His last request

Written by Iatros Polygenos

I know that a lot of people know by now, but I needed to write it out again. Jeff Medkeff died August 3rd, 11:05am at Queen Elizabeth the Queen Mother Hospital in Margate, England.

One of the last things that was said to me was a request to post a blog. I didn’t realize how hard it was going to be to sit down and write about the things that have happened. I just realized today that it has been one week since Jeff died, and that it was time that his request should be upheld.

Jeff never let the diagnosis get him down. He kept pushing forward in trying to find someone who could treat the cancer, while all the time knowing the chances were slim. When it became evident that there was no major treatment available, he decided to start the oral chemotherapy, Nexavar. Unfortunately, he came back from MD Anderson with a nasty upper respiratory infection and couldn’t start the chemo until that was cleared up.

Early on after diagnosis, he said that he wanted to go to England to see some of my family. He still wanted to do this and so we planned to go after returning from MD Anderson. The doctors all told him that he was fit to fly. He seemed to be in pretty good spirits about everything. So, off we went to England. Our flight went over the pole and landed in Frankfurt and was a fairly smooth flight. There was a day layover in Germany and the flight left from the Frankfurt Hahn airport. Traveling has been pretty uncomfortable for Jeff, so the bus ride to Frankfurt Hahn was not something that he enjoyed.

My brother had requested a list of things that we wanted to see while over here. One of which was Westminster Abbey, to see Charles Darwin’s grave. There was a pleasant surprise when we arrived however. Charles Darwin’s House – the Down House – is located on the south side of London. Jeff had thought that is was north of London. Since we were staying in Deal, that made it pretty easy to visit. I think that the visit to this house as well as to the Royal Observatory in Greenwich were the highlights of the trip for Jeff. At the Down House, Jeff picked up a book to write his thoughts about his trip.

Jeff with part of Herschel's large scope

Jeff with part of Herschel's large scope

Some of his thoughts on the Royal Observatory are as follows:

R.O was largely as expected, being very much like its pictures. The camera obscura, which was trained on the Naval College, was impressive…Piece of Wm. Herschel’s large scope was sitting in courtyard; had my picture taken with it. Very nice to see the transit instruments, which essentially founded my field of astronomy (astrometry).

Jeff at Down House

Jeff at Down House

The same day we went to the Down House.

Down House was a great pilgrimage. It is a large, but not huge, country house on the outskirts of London. Presumably it is Regency in origin? It looked v. comfortable and I envy Darwin his opportunity to spend years there reducing the Beagle data. I walked the Sandwalk and visited the greenhouse as well. Was impressed that Darwin was so well-instrumented for the Beagle voyage – including clinometer, barometer, magnifiers, etc. Most accounts of Darwin in the Beagle years that I’ve seen depict him as more of a specimen collector, rather than as someone also doing quantitative work.

Darwin is huge, personally and scientifically. It is remarkeable to think that his theory predicted genetic mechanisms of inheritance. But the cultural impact was also large. On a personal level, Darwin makes it possible to view my disease not as the result of the actions of some despicable god, but rather as a predictable and impersonal consequence of the way my species came into being. The universe, along with its “creator” or universal personality, or whatever, is not out to get me. The universe isn’t capable of being out to get me or anyone else – it hasn’t got the necessary attributes to do so. This is an impersonal problem. That’s very comforting, far more so than thinking that there is some shy ghost fucking with people in senseless, cruel ways.

We visited these two places on the 25th of July. We were taken all over the place looking at Roman ruins, Roman painted houses, Canterbury Cathedral (which he had some very scathing things to say about, especially since it was crawling with Bishops at the Lambeth conference)and also the British museum, where he was thrilled to get up close to the Rosetta stone.

He was doing very well during this time, walking and feeling quite hungry(he got an inexplicable craving for McDonald’s once). He had also started taking the Nexavar and had no side effects that he could discern. The only problem was trying to time things right. He was eating small amounts all during the day. The Nexavar was supposed to be taken 2 hours after eating and one hour before which required some timing and usually happened after breakfast but before lunch. The chemotherapy was started very slowly and was going to be worked up to the full dose of 2 tablets twice daily. It was going to start at one tablet daily for several days, then one twice daily and so on. He only got to take 2 evening doses.

On July 30, we toured Walmer castle(if anyone goes there – don’t listen to the tape. It was awful) and then had some drinks on the beach at the Zetland arms. Everyone was in a very good, mellow mood. In fact, while on the beach, my brother found a fossil that Jeff was looking forward to identifying when we returned from England. It wasn’t until dinner time that things started to get bad. Jeff was only able to take one bite of dinner and then after we finished, started to get nauseous. I thought that it might be side effects from the chemotherapy. As always, when offered some antinausea medication, he looked it up to make sure it was compatible with the loads of medications that he was taking. Unfortunately it did react with the medication to lower the calcium, so he had to settle for plain soda water. This seemed to help and he felt better quickly, but was extremely tired. He was also uncomfortable and was hoping that some hydromorphone and laying down would take care of the problem. At around midnight, he woke me up because the nausea had returned and he needed help to get to the bathroom. That is when the vomiting of the blood started. Earlier in the evening, he told me that he was concerned that if he did any vomiting, that could start the enlarged verices in his esophagus bleeding. What we didn’t know at the time was that the verices had already started bleeding and that was what came up. It is hard to say when or why they started to bleed, but I would expect that they had started earlier that evening. We are unsure whether the tumor had gotten bigger, causing more pressure on the portal vein.

