Why I did advance care planning at age 23

When I was rediagnosed with tongue cancer at age 23, I had to deal with a lot of things most people my age had never considered. But whenever people suggested that I do advance care planning and complete a living will, I almost laughed. I wasn't even old enough to rent a car.

I kept putting it off. But as the date of my tongue cancer surgery crept closer, I decided I didn't want to leave my parents with any questions. It was time to complete the advance care planning forms.

Starting the advance care planning process
I started by emailing my social work counselor at MD Anderson. She gave me some paperwork and told me I could complete them during my upcoming visit to MD Anderson.

A few days later, I told my dad I wanted to add him to my checking and savings accounts. He looked at me like I'd grown two heads. As I expected, he asked why. My response was simple: "Because if anything happens to me, I want you to be able to access my money and pay off any bills in my name," I knew he would take it the best of anyone in my family. What daddy wants to cry in front of his little girl?

A couple weeks later, my dad and I returned to MD Anderson. During the trip, our social work counselor gave my dad my blank Living Will and Medical Power of Attorney forms. These legally binding documents would state my wishes about who would make decisions for me and what types of decisions would be made if I couldn't make them myself.

My dad just looked at me. Here was his 23-year-old daughter, her baldness covered by her mom's scarf, face full of chemo-induced acne, holding pieces of paper that would dictate what the rest of her life would be like if the 12-hour surgery to remove the tumor in her neck did not go as planned. I smiled at him. "Everything's going to be OK, Daddy," I said.

Considering what I want
I waited a few days to even look through the Living Will before I started writing with my purple pen. The first few pages were easier than I'd expected.

The first questions asked how I'd want to be comforted or supported. Then, they got a little tougher. Who did I want to have Medical Power of Attorney? What kind of life support did I want?

I turned to the next page, took a deep breath and began to fill out the section on what I want my friends and family to know about me. Then came another toughie: how I want to be remembered. I knew I could have a little fun with this part. I don't want a funeral; I want a celebration of my life! I want people to wear bright colors, drink wine and listen to my favorite music. I want my dogs to run around without leashes and have lots of scratches and belly rubs!

The next section was on how I want to share my belongings. I wrote down a few things and left my dogs to my dad. I knew he'd take good care of them.

Finally, I turned to the last section, the part where I could write messages to all my loved ones. I wrote and wrote until my fingers became numb.

Finding comfort in advance care planning
Once I was done, I shared my Living Will with my dad.

"I need you to read it now, so you can ask me any questions." He understood.

My mom was tougher because she refused to read it while I was there. But before I went in to surgery, I looked her in the eyes and said, "Mama, everything is going to be OK. This is mainly for me, so I know everything is taken care of if anything happens. I need to know that you all will know what I want if something happens to me."

She didn't read it before my surgery, but I still felt a huge relief. I knew it was unlikely that anything would go wrong, but I took comfort in knowing that my family would have a plan if anything happened. 

My parents got to visit me briefly before I was rolled into the operating room, and I smiled at them with one of the biggest smiles I can remember. While deep down something told my cancer treatment would turn out a success, I also took comfort in knowing I'd prepared a document that said, "This is how Rita wants it done, and this is what Rita wants for all of you."