A Well Timed Wry Smile
The left side of my mouth no longer curls up into a smile. And my left eyelid doesn’t blink in unison with the right one.
I had recently switched my cancer treatment from palliative care to home hospice care. The difference in those terms was brought home by my facial defects.

My wife and I called the home hospice nurse because we suspected I might be having a stroke. After a couple quick visits and tests, the hospice staff determined it was Bell’s palsy, not a stroke. Bell’s palsy affects a facial nerve and is often a temporary situation.
One of the hospice nurses, however, asked me, “What if it WAS a stroke? Hospice care doesn’t treat illnesses. We try to make patients comfortable while dealing with an illness.”
In essence, she was asking whether I would have left hospice care to get treated for a stroke or let it run its course.
I asked what the effect of the stroke could have been, and she replied I would likely have lost some bodily function, possibly become incontinence likely unable to care for myself.
“But that would have just made things harder for my family,” I responded. “It’s not like a massive heart attack that would take me out.”
A stroke could result in death, she replied.
The implication was am I ready for hospice care? Am I ready to let go?
Hospice does allows patients to slip in and out of its care for treatment, with some limitations.
I thought about what she asked, and concluded I am ready to let go. But there are no assurances that when you do let go, the disease takes you all the way. That could be distressing.
She said the Bell’s palsy could have been brought on by my nodes enlarged by cancer squeezing against a nerve, and suggested some steroids that might reduce the swellin. It had a 50% chance of working, I was told.
I said no to more pills that might or might not work, but would surely have a side effect. And, I thought, maybe the Bell’s palsy has come at a perfect time. I need a wry smile to face the world.
This is the latest installment in the blog Closing in on -30- about my doctor’s pronouncement that I have about two years to live.
