About a year ago my brother Jesse Eugene was diagnosed with pancreatic cancer. We were told he had maybe six months to live. He exceeded expectations, though it didn’t go easy for him. In the course of the last year he went from being around 235 pounds to about 145. He became increasingly feeble. It wasn’t pretty.

Yesterday we were at the hospital for a routine visit with his primary care physician and a consultation with the oncologist. The lab work revealed that his hemoglobin was extremely low, so they decided to give him a quick transfusion and send him home. After more discussion, the doctors decided it might be best to keep him overnight to see how he responded to the transfusion. Almost immediately after being admitted, he began to vomit blood. Lots of blood. Liters of blood.

They don’t have emesis basins anymore–those kidney-shaped pans you see in the movies. Now they have blue mesh vomit bags. Red blood in a blue bag. It’s another image I’d rather not have in my head. I already have too many of those.

For a while he was vomiting blood as quickly as they could transfuse it. I held the bag, he vomited, and every time the blood hit the liter mark I’d hand it to a nurse to measure and record. Input/output. Blood goes in, blood goes out. Eventually the vomiting stopped long enough for them to insert a naso-gastric tube into his stomach and pump the blood out.

The bleeding seems to have stopped for now. Or slowed to a negligible level. But it’ll start up again. It’s inevitable. With the NG tube in place, we’ll be spared the vomiting, but the bleeding will still take place. We’ve decided to stop any more transfusions. At some point in the near future the loss of blood will make him light-headed, then he’ll lose consciousness and die. It might be tonight. It might be a week from tonight. It probably won’t be as long as two weeks.

Part of me hopes it’s sooner than later. This is not how he wanted to die–slowly, messily, in a hospital. But how many people ever get what they want?