Victor has been the heart of this project since the start, and his ability to speak for himself has always been a key motivator.
This is Vic's last entry, his last story to tell in his own voice.
He knew that his time was limited and he felt his strength waning, but he tried to keep telling his story using his own voice. This may be painful to hear, but this is Vic telling his last story from his hospital bed, only a few days before he died. He did it in one take, unedited and it is a brutally honest testament to his strength and single-minded determination.
 |
| Victor C. Dino July 21, 1957 - November 18, 2018 |
Still, there turned out to be more to say. I reminded Vic that his cancer diagnosis was a major life event, and so if he wanted to talk about it, we could always add a new chapter. He replied "But we finished the last chapter." I countered that we could always do an epilogue if he wanted to append something new. "Epilogue", he said knowingly. The wheels were turning and I could tell he was already thinking about the new stories he might add.
Vic's health was always a challenge. Since moving to Kelly Court in 2015, he'd always seemed to have chronic sinus blockage and water in his ear. Pop cleaned out Vic's ears as he'd done since Vic was a boy, and I helped put in sprays or drops to help dissolve ear wax. Eventually, this and some nasal sprays helped him a little, but not much.
In 2016, Vic was referred to a prostate cancer specialist named Dr. Black. Vic's PSA level had been in the double digits. PSA is an enzyme in the rectum that's watched as one of a number of risk indicators prostate cancer. Vic started taking Saw Palmetto, and was scheduled for an MRI.
Vic began telling his friends that he had cancer or that he was going to die from cancer. I chided him that the tests were incomplete and the results were inconclusive, and that it was wrong and irresponsible of him to worry his friends without having enough evidence. We believed that it was Vic's nature to instinctively use the seriousness of the situation to get attention and sympathy. He was also legitimately afraid of dying, and I think this was how he tried to generate support from the people around him. We were as helpless as he, and tried our best to help him think about his prospects optimistically and constructively.
Months later, when his MRI appointment did finally come, he was unable to complete it. It was too difficult for him to get onto the table and turned out to be a nerve-wracking procedure that he simply could not complete on his own. He never got the MRI, but a biopsy from his rectum in December 2016 came back negative for cancer. We all breathed a sigh of relief, and I told him to remember this good news and to focus on living instead of dying.
Nobody knew why his PSA levels continued to be in the double-digits. Vic stopped talking about "having cancer" as often after this and focused on his eye doctor appointments. He'd been told that he had the beginnings of cataracts in his right eye, and we reassured him that his sister had also had the beginnings of a cataract in her eye, and also that that their 90 year-old father had undergone cataract removal operations in both eyes with no complications. Even with these reassurances, Vic still fretted over the idea of possibly going blind one day.
In one of our frequent talks, Vic told me that he felt he'd become more pessimistic as he got older, and it made me worry that I might not be able to help him to generate his own hopefulness. He was frustrated and sick of having to go to so many doctor's offices for his prostate, or his ears, nose, and throat, or to get blood samples taken at the lab, or even to get his prescriptions renewed by his doctor. He complained that it felt like his whole life had become eclipsed by his health issues. In a fit of frustration and anger, he phoned Dr. Black's office to say that he would not be returning there again. Vic was sick of all the doctors. For him, the prostate cancer chapter was closed for good.
Years
Vic had suffered from chronic acid reflux in recent years, and was taking a medication for it. It often kept him awake at night. I gave him a bag of Tums to keep by his bedside, but it didn't seem to help much. It just seemed like another ailment in a long list of chronic ailments that plagued him. We had no idea how significant the acid reflux would turn out to be.Through much of 2017, Vic seemed infected or sickly throughout his body in many little ways: he had cavities in one tooth and another tooth was bad enough that it needed extraction. He had toenail fungus that never really cleared up in spite of medication. I told him and his sister Grace that combined with his sinus issues, all these different small infections could be dragging down his immune system, and that a dental infection could have even gotten into his bloodstream if left untreated. Overall, Vic seemed to be increasingly frail and vulnerable to disease.
Around this time, Vic developed a terrible fever and was confined to his bed with chills, sweats, and aches and pains. I found out from asking him afterwards that he'd recently sat out in the rain while waiting for a HandyDart bus to arrive. Apparently, this wasn't the first time sitting in cold wet weather had given him a fever. In fact, it was the second time that he'd admitted that kind of cause to me. It seemed that he simply wasn't aware of just how vulnerable or susceptible he'd become. He barely had any body fat at the best of times, and seemed to be getting weaker over time.
Months
Throughout the spring of 2018, Vic developed Edema, a water retention that caused his feet and legs to swell up like balloons. He was prescribed water pills, which didn't seem to help very much. By the summer of 2018, Vic had told us of bouts of paralysis in his left arm and a lot of pain in his legs. He would phone us every few days and describe terrifying night-time bouts of paralysis, and on one occasion, even temporary blindness. We advised him to tell his doctor about every symptom.By July, his Edema had mostly cleared-up. The care-aides and resident nurse finally convinced Vic to use a catheter, and soon after that, they convinced him to get a circumcision for the sake of his genital hygiene. Vic was afraid to go under the knife, but did so, again at Burnaby General.
