When I met Tommy for the first time his face erupted with a smile and he extended both hands to greet me. Sitting up in bed, he nodded appreciatively during our handshake and gestured for me to sit in a chair — he knows I’ve come to interview him and he seems glad for the company. As we begin to talk and settle into our conversation, his bright smile projects a positive demeanor. For a moment I forget how sick Tommy is and why he’s in the palliative care unit at The Salvation Army Toronto Grace Health Centre (TGHC).

Originally from Vietnam, Tommy left there thirty years ago. He now calls Canada his “first and number one country.” Like many immigrants, he has worked at several different jobs since his arrival in Canada. For the last ten years he was employed at a company that fabricates aluminum window frames.

When I ask about his family, he tells me he has no relatives here in Canada except for his sister’s brother-in-law, Daniel. Tommy’s sister lives in the United States and is unable to come to see him, so Daniel, a young student who lives in Mississauga, comes to visit Tommy on her behalf.

In August 2014, Tommy began feeling chest pain and went to see his family doctor; he was admitted immediately to Humber River Regional Hospital (HRRH). After undergoing many tests, including a CAT scan, Tommy was told by the health care team that he had lung cancer. In November 2014, Tommy began radiation treatments and chemotherapy at HRRH as well as Sunnybrook Health Sciences Centre (SHSC). Additionally, to help alleviate the buildup of fluid in his lungs, HRRH performed a thoracostomy — a procedure in which a thin plastic tube is inserted into the pleural space, the area between the chest wall and lungs, and then attached to an external drain — in Tommy’s case, to a mobile chest drain.

While these procedures were being performed it was discovered that the cancer had metastasized to his brain. Tommy remained at HRRH as the staff there tried to treat him. In June 2015, however, the health care team there told him that they had done everything possible to stop the cancer; it was terminal.

Tommy asked, “What do I do now?” The HRRH health team asked him if he had any family. He told them that he didn’t. Then they asked if he lived alone? He told them that he did. The HRRH’s health care team recommended that Tommy be sent to the palliative care unit at TGHC. He was admitted to TGHC on July 3, 2015.

I asked Tommy if he knows that the care he is now receiving is end-of-life care. “Yes,” he says. “I had heard about TGHC. At first I was nervous, but the care is very good, I see how hard the nurses work. They care for me twenty-four hours a day.” He holds up three fingers and says, “The nurses work three shifts and I know them so well they are like my family.”

Despite the advancement of his cancer, Tommy is ambulatory and can do a lot for himself. Because of his independence he is able to take himself out into the community. Eagerly he tells me that on Fridays he takes transit to Chinatown, where he purchases a newspaper and some Vietnamese food.

He notices that I’m looking down at his mobile chest drain, and he anticipates my question. He quickly describes how he puts the unit in a plastic bag and carries it with him when he goes out. Laughing, he says, “It’s not that terrible. I just look like someone who has gone shopping.” He enjoys his outings but he also tells me he looks forward to coming home to appreciate the quiet.

I ask Tommy if he thinks of the TGHC as his home. “Yes,” he says. “I tell Daniel — this is my home now.” He emphasizes this point by telling me he resisted going back to HRRH for another procedure unless he knew for certain he was going to return to TGHC. “I only went after the nurses and the health care staff promised me my bed would be waiting for me when I returned.”

He explains that the nurses and the health care team at TGHC are very attentive and noticed that the dressing around his chest tube insertion was always damp. He was told he needed to have the tube replaced. The TGHC health care team contacted HRRH and asked if they would consider doing another thoracostomy. HRRH agreed and after the procedure they reported back that the tumour growth had obstructed the draining of fluid into the chest tube. However, they succeeded after some difficulty in removing the original tube and replacing it with a smaller one.

In the corner of his room, on the side table by his bed, there is a framed picture of Buddha. Along the bottom of the picture frame there are two small black-and-white photographs of his parents. He tells me that every morning he asks Buddha, and his father and mother to give him the strength to live another day — to live long enough to see the sun set.

He says, “Sixty-four years old for me is still early…I wanted more. For now I try to eat and drink for strength. I don’t worry anymore because I know I’m in palliative care…end-of-life. I don’t think about how much time I have left. I just wake up and I’m thankful that I have one more day.”

I thank Tommy for the interview. He graciously shakes my hand and thanks me for allowing him to share his story. I tell Tommy I’ll come by to see him soon to visit him and to get a nice picture of him. He nods agreeably and gives me a warm smile.

Gerry Condotta