So I'm in the market for a terminal illness, not for me but for my character. Normally I'd try to find something myself but today I thought I'd see if anyone had any suggestions before I deep dive into Webmd and find out I have days to live. So I'm looking for something that can be diagnosed early on, and can leave the person feeling lucid and healthy for up to or more than a year before deteriorating into death. Minor ailments are allowed but I don't want them to be bedridden. Schizophrenia crossed my mind as that is a disease where people are physically able for long periods of time but may or may not deteriorate over time. However, I would prefer my character to be reasonably lucid. Basically I want this person to have that 'nothing to lose' attitude for at least a year or more.
I think many types of cancers are like this. My own mother had lung cancer for years and was able to work, albeit while in discomfort. That said, she didn't actually go to the doctor and find out she had cancer until it was already very developed. So, detection might have to depend on what type of cancer you give your character. Also, best topic title to take out of context!
Sudden Death Syndrome!!! Also known as Long QT Syndrome. It's a condition where the patient has a heart arrhythmia (pulse goes one-two-miss a few-oh, allright, three-four...) because the heart rhythm has an elongated portion of the heart graph in the area known as QT... It's known as SDS because, in many cases, the first symptom is...sudden death (I think a lot of the sports stars who collapse on the pitch and die/are just about saved is this). However, it can be diagnosed if a medical exam reveals the irregular pulse AND the medic is sufficiently on the ball to notice...heart traces done to identify the long QT, etc. After that, the patient can live a normal life, no problem...until they die, suddenly. So, they're living with a death sentence (aren't we all). The one thing is it doesn't deteriorate into death, life goes on and then it doesn't. Big question is, will they have a "nothing to lose" attitude? If the Long QT is perceived, by the medical community, as being a sufficiently risky thing, they may operate to implant an ICD to take over if and when the heart suddenly decides it's had enough of this. The vast majority of people who've undergone this procedure are fairly traumatised. They spend their lives in dread of the ICD going off and, far from having a "nothing to lose" attitude, are excessively timid...they become agoraphobic in case it goes off when they're out. Or, as a variant to basic Long QT, you could have them have a cardiac arrest (this is DIFFERENT to a heart attack! Don't let the fact that the papers conflate the two tell you otherwise! This makes me so mad!!!) caused by the LQT, be saved by rapid intervention (CPR within seconds, paramedics with a defibrillator within minutes, good luck - 1 in 20 survives the initial arrest, 1 in 5 of those survivors doesn't make it out of hospital afterwards), fitted with an ICD, etc. Then you've got somebody who knows how close to death she came, and knows that this life is all she's got, so live it. You'll have to establish beforehand that the character in question will go "nothing to lose" when the death sentence is pronounced, otherwise it'll come across as Deus Ex Machina.
Another vote for cancer. People can live with it for years even if it is untreatable. You could also consider a progressive neuro-degenerative condition like motor neurone disease, though the degradation in functioning might not be on the timescale you need in that case.
Also bear in mind that depending on your genre and setting, you might be at liberty to invent a disease.
Thanks for bringing this up, it was very interesting to learn more about this disease. However, I agree the ICD kind of ruins the psychological effect. Also it's worth noting that this character is a stripper and the ICD might look awkward, although I hate to be judgey. My character has to be aware of this illness however if she's aware it's hard to justify not seeking some sort of treatment which makes the sort of resignation of fate I'm looking for hard to achieve. I'll definitely still keep this illness in mind though, thank you again for the detailed description!!
It seems like cancer may be the option that makes the most sense, the detection time line is a concern however with further research I may be able to write around it? Thank you for your response and for sharing your personal story, very much appreciate it.
Cancer is definitely something I'll be keeping in my back pocket if I can't find something better. Also, as tempting as it is to make up my own disease, I already have so much bullshittery going on in my story that at least something should make sense haha. Thanks you for your suggestions!!
