Alex Trebek, Cancer, and the Language of Life-Limiting Illness

“Living with a terminal disease is like walking on a tightrope over an insanely scary abyss. But then living without disease is also like walking on a tightrope over an insanely scary abyss, only with some fog or cloud cover obscuring the depths a bit more — sometimes the wind blowing it off a little, sometimes a nice dense cover.” ― Nina Riggs

Earlier this month, TV personality Alex Trebek announced his cancer diagnosis on national TV. On March 5, the 78-year-old host of “Jeopardy” told the world he had been diagnosed with stage 4 pancreatic cancer. In his statement, he mentioned the extremely poor prognosis associated with the disease. But then he went on to say,

“But I’m going to fight this. And I’m going to keep working, and with the love and support of my family and friends and with the help of your prayers, also, I plan to beat the low survival rate statistics for this disease.”

Trebek even added a touch of humor to the announcement when he said, “Truth be told, I have to. Because under the terms of my contract, I have to host ‘Jeopardy’ for three more years!”

Alex Trebek’s announcement was met with an outpouring of support from hundreds of thousands of fans from all over the world, the popular TV host said when he returned to the set the following week. But in some quarters, notably among those who have been working to change our vocabulary around illness and death, it was met with consternation and even disdain. To them, Trebek’s choice to fall back on the familiar battlefield lexicon was disappointing — a missed opportunity to introduce new language and a new way of looking at life-limiting illness on one of the most popular TV shows in the world.

But then, the man just learned he’s almost certainly dying. So who are they (or we) to judge?

Battle Metaphors Abound

Make no mistake about it. I intensely dislike battlefield metaphors when they are used in the context of serious illness. I believe it is imperative for the mental health of those who live with life-limiting illnesses and the people who love them that we find new ways to frame the journey they live with every day. I also believe we do irreparable harm to ourselves and our society when we embrace language that fails to acknowledge the fact that frailty and death are something each and every one of us must face. We can’t “beat the odds.” The odds are 100 to zero that none of us will make it out of here alive.

With that said, I also believe we must honor and respect the confusion and terror that every person who hears “The News” endures. It doesn’t matter if they are rich or poor, old or young, famous or unknown, a cancer diagnosis is a horrible blow. And, as Elizabeth Kubler Ross wrote in her book “On Death and Dying,” 50 years ago (a book which was written from the perspective of people like Alex Trebek) the journey from shock to acceptance is neither easy nor smooth. Impossible news must be processed. And it’s not up to me or anyone else to tell someone to do that in a certain way.

I wish Alex Trebek had framed his announcement differently. I wish he had said he is going to work hard to keep his spirits up and to meet each challenge as it arrives. I wish he had said he was going to take the next few months off to travel or stay at home with his family. I wish he didn’t feel the need to “fight” his illness so aggressively or spend what will likely be the last months of his life debilitated by chemotherapy and whatever else the doctors have in store. Because that’s certainly what I would choose for myself. ( I think.)

But I’m not him. And more importantly, I’m not “there.” I haven’t just been told I have an illness that has a 5-year median survival rate of about 1 percent.

Let’s Meet People Where They Are

I have no doubt that Alex Trebek is facing a long and difficult road ahead. Nor do I doubt that underneath the brave exterior and valiant messaging is a man who is scared and angry and very sad. And I’m not going to judge him for putting on a brave face because I would not wish to be judged if I were in his shoes. If I had just learned that I had a life-limiting illness, I would want everyone who knows me or knows of me to honor and respect my choices, no matter what they were.

Because the fact is, no one knows how they will react to a devastating diagnosis until they are given one. I think now that I would bow out gracefully — refuse the treatments that would rob me of a quality life and go to the beach every day. And when life became impossibly painful and difficult, I would ask my doctor for a prescription for a drug that would let me die with the same dignity with which I have lived.

But there’s a better than even chance I would do no such thing. As Dr. Steven Pantilat said in the documentary “End Game,” “When we’re well, we talk about a good death. When we’re dying, all we want to do is live.”

So, my plan is to meet people like Alex Trebek and the millions of other Americans who will get a cancer diagnosis this year exactly where they are. I will leave it to the media and policymakers and healthcare providers to work on changing our lexicon around illness and death. And I will do what I can on a personal level not to contribute to the harmful conversations that frame every serious illness as a battle to be won or lost.

But I won’t condemn anyone living with the diagnosis for calling cancer the enemy. Heaven knows it would be hard to look at it as anything else if I were in their shoes

About Kathleen

Each month Kathleen Clohessy, R.N., offers a new perspective on living with a terminal illness. Kathleen comes to SevenPonds with 25 years of experience as a registered nurse caring for families and children facing life-threatening illness. She began her career in the Pediatric Intensive Care Unit at Nassau County Medical Center in New York. After relocating to California, she spent 15 years as an R.N. and Assistant Nurse Manager at the Pediatric Oncology & Bone Marrow Transplant Unit at Lucille Salter Packard Children’s Hospital at Stanford. She uses her knowledge and expertise to enlighten our readers about the challenges associated with chronic illness and its effects on family relationships.