A Good Death

Patrick Koske-McBride
6 min readFeb 13, 2020

And just when you’d think they were more malignant than ever Hell could be, they could occasionally show more grace than Heaven ever dreamed of. Often the same individual was involved. It was this free-will thing, of course. It was a bugger. — Good Omens

Rush Limbaugh, awful human being par excellence, has been diagnosed with “advanced” lung cancer. Avid readers may recall an earlier comment of mine about how cancer support groups tend to weed out the horrible brutes? This is that essay.

First of all, a little bit of background before you get off of your high horse and accuse me of demonizing “political opponents.” “Political opponents” are what people in power have. People on disability benefits, LGBTQ folks, the elderly, PoC — we don’t have “political opponents.” We have “existential threats.” And Rush has been — for decades — the voice of regressionist politics and policies that would bring about a swift end for far too many of us (my mother perfectly summarized American politics and political enemies by saying, “We don’t need death camps or gulags here; we just defund or repeal policies and programs that protect some people, and the end is identical”). He has defended the tobacco industry against scientific linkages between smoking and lung cancer. And now he has lung cancer. Martin Luther King was wrong; the arc of the universe does not bend toward justice; it bends toward ludicrous irony. Also, just a reminder; Rush is a white, heteronormative millionaire, and you don’t have enough time on this planet to waste it defending someone who has made a career off of cannibalizing the working class and disenfranchised minorities.

Another friend pointed out that I am, retroactively, a fan of John McCain. Sort of. I still find most of McCain’s politics abhorrent, and his wife-swapping habit repugnant, but, at the same time; somehow, when McCain got that call from his neurooncologists, he figured out a way to make his last year on this planet count for more than the previous 80. I wish Rush the best on that aspect, but I’m not holding my breath. In his last few breaths, Rush has taken time out of his busy schedule to make fun of Pete Buttigieg for being gay. I think Buttigieg should challenge Rush to a breath-holding competition to drive home the point that Rush’s eligibility for being a member of the majority are now being reconsidered.

But that’s my entré into this piece — how someone can finish better than another. So; I’ve been in writing groups for cancer survivors; support groups for under-40 survivors; general cancer support groups — the commonality, aside from a common affliction, is that everyone in all of these groups is unbelievably sweet, kind, supportive, and compassionate. If anyone in these groups announced that they’d just taken a turn for the worse, and then said that their lifelong dream was to do pure heroin in a Thai brothel (sorry to use lurid imagery, but you go for extremes after being exposed to, well, life’s extremes), I guarantee you that smart phones would come out, we’d be pounding doors, and someone would be on a plane to Bangkok to meet a seamy opium distributor within the hour. Again, that’s a ludicrously extreme scenario, but I have been in the room when a fellow wanderer announced that she’d had a recurrence and needed to go back into treatment, and the immediate, unasked-for response was, “What do you want us to do? Do you have someone to drive you to infusions? Are you good for all your copays? Do you want us to help you with the laundry?” I don’t think that cancer survivors are any better or worse than anyone else (and our moral standing has been substantially diminished now that Rush has entered the ranks), but, I do think that the successful ones — those of us who graduate to long-term survivalship — recognize the innate value of kindness and charity, and want to pay it forward to the next folks in line. It’s that old trope, “There are only two responses to tragedy, either, ‘Never again,’ or, ‘I suffered, they should, too.” If you walk into that chilly room and sit in those uncomfortable chairs, you’ve already cast your lot.

I’ve had one friend point out that it’s amazing what money can buy in this country, and she’s betting that Rush’s name and fortune will be able to buy him an effective treatment. She’s half-right; I’m sure I would be baffled at what money can buy (Hell, I’m confused that anyone buys anything from Hammacher Schlemmer), but there is a reason I refer to living with cancer with analogies of deep sea biology — it’s also unimaginable here until you’ve been in a submersible. And the weird flip side of “You’d be amazed at what money can buy” is “You’d be amazed at what no amount of money can buy, but a tiny amount of goodwill and generosity can.” Jenna and I have both been the recipients of researchers and physicians putting in unpaid hours on our behalf out of the goodness of their hearts. To put Jenna’s cancer survival situation into context; at one point, she had 26 solid tumors in her body and an almost-fatal reaction to conventional treatment; she got a late-night call about a slot in a clinical trial opening up, and she’s now down to three tumors that have “only” shrunk by 40%. In my case, it was only because my first neurooncologist was reviewing some of my old scans after-hours that she caught Tumor #2, which would become Tumor #3, and she’s the one who referred me to the Warlocks (she’s still my second opinion oncologist, because she’s smart and dedicated)(the Warlocks are first on the medical speed-dial and I see them regularly because, if there is one thing Harry Potter and Tolkien have taught us, it’s that you piss off dark wizards at your peril). So, yeah, Rush has a ton of money and, probably, treatment options, but if cancer made exclusions for the rich, there would be no funding for cancer research. And it’s possible he’s a delightful, charming human being in-person; I hope so, for his sake. If he’s just another entitled, rich asshole who’s cruel to the nurses, that’ll shorten his life expectancy far more than the biopsy report (AUTHOR’S NOTE: I’m not implying that nurses or medical staff are homicidal maniacs or anything, just that survival requires every single person on your medical team to give it 110%, and money can not buy that kind of effort and dedication, especially if you’ve spent your professional life making their professional lives harder).

Rush has enjoyed enormous benefits from being an able-bodied Boomer. Hell, he’s been on unemployment benefits (this is true). I’m normally all for the concept that human beings are fundamentally hypocritical, and judge not lest ye be judged, but Rush has, upon achieving “success,” dedicated his life to making it that much harder for everyone else — especially people who don’t look, talk, or love like him. He is now going to benefit from agencies like the NIH, CDC, and, yes, Social Security and Medicare — all things he vociferously tried to defund and destroy. If he’s “cured,” it’s possible he will, like McCain, have a change of heart and try to secure and fund those things and broaden access to care. Or it’s possible that crazed, rabid talk-show host persona is the real deal, and he’ll spend his last irreplaceable hours on this Earth bullying and belittling other people and we’ll have to bury him with a steak through his heart and garlic in his mouth.

Jenna recently commented that I’m a gifted writer; I shrugged it off and pointed out that I’ve been writing since I was six or seven (let’s call it 15 years in total), and you’d get that good at anything if you spent that long on it. This is partially true, but here’s the other aspect: expressive dysphagia is a very common symptom of end-stage brain cancer. For all of 2018, I thoroughly believed — not knew, believed (belief is the more powerful of the two, trust me) — that every time I was at the keyboard, it would be my last. Every time I sit down to write, now, there’s still a not-inconsequential bit of me which still believes that. I know that, one day, for one reason or another, I’ll be right. Rush has said that he’ll try to produce his show until he no longer can; whether that will result in his most brilliant or vile work remains to be seen.

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Patrick Koske-McBride

Science journalist, cancer survivor, biomedical consultant, the “Wednesday Addams of travel writers.”