care for her. We fought the cancer from October 2017 to 12:08 p. m. 2/15/2019. She died at 12:09 p. m. in my arms. She told me never to give up on her and I didn’t… My bottom line is this: NEVER NEVER NEVER GIVE UP!!! There are no situations that God cannot change. And though God didn’t answer our prayers in the way we wanted, I know that she’s in a better place; and I will always hold her in my hear until I hold her again in Heaven.

  20. rebeccaruhlen says

    Thank you for the gift of this essay, which I will share.

    Thank you for seeing, recognizing, and recounting how hard your wife fought, how furiously and un-gently she died.

    In 1972, my mother died of leukemia at age 35, when I was three years old. I was too young to remember anything about her illness — too young to remember her, even.

    Years later, people would tell me how impressed they were that she took her illness in stride and died — in their words — gracefully. I suppose they thought they were praising her to me, giving me something about her in which I could take pride, passing on an inspiring legacy.

    Fuck that shit.

    So hard.

    No child wants to hear that her mother died gracefully. I am so glad to know that your children will grow up feeling assured that their mother wanted nothing more than to survive and be with them, care for them, love them, and that she was mad as hell when she didn’t get to do that.

  21. P A Povlock says

    Please accept my deepest condolences on your family’s loss. When I first read your comment regarding your wife several months ago, my wife had just been diagnosed with cancer after a “routine” surgery, a type with a pretty poor prognosis. After several tests, it turns out it was a less nasty type and she is “probably” OK. She is still recovering from the surgery as 50+ year old’s don’t heal as quickly as those in their twenties. I remain hopeful on all fronts.

    We went through the bouts of despair and depression associated with the initial prognosis, everything from getting the finances in order (she did it) to where do we want to be buried (still to be determined). It was not fun. The incredible emotional drain was beyond anything I had experienced. The family plan was for me to die first, as the males in my family historically don’t last too long. When this was upset our world started to unravel, and it was a stress to even do the necessary events required to get through the day. My children are older, though one is still in the house. We did not inform them of their mother’s condition, partly to shield them from the process and partly because my wife did not want to share the information with anyone. She had similar concerns as your wife did, not wanting to be spoken to as someone who is about to die. We learned just prior to Thanksgiving that she was probably OK, so even though we had turkey slices and stove top stuffing for dinner, we never felt as blessed saying grace.

    I do not know what the future has in store in this respect. We had many plans for our upcoming retirement that may never reach fruition. We may have to do many different things than we would like to do in order to keep her healthy and deal with any future recurrence. Welcome to the real world. Ours is not a terrible spot to be sure.

    I wish you and your family well and hope that you and your children are able to find some peace. I wish there was something I could say to help ease the pain but I don’t think there is.

    Rest in Peace. May God bless you and your family.

  22. jasmos says

    B.J., this is beautiful and impactful. Thank you.

  23. Kathleen says

    You could not have picked more beautiful words to say to your wife after her breathing slowed, but then she revived. Just beautiful.

  24. Dona Somerville says

    I am in tears. My mother was diagnosed with stage IV ovarian cancer at 40. She fought hard for four years (surgery, treatment, remission, recurrence, treatment…). My mother died at 44 – I was 26. She did not go gently either. I thought that was the worst day of my life.

    Fast forward several years… At 45 I was a mother of 5 and 7 year old boys. My husband was diagnosed with stage IV lung cancer. Diagnosed in March and died October 9th the same year. My husband did not want to “prepare” for his death. In hindsight, I wish we had not done treatment. We knew from diagnosis what the outcome would be. Treatment was supposed to extend his time – not cure. But the treatment was so harsh that he had no quality of life. When he died, it was honestly a relief. The saddest thing about that is that I know my older son – 7 at the time – felt the same way. I had (have still) a hard time processing that. Imagine how hard it is for him.

    My heart is sad for you and your children. I hope for peace for all of you.

  25. Kevin Doyle says

    BJ – we don’t know each other, but I feel like you’re a friend, since I’ve read so much of your work. I’m sitting here at my DoD job in tears after reading this – it is beautiful and sad at the same time – like life I guess. I hope that writing this helps you recover and get stronger.

    • Thanks Kevin. I appreciate it.

      It turns out, the secret to writing a tear jerker is to write it while you’re crying. I took the kids up to the mountains the day after the funeral and we went hiking and played Dungeons and Dragons. Wrote the bulk of this when they were in bed.

      Things are getting slowly better, but I didn’t really write it just for me. We had a lot of friends with whom we fell out of touch as the thing progressed, and I hope it was helpful for them. Also for my wife’s Marco Polo buddies, who it turns out were struggling with some of the same issues I was. Also for other people in similar situations.

      • Valerie says

        A beautifully written piece, BJ. Thank you for including the part about turning away friends in those final days/weeks. My husband did the same (including most family members, too). Neither of them went gently or quietly or without fighting to the end.

  26. A Quillette Reader says

    Hi B.J., I’m very sad to hear about your wife. I would not be able to process my thoughts after a loss like you did here. If you and your children are interested, there is a camp for kids who lost a loved one – Camp Erin. There are forty or so across the US. I decided to volunteer for one of them this summer immediately after I heard what is was about.

