“Doc, this is the hardest work I’ve done”. Melvin is being treated for a lung cancer with chemo and radiation. It will involve 33 treatments M-F for radiation, along with 6 cycles (one every 3 weeks) of chemo-immuno-therapy. “How so?” I ask, since at 81 I am sure a long life wasn’t all that easy. Also I wonder about the side effects he is having. I am not prepared for his answer. “All my life I traveled working in sales. I was never home. It was like a honeymoon each time I returned. Now I am stuck and can’t go anywhere. This cancer is killing me.” (True… if he doesn’t stay put for treatment). I love and admire the care spouses and families give to our patients. In this case, Melvin wants breathing room. His wife is over involved and he is feeling helpless and powerless. I wonder if I can help. I invite his wife back to exam room and she immediately thinks its bad news. Rather than having Melvin mix it up with her, I decide to be the fall ‘guy’. I tell her,” Your husband is doing fantastically well. We keep a very close eye on him daily and so I had a thought for you. At the beginning of the diagnosis, you mentioned the need to postpone your visit to Maine to see your ailing sister. I would like to suggest that you reconsider before the weather turns. I promise you that Melvin is managing and on a fairly boring path now.” She looks confused but says, “Well Doc, if you think it would be okay to go, he does have friends who could come over if needed”. Cancer always happens uninvited and disrupts plans and life. I advise them both that this would be a refreshing change in the midst of all their efforts. By the end of the visit, his wife looked energized and he was relieved. A plan was hatched.

Labor Day isn’t just to celebrate American workers. It also signals “get back to work and school”, but for many it is also a day of rest. We all need that extra time away from involvement. Many patients will even feel better Tuesday because they had a 3 day break from radiation and symptoms start to improve.

Melvin teaches us a lesson this week. Living is hard, staying alive is harder. The efforts logarithmically increase with age. This is also a reminder that our caregivers need care and support. I have no doubt after a week or 2 away, Melvin and his wife will reconvene with increased spirit. Too often we get so caught up in the work, even the work of cancer treatments, that we forget we are meant to enjoy a full life- otherwise why do it all? So today, find a way to enhance your relief efforts, may be a solitary walk, take yourself to lunch, shut off the TV and phone and catch up on a good book in peace. Your immune system will thank you. Monday should be “Labor-free” Day” and you earned it.