BROOKINGS – “You can’t write about dying and have the answers. It’s just a shot at it; it’s a best try. It’s a shot at it from the perspective of a physician. It’s the best shot that I can give.”

The physician is Richard Powell “Rick” Holm, a board-certified internist, who at 69 and retired after 40 years practicing medicine in Brookings, is now himself a patient and fighting the battle of his life against pancreatic cancer.

Over Tuesday-morning coffee at Cook’s Kitchen (for decades an early-morning haunt for Holm), he shared that perspective – and more – with The Brookings Register, as penned in his new book: “Life’s Final Season: A Guide for Aging and Dying.” The book is now available on Amazon and will be in select book stores in South Dakota.

“The book started probably two years before I was diagnosed (on Oct. 1, 2016),” Holm explained of the genesis of his book. “I started putting together essays that I’d written during the previous 12-14 years.”

Seeking publishing advice for a topic, the pros advised him to find “a special niche where people will go on the Internet to find you.”

“I was dissatisfied with that,” Holm said, “because my niche has been everyplace. My show and the essays that I write for my show and the newspaper have been about everything.”

Then a friend and fellow physician, Jeremy Beireis, came to the rescue. His advice: “Rick, you take care of mostly old people. What we have a need for is for those of us in the ‘sandwich generation,’ who are caring for our parents who are at the end of their lives; we need to try to find something that would help them.”

“That was really the initial deal,” Holm added. “What it evolved into is how to care for yourself, your spouse or your aging parents – as you age and go into that final season.”

Too much of a physician

As the book unfolded, the author, a husband and father of four adult children, found himself writing in an autobiographical fashion. 

“This is one tale I never thought I would tell,” said Holm. “I was a half-marathoning, spiritually healthy, family man. I had abundant friends, more interests and activities than I could accomplish. I was a person at minimal risk of an early death, or so I thought.”

Then came the first round of the battle, which saw the physician-patient undergoing chemotherapy, radiation and a “Whipple procedure,” described by Mayo Clinic, where he had surgery, as being “used to treat tumors and other disorders of the pancreas, intestine and bile duct.”

All went well until nine months later, when cancer reappeared in his liver. And now Holm is undergoing chemo as a prelude to another surgery this fall.

“There’s no denial that I’m going to die,” he said matter of factly.  “There’s a chance that I might get a really good reprieve with this last round of chemo and the surgery. And it may be that I’ll live a long time.

“So, I’m facing it. Yeah. Denial does not work for me. I’m too much of a physician.”

Asked about the Kubler-Ross model that cites the five emotional stages that people go through chronologically following a diagnosis of a terminal illness – denial, anger, bargaining, depression and acceptance – Holm said, “I think I went through those in high school. My sister died in a car accident.”

He admits to a bit of depression now and then. And he harks back to being depressed in college, thinking that he might not get into medical school.

“I got into medical school and I’ve just had a gleeful life the whole time,” he added. “I got what I wanted, and I’ve tried my best to be a good doctor. And I’ve tried to be a good dad.”

More about living than dying

“Some chapters are written specifically to reduce the fear of death,” Holm admits. “But the intent of this book is that it be a guide to help individuals and caregivers in our quest to age and eventually face dying with courage, grace, dignity and enthusiasm.

“It starts with how to stay healthy. It starts with wellness and it ends with the end of our lives.” And wellness can be pursued in simple ways; the doctor points out four of them.

No. 1: Exercise every day, “even if it’s going out to walk for a mile.” Exercise is “so important for the soul and everything.”

No. 2: Eat less, with an emphasis on vegetables and fruits.

No. 3: Cherish the “brotherhood or sisterhood component, the family around you, feeling connected to other people, expending outside yourself.”

No. 4: Have a spiritual component in your life.

Holm considers his 432-page book “a long one. It’s a lot of words, 82,000.” But each chapter focuses on a real person who “is pertinent to the point of that chapter.” And each topic “ends with an essay that tops it off.” Finally, there are questions and answers.

The doctor’s book doesn’t have to be read cover to cover. The reader can dip into the book and pursue any topic that catches their attention.

Holm threw out a few questions he asks himself: “How much difference did I make? … How much difference do you need to make? …  Is there really a God? Am I really honest with myself? I’ve gone through all of the motions and I go to church, I pray and I’m hopeful that there is one. But if I have any doubts, does it mean that I’m not going to get there? How much belief do we have to have to survive this question of dying?”

Meanwhile, life goes on and he takes it day to day with a don’t-feel-sorry-for-yourself approach.

“Mostly I just kind of stiffen my upper lip and push through and try to savor the good things in life,” Holm says. “The good things happening around me are the same good things that have been happening around me all my life. I just look at them and enjoy them.”

One reviewer of his book is Maggie Callanan, a registered nurse and co-author of “Final Gifts,” which Holm reviewed years ago. Of his book she writes, “Facing life’s last inevitable journey is difficult. Holm helps us with his expertise and his own final season. This guide is a gift for anyone aging or dying, and for their caregivers.”

Holm has posted dates and locations for his appearances and availability on the Prairie Doc Facebook page, https://www.facebook.com/ThePrairieDoc/, and website, https://www.prairiedoc.org/book.html.

Contact John Kubal at jkubal@brookingsregister.com.

Courtesy photos