The patient has to be proactive. May are not. Need an example? when the doctor seemed ready to breeze past initial blood results showing normal white blood cell counts, but red blood cells suddenly below normal, I forced her to opine. “Oh,” she mumbled while looking at the computer. “These results are way out whack. We need to run more through some more blood tests. I need to see if your results are iron-deficient anemia or something else. I don’t believe you have colon cancer, for the blood results are right for Colon Cancer. So, an Iron+TBIC+Ferritin blood test will be the first test.”Proactivity ensured doctors did not miss critical information, but I am unsure what ‘not right means.’

I know Iron+TBIC+Ferritin indicators suggest a low TIBC might identify conditions other than anemia. When iron levels are insufficient, the iron level in the blood drops, and the body depletes its reserves. Iron depletion may occur because of diet or an increased need for iron during pregnancy or from a condition from chronic blood loss (e.g., peptic ulcer, colon cancer). The American Cancer Society reports that in people with cancer, the cause is cancer itself, nutritional major organ problems, sickle cell disease, or thalassemia (an inherited disorder in which the body destroys too many red blood cells). Anemia iron was also commonly seen in pancreatic cancer, colorectal cancer, and lung cancer. These tests will provide some insight for the clinician as to where to narrow the focus.

Many medical conditions are diagnosis by exclusion (DOE). Diagnosis by exclusion is a diagnosis of a medical condition by elimination, a process by which the clinician comes to a diagnosis after excluding all other possibilities in such cases. In essence, you start with many medical options and begin eliminating that which does not fit. Finally, the clinician is left with one medical condition. And that one medical condition is ‘you,’ the patient.

The patient (i.e., ‘me’) already has some known conditions. Every clinician who has read my medical history has seen blood loss before. Yet, they failed to connect the dots or ask the fundamental question, “Why is this patient experiencing anemia?” And I was surprised by the answer to my question. “Oh.” I keep thinking how many dead people there are from ‘Oh.’ Finally, you get to heaven, and St. Peter (or whomever) says, “Hey. Sorry. You died from ‘Oh.’ Sucks to be you.”

Some head angel comments you weren’t supposed to die from ‘Oh.’ And you end up watching a debate about whether to send you back because no one should die from ‘Oh.’

“But oh great beings,” I’d counter, “I am tired. I don’t want to go back.”

After a slight pause, “Oh.”

My clinicians also know I am tired. I am tired of living. I am tired of the pain. I live every day listening to the pain of others, yet I hide. Intuitively, I know most folks avoid people at the end of life. Many of us dying don’t win sports events, athletic track events, Olympic Gold Medals, beauty contests, or Dancing with Stars. Those of us dying tend to become repulsive. We are a consortium of body aches that can barely stand straight from a kneeling position. We are often cold and want to roll back under the covers and sleep. And here’s my rub. There are many pointers about the end, but few pointers about how to ‘live’ it.

My goals are more immediate. How can I live through this? How can I feel like I ‘live’ the best human life despite dying? Can I, should I break this current into weeks or months? At my stage, a year seems Like a dream. Therefore, what is most important? What matters? Can I live life while acknowledging its pain? Does life have value? And, do I value it? However, I’m unlikely to answer the above questions without remaining proactive in my health.

Just as you are to yours, I am responsible for being proactive in my health. I cannot be an unwilling participant. Stephen Covey once hinted that nothing is given. You want health; you must be proactive. You want to live the best you can while dying; then proactivity is counts. When presented with a medical condition, you have to learn about it and make sense of it. Education allows one to choose paths and choose what’s most important. No one and nothing can do this for you. Proactivity allowed me to focus, think, and ask myself, “How can I find a way to improve the situation?”

It’s not about just staying alive and healthy as long as possible. It’s fighting for your dreams, becoming a better person every day, and feeling good with others. And all these tests allow one to proactively ask questions, participate, and ask myself (and God) what’s important.

God knows most of us are profoundly unsettled by the dying and our tendency not to associate with those experiencing critical illnesses. God also knows friends and relatives abandon many to any number of hospitals and nursing homes. ‘Out of sight. Out of mind,” I once overheard. And for the patient, it’s as if everything they have done and everything they are, is suddenly overshadowed by a plethora of tests and physical degradation.

After all the tests, there may be a temptation to stop trusting God in the pain and loneliness. However, God is not solely an example of faith but rather highlights His love’s importance. Moving forward into the next round of testing, I am fully aware of the inevitability of death. Yet, by proactively ‘living,’ I embrace the preciousness of life’s opportunities and the value of ‘mindfulness’ in the end.