After completing a fellowship in speech pathology, I began working sixteen hours a day, five days a week, and ten hours a day on weekends.  I would drive over one hundred miles a day seeing patients in Westchester, Long Island, and the five boroughs of New York City. I was totally convinced that to make it in New York, I had to devote myself to building my career. Then I met two men, from two separate families, who wholly shattered that belief.

Aubrey and Gerard were forty-two years old, married with children, and phenomenally successful in their careers. Both men were dying of brain tumors.

I would receive speech pathology hospice referrals in the last few weeks of a patient’s life to provide techniques to facilitate every day communication, and to help them say or do the last things they wanted for their families.

The growth of the tumors had left both men with expressive aphasia, the impairment in language production, and apraxia, the inability to control oral movements for speech.

During my initial visit to Aubrey’s home, his wife provided the background information. Aubrey, a private wealth advisor, had moved to New York in September, following fifteen years of extremely hard work. He had finally achieved the promotion he had long sought. Now he would have time for his wife and sixteen-year-old twin daughters.

Aubrey purchased a spectacular condominium on Fifth Avenue, across from the Metropolitan Museum of Art, and prior to their move, had it decorated as a showplace of his success. This was to be a place to entertain and enjoy life.

Three weeks after their move, Aubrey was diagnosed with a brain tumor.  In order for Aubrey to communicate I had to provide fill-in sentences, such as “You want a drink of______” and phonemic cues like “bla” for blanket.

The sessions could last longer than an hour because communication was so laborious for him and so dependent upon my finding the right prompt.

During these sessions Aubrey expressed his anger at being cheated, having spent his life only working; now, when he could begin to live, he wouldn’t get that chance.

Two weeks after our sessions began, Aubrey took over two hours to tearfully express his desire to purchase emerald necklaces to be given to his daughters upon their high school graduations as his legacy. He also wanted to make a recording for them, which we never completed. The following Friday — only six months after the move to New York, a few days after the necklaces had been purchased, and less than twenty-four hours after he signed papers transferring his money to his wife — Aubrey died.

A month later I met Gerard, a prominent physician, in his Sutton Place apartment. In contrast to Aubrey’s daughters, who made it a point to stay away from their home and the father they hardly knew, Gerard’s two children always interrupted our sessions upon their return from school, tennis, or music lessons, to give their father a kiss hello. His wife was always nearby; and his mother, a widow who lived in New Jersey, was a frequent visitor.

Through the use of the same speech therapy techniques, Gerard stated the he had enjoyed his life, his wonderful family, good friends and rewarding work. Through tears, he said that there was so much more to do.

Gerard’s home was always filled with family, colleagues, and friends. He had kept close with his college and medical school buddies. Even now they came over to watch the nightly basketball games and share conversation and chips. The fact that Gerard could no longer see due to the tumor involving the occipital lobe did not seem to distract from the fun of those evenings.

For three weeks, I individually worked with Gerard. Then, at his request, we had a family session. We were all in the master bedroom with Gerard lying on the bed as usual. His mother sat on one side of the bed, and I, on the other.

His wife and children were snuggled around him. His sixteen-year-old son spoke of always remembering the good times, playing softball together, and the numerous family trips. His fourteen-year-old daughter spoke about the fun things the family did and how she would miss him very much. His mother, through tears, spoke of how she would gladly die in his place and how he had been such a wonderful son.

His wife startled everyone when she said that, in a way, she was glad this had happened. At first it sounded outlandish, but she said that through this traumatic period they had achieved a level of love and closeness that people who spend a lifetime together never achieve.

Through tears and my prompts, Gerard conveyed how much he loved them and would miss them.  Then he gave each one a special message which he hoped would give them strength later on.  Gerard died peacefully that same evening.

Several years later, I was jogging with a friend through Central Park when I caught a glimpse of Aubrey’s apartment. I remembered thinking that his daughters must have graduated high school by now and probably received their legacy, the emerald necklaces. The thought saddened me.

But then a smile crossed my face as I remembered Gerard and his legacy to his family and to me. Each day of life should be filled with a balance of family, friends, and purposeful work.

When you face death, you just want more days with the people and the purpose that have filled your life. You do not want to die regretting that you never got to really live.

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