You can get around the detection timeline with cancer if you consider metastases. The primary could be easily detectable (skin cancer is visible, breast/cervical cancer are detected in routine screenings, bowel cancer causes bleeding, etc.) Then the one which causes the decline in functioning you need could be a secondary. The part of the body it metastasises to would be determined by the type of impairment you need the character to have. Reduced stamina might mean lung, malnourishment might be bowel, sensory, motor and cognitive impairment might be brain. And because the character would already have been treated for the primary, he/she would be being checked regularly so could have the secondary detected early enough to live with it for a while. That does leave the problem of why an early detected cancer would be considered untreatable at that stage (I’m assuming for the year they live with it they already know they are going to die). You could add a pituitary or thyroid tumour which would eventually affect growth hormones and trigger a change in growth of the other mets. That further leaves the issue of why a pituitary or thyroid tumour isn’t just removed (they are both basically curable by removing the gland), so you may need to make one of your mets inoperable, and include a period of treatment which basically didn’t shrink the tumour.
Chronic Leukaemia might be a good fit. It's often detected by a routine blood test early on, goes on at a low level for years (but one year probably wouldn't be unbelievable), then turns into acute leukaemia, which could potentially be treated for a while, but which could also be really aggressive and kill quite quickly. It gets more common as people get older, but younger people can get it too. Your stripper would be aware that she has this illness that will eventually kill her for years or a single year, but have no symptoms or minor symptoms for a lot of that time and still be able to work and function as normal.
Depending on how long you're okay with things dragging on Huntingtons Chorea is a tragic and terrible illness, with no cure. People usually know they are at risk, because it's genetic but not always. Onset of minor symptoms between 30-50 with a few (8% I think?) in their 20's. But if all you're looking for is that nothing to lose feeling and death being imminent, cancer will work, but personally I'd go with an inoperable brain aneurysm. You don't know when it's going to burst, there's no way to clip it and you just live every second because it may be your last. Some people live with them for years, some only a couple of months, some only days after diagnosis. They're incredibly unpredictable and would work well for whatever you were intending to do.
'This brain aneurysm might kill me at any time. I'm going to New Zealand, you bastards to bungee with dolphins, swim naked under moonlight in the hotel bar, make love to the New Zealand rugby team, the back-line at least. My bucket list & on.' Tho,' when my Dad was dying he didn't want to go out or anything, wore a dressing gown, just watched box sets and drank morphine, loser.
My dad was the same way, but he had lung cancer and was in a lot of pain. Depending on the location/size of the aneurysm, pain would be minimal.
Sorry @Trish, the aneurysm was a response to the Q. No, my hero suffered prostate cancer. The 'staying indoors' part - I was curious at the time, 'Dad, come see the sea,' met a response of 'no, you're fine, carry on...' This confused me, but reading around the subject - it is quite normal. The stages of death are very strange, strangest is the phenomenon that has a name, god knows what, but - days before death the invalid gets out of bed, and 'does stuff.' My Dad was the same, skipped out the ward for a final struggle with nurses.
True, chronic leukemia is a strong contender for the prize here, meets pretty much all of the criteria. Thank you for your detailed response!
This is very interesting! The inoperable brain aneurysm is something I would definitely consider writing in. The Huntington's Chorea might not fit in with this story but is something I'd keep in mind for another story. Thank you for your suggestions
I think that'd make for a very interesting story! I think that kind of going out in a blaze of glory attitude is good, personally if I was dying I'd probably not be doing anything interesting, 'what's the point if you're dying' kind of thing. Unfortunately my character is written more like myself but kind of changes into that more adventurous attitude as the plot progresses. Thank you for your response!
Hi Lily, You're new here. You've just (I think) met Matt at play. I love him dearly, but much of the time he shouldn't be taken too seriously! (I think the reference to making love to the New Zealand rugby team should have been the clue! Although that bit about bungeeing with dolphins???) To the OP, my father died of AAA - Abdominal aortic aneurysm - which had been diagnosed a couple of years prior. He was offered an operation to repair it, and given odds of 20% chance of dying on the operating table, or 50% chance of the aneurysm bursting within a year. He declined the operation; my brother put it down to his being unable to undersand the odds because of his lack of lucidity; I put it down to his not being able to understand the respective odds because his hardness of hearing meant he didn't HEAR what the odds were. So, he knew what was going to kill him, and sometime, any time, soon. Problem with it for your purposes is...AAAs occur most commonly in those over 50 years old, in men, and among those with a family history.
