Every year, in the Fall, Dr. Ron Naito makes a trip to Still Creek. The Portland, Ore. primary care doctor visits the creek, in the shadow of Mount Hood, to watch the salmon come back.
“They always return to within 100 yards of where they were born, and it’s quite sort of a spiritual kind of thing, because that’s where they die and also where new life is coming in the coming months,” said Dr. Naito, from his hillside home in Portland, Oregon.
Dr. Naito has drawn nourishment from this ancient dance of life and death for years. But this year was different: It’s probably the last time he’ll see it. You see, Dr. Naito is dying.
He has advanced pancreatic cancer. He recently stopped chemotherapy because it wasn’t helping anymore, and he’s getting palliative care at home.
Dr. Naito became a primary care doctor because he genuinely wanted to help people and he wanted a chance to get to know them over a long period of time.
He practiced for almost 40 years, treating generations of Portland families. Then, in the summer of 2018 he started to suspect something was wrong.
“I was having abdominal pain, where I could only relieve it by sitting up. So, I spent many nights sleeping, sitting up in a chair,” Dr. Naito said.
It was time for the doctor to go see a doctor. That led to a pivotal moment in this chapter of Dr. Naito’s story.
First he had a blood test, and the results were sky-high. Dr. Naito instantly suspected cancer, but his physician deflected the obvious conclusion and said it could be something else. Besides being devastated by the news, Dr. Naito was annoyed at how it was delivered. His doctor was being cagey.
He saw another physician to have the tumor confirmed and sized. This time he learned the bad news -- that his tumor was already quite large -- by overhearing a conversation his gastroenterologist had in the hallway with a medical student.
“And I had this eerie feeling, like I was kind of divorced from all humankind. I was on a little island somewhere and everybody else was on the mainland. I was on a little island or a boat adrift at sea, cut off from humanity now,” Naito recalled of that moment.
Dr. Naito doesn’t know how much time he last left. But, what’s remarkable is how he has chosen to use this last chapter of his life -- to continue to help other people.
He’s devoting his last months to teaching medical students how to deliver bad news. It’s for a class called Living With Life Threatening Illness. He hopes the next generation of doctors will be able to guide patients through an overwhelming diagnosis with more candor and compassion.
In this story, Sound Effect Host Gabriel Spitzer and Dr. Ron Naito discuss how the moment when a doctor delivers bad news to a patient is not something to avoid, but rather is an incredible opportunity for two people to connect on a spiritual level. Dr. Natio says the end can be the richest part of life, if we allow it to be.