By early August, while still healing from his circumcision, Vic's pain and fever returned and he spent most of a couple of days at home confined to his bed. One day, after Grace and I couldn't get an answer from his phone number after calling repeatedly all day, Grace went over and found Vic in a weak and delirious state, refusing care-aide's suggestions to go to the hospital. They couldn't do anything if a resident refused, but Grace convinced Vic to go, and they immediately called 911. He was weak and white as a sheet when he was put into the ambulance.
Vic arrived at Burnaby General semi-conscious, severely dehydrated, and in a lot of pain. He complained of abdominal and chest pain, and got chest x-rays, CT scans, and gave numerous blood samples. He was diagnosed with sepsis, a serious bacterial infection of the blood, and was also found to be anaemic, with a dangerously low red cell count. He was given transfusions and IV antibiotics, and over the next few days, his colour, strength, and appetite returned. A dietitian suggested a healthier diet, rich in iron. We were hoping that malnutrition had been his biggest problem. If so, it would be something that we could help him with, if he could stick with his diet plan.
But before he was discharged from BGH, they did an endoscope of his esophagus and discovered an edemocarcenoma, a mass of cancer cells in his lower esophagus. He was diagnosed with inoperable esophageal cancer. It was the same illness that had killed Humphrey Bogart. Vic's cancer was described as advanced. We learned that one of the possible contributing factors for cancer of the esophagus was long-term chronic acid reflux.
Throughout the summer, Vic became obsessed with the idea of having inoperable cancer. It was the worst news that anyone could receive. He struggled with eating more frequently and healthily, but seemed to be feeling weaker and more tired. The doctors had estimated that he might have anywhere from six months to two years to live.
Vic constantly told us about his desired funeral preparations, and whom he'd like to perform his service (Father Hamilton) and whom he'd like to say his eulogy (Susan).
He was referred to the Cancer Clinic near Vancouver General Hospital. Images shown to him by another cancer specialist showed a large spherical-shaped mass at the base of his esophagus, and there were also clear indications that cancer may have spread through his lymph nodes into his back and shoulder. Any cancer in his prostate was still inconclusive, but that no longer seemed to matter.
In his typical forthright manner, Vic said "Give it to me straight Doctor. Is it inoperable?" The doctor didn't want to say that his cancer was inoperable, but said that operating would be risky, and radiation and chemo would improve the chance of success if they could operate later on.
Weeks
Ten days of radiation therapy was scheduled, to try to stop the growth of the tumour, or to even shrink it. Chemo would follow, to try and stop it from spreading. Doctors were hoping this might allow a surgery to be more likely to succeed but also cautioned Vic of the late stage he was in, and of the risks associated with surgery. |
| Vic in the Burnaby Hospital ER. |
Days
On Saturday, Nov. 10th, we visited Vic, and found him feeling very weak, and slumping in his chair. He complained of back pain, had a fever, and was sweating profusely. He didn't have much of an appetite at all.The next day, Sunday, Vic stayed in bed, still extremely weak. Grace began nursing him at home, making sure that he ate whatever he could, and drank lots of tea and pop. This pattern continued for the next day or two.
By Wednesday, Nov. 14th, his condition had not improved and he was eating less. By 4:30 pm, we decided to call an ambulance and get him to the hospital. Vic was admitted to Burnaby General Hospital.
By Thursday, Vic was in dire condition; cancerous lesions had been found on his liver, confirming the serious spread of cancer, and he'd been diagnosed with a blood condition called Disseminated Intravascular Coagulation (DIC). His younger brother and his family flew in from Calgary to be with him. Vic was in a lot of pain and, still as straightforward and blunt as ever, told us that he knew he was dying. There was no denying it anymore.
On Friday, November 16th, Vic was transferred to BGH's Palliative care ward. The goal now was simply to alleviate his pain and to make him as comfortable as possible. He was in and out of consciousness at this point. When he was lucid, he asked for his favoured Catholic Priest, Father Hamilton, to visit him. Vic wanted Father Hamilton to perform his funeral service when the time came. While Victor's own father prayed over him, and wiped his head and whispered words of comfort to him, Vic's sister contacted his priest, who dropped everything and arrived at Vic's bedside in about an hour and a half. Father Hamilton gave Victor his last rites, and ensured that Vic knew what was happening at each stage. Vic indicated his acknowledgement and afterwards thanked the Father before falling asleep again from his anti-nausea meds.
Saturday, November 17th was a fairly good day for Victor. He had an early morning visit from his old friend Susan, who arrived early before the family did. His nausea and pain meds had been adjusted so that he was less groggy and in less pain, and he had more pain-free, lucid moments. I asked Vic whose music he'd rather listen to, Julie London or Frank Sinatra. In a strong voice, Vic replied "Frank", so I put in his Sinatra CD. With Frank crooning in the background, Vic enjoyed visitors from his high school days, and later after dinner, he enjoyed a bowl of ice cream fed to him by his sister Grace.
Sunday, Nov. 18th, at about 4:40 am, Victor passed away peacefully in his sleep.