    • Thank you for the recommendation. There is a camp local to me called MAGIK that my son will be attending, which sounds similar. Thanks also for the kind words.

      • A Quillette Reader says

        For sure B.J. Yep, same idea. That will benefit him immensely.

  27. Carl Geier says

    Quilette,as an open forum, delves into many complex questions and societal issues, but the question you end this commentary with is as profound as any question that can be raised. “What do we learn from death, and from our choices in trying to deal with it?”

    BJ you have learned more than you ever wanted to know about death and the choices we face. Unfortunately the nature of life is that you will have to learn more. I pray that as time passes you will share those insights as eloquently as you have here.

  28. Angie Gillespie says

    So sad. Thank you for writing this, BJ. ❤️

  29. Elsa says

    Denial was my friend too. It made the 6 months after my husbands diagnosis somewhat bearable. It held me upright. It made it possible for me to be a mother for my two children, aged 7 and 3. Denial was always my friend, because to survive I needed to keep to truth out.
    I always knew the truth would come in the end

  30. Dan Warne says

    Beautiful story. Thank you for sharing. I was diagnosed with pancreatic cancer in 2003 and coped with the news in a similar way to Buffy. After the diagnosis I went and sat in a park and made myself cry because it kinda felt like the right thing to do, but honestly, I was happy to believe that I was going to be OK and leave it to my doctors who were much more expert in handling these matters than I was.

    Luckily, I was one of the incredibly incredibly lucky few that recovered due to fortunate circumstances and a very clever and dedicated surgeon who worked in theatre on me for over 12 hours and then cared for me daily for 3 months in hospital and afterwards for years.

    It seems that denial is generally frowned upon by society, as if facing up to the bad news is the more virtuous path, but I can completely understand why Buffy chose her path – if you may have limited time left, and you have enjoyed your life as it is, why add further instability into the situation and start chasing bucket list items? Denial can at least allow you to continue living your life in the framework you’ve fitted yourself into in the world.

  31. Dan Warne says

    One follow up thought. As I mentioned in my comment earlier, I’m one of the lucky few that made it through pancreatic cancer. You might assume that after that it would give you a new focus on living the best life possible. In reality, I have lived my life in a comfortable way – I still eat somewhat unhealthy food and too much of it; I still work in a job that can be occasionally boring (which job isn’t); I haven’t prioritised seeing the wonders of the world as much as you might expect someone who has had a second lease on life to; I still don’t exercise as much as I should. I think perhaps the answer lies in the fact that some people just value consistency over adventure. Is that good or bad? I’m not sure.

  32. Nathan Pike says

    I am so sorry for your loss. My Dad was diagnosed with stage 4 pancreatic cancer on the 2nd of March and he passed away on the 2nd of April. He, and we as a family, had very little time to prepare for what was coming and are still struggling with the speed of his descent and the empty hole in our lives now just 4 weeks on from his passing. Be strong for your kids and I always remind them just how awesome their Mum was.

  33. MJC says

    Thank you. Whatever the situation it’s worth feeling, thinking, feeling and then thinking again, as your writing shows beautifully.

  34. Guy says

    Very sorry for your loss BJ, losing your best friend and life partner is heart breaking. I hope you can find peace with yourself and children.

  35. Bill Rodriguez says

    It has been 23 years since I lost my wife of 20 years to colon cancer that spread to her liver. She was 53 and I was 48. She had five kids when I married her.
    I was her devoted caregiver for 18 months. We found out she was terminal after 9 months. I was up every two hours giving her the morphine. I cleaned her colostomy bag for the last time as she lay semi-conscious on her last night. Two days before I rushed to the pharmacy to get liquid morphine cause I couldn’t get the crushed pills down her anymore. She also had a morphine pump and fentyl patches. I gave her the last liquid dose hoping I had given her too much. She died in my arms the next morning. It took me two years before I could sleep more than two hours at a time after she passed. I still cry when I think of all the pain and suffering she went through. I have tears in my eyes right now.

  36. Arthur says

    Thank you very much for sharing the final months/days with your wonderful wife. I’m deeply sorry for your loss. My wife was diagnosed with Stage-4 colon cancer and died a year later in November of 2013. I had my own version of praying for her to “go into the tunnel/light” at the end Your story meant a lot to me. Thank you again for sharing.

  37. Bill Rodriguez says

    Sorry I could not continue last night. Just needed to say that I deeply feel your loss and as with mine I have learned that things turn out as they are meant to be. Looking forward is the only way to deal with the pain.

  38. Michelle Mays says

    your article was recommended to me by some friends
    they said it reminded them of my story
    I could have written every word……except the graphs…..I didn’t make graphs
    My husband died Dec. 2018
    I live in Maine and am raising the 3 sons he left behind

    If you would like a friend who has been there, please contact me via the email address I provided.

    navigating the after is just as full of stoicism as the before, I am looking for people who understand the finer details that I can support and gain support from

    • Michelle Mays says

      Actually he died in December 2017……..I guess I lost a year …..cant imagine why

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