"I just spent the day shopping for my casket."

I have taken care of patient P. for almost 18 years now. He has been one of the hardest workers I have ever seen working 2 jobs to make things work. After his neck fusion he returned to work in just 3 weeks and never looked back. After each visit he would share a joke or two, none of which were very memorable.

He started to feel tired and lost his appetite and then developed a RUQ ache that led to a CT. Liver mets and a pancreatic mass were to blame and I will never forget the Friday 5 PM visit with he and his wife.

He came in today to drop off some paperwork and I saw him at the check-in window. I approached and took his arm with mine. Holding his arm I asked how he was doing. "I just spent the day shopping for my casket and picking out by gravesite."

The tears immediatly welled up in my eyes spilling down my cheeks. I couldn't look away as he and I stared at each other. I didnt know what to say and I felt him squeeze my arm in response to my tightening grip on his. After just a few seconds he broke his hold and thanked me for filling out the paperwork and off he went.

Tears flowed as I watched him leave. I found some quiet in the bathroom where I cried for another few minutes. We are all just a nudge away from death. I do not fear death any more than most of you do. This man is not just a client and I am not just a provider. He is the very center of everything for a loving wife and a caring family. Many tears will be shared at his passing and many families will miss his humor.

We are so blessed to share these moments with our patients. I will always be grateful for these lessons in humanity that I have been given. I will miss him and I am grateful for how he has changed me.

Vance Harris, MD