We went to the hospital by taxi. As it was explained later that sometimes getting a taxi was quicker than getting an ambulance. It was interesting once we got to the hospital, since they weren’t that busy. They nurse handed Jeff a hospital gown and had him change and then just left him sitting on the gurney for a short time. I went off to find a container and he vomited blood again. At that point several doctors came running and decided that he was now someone to pay attention to.

I do admire Jeff for the way he handled all the discomfort he was put through initially. They put 2 catheters into his arms without a problem, but then another doctor came up to take over and advised him that they needed 2 other bigger catheters going as well. They had to try several times before being able to get those in as his blood pressure had dropped to 72/24. Yet he was still totally coherent. He even asked if he could get up and use the restroom. The doctors looked shocked and told him that they were afraid he would faint if he tried to get up.

During all this time, they were assembling a team to scope his esophagus and stomach and try to band the bleeding vessels. They were able to get him down for scoping by 9 the next morning. The team was trying to decided if they should just lightly sedate Jeff or if full anesthesia should be used, when Jeff vomited on the surgeon. He decided full anesthesia was needed. (We had planned on going to the National Gallery in London this day). I don’t remember exactly when they finished with him, but it couldn’t have been before noon. They said that they had been unable to put bands on them as they first had hoped, but they injected all the ones they could with a substance that would seal them off. The doctors told me that the verices were severely engorged, which was different from the scoping 3 weeks previously. Even with all the injections, they were unable to get all the bleeding stopped and the vessels were still oozing. They had placed a sanstocken tube into his stomach and inflated balloons on the tube to put pressure on the stomach and esophagus. Then this tube exits the mouth and they hang a weight to help with the pressure. While this tube is in, he was anesthetized and had a ventilator.

The staff would leave the weight on for 3 hours and then take it off for 2. This was kept up for the next 24 hours. When I got back from breakfast on the 1st, he had just been woken up and was soon extubated(the breathing tube was removed). The staff were quite surprised that Jeff was so calm and didn’t try to rip out the tubes. I was told that a good proportion of people coming out of anesthesia are frantic and try to remove all stuff from their bodies. I could tell that he was uncomfortable with the sanstocken tube, but he still had some drugs on board, making it bearable. They couldn’t take that tube out until late afternoon. He was certainly happy when they were able to remove that, but he said it was extremely uncomfortable. In fact, later he would start to doze and then remember them removing that and it would startle him awake. Also, his swallowing was screwed up for the night. He said it felt like he swallowed up. One doctor was talking about placing a feeding tube, but he said that he couldn’t swallow it, so they didn’t follow through with the feeding tube. They were able to get the nausea under control and finally the pain was also well managed. They always listened to us when told that he does not respond to morphine. They never tried to give him morphine and went straight to the fentanyl, which he responds to very well.

After the sanstocken tube had been removed and several hours had passed, it was evident that he was continuing to pass some blood. At least he wasn’t vomiting it up anymore. The doctor which had performed the scoping, came back and wanted to re-scope Jeff and possibly put the sanstocken tube back in place for a little time longer. We had discussed the issues and then asked some questions. One of which was the likelihood of Jeff walking out of the hospital after the procedure. The doctor said that the chances were less than 50%. At that point, it was decided to just continue with palliative care and not do any heroic measures. He wanted to live out the rest of his time in comfort and dignity and not with tubes everywhere.

August 2nd was a very good day for him. He was talking softly and joking around with all of us. The pain was under control and he was drinking water and really enjoying a strawberry protein shake. Even some of the nurses were thinking that during the week he would be moved to one of the wards. One of the medications that they were giving him was supposed to tighten up the vessels and it appeared to be helping. During that night, he was given a sedative to sleep and was very happy when I left to get some sleep myself.

The next morning, as I got ready to return, the nurse called and said that he had started to breathe differently and suggested I come in. When we got there, he had passed a large amount of blood and was stretched out, breathing deeply and was not responsive. I have been present for lots of deaths ( I know, animals, but they die in a similar fashion) and this was one of the smoothest deaths I have seen. He just gradually slowed down, until his breathing just stopped. He was in such good shape with the rest of his body that his heart continued for another 5 minutes. And then he was gone

So, we have lost a wonderful person. Someone who fought for better education and loved to teach kids himself. I know that I will miss him. Somehow, everything seems a little smaller.

42 Responses to “His last request”

  1. Blue Collar Scientist » Blog Archive » His Last Request Says:

    […] Jeff’s last request was for me to write a blog post for him. I have written this and posted it at Yucantgee Eventually Shuts Up. […]

  2. Martin R Says:

    Many thanks for telling us! I’m so glad that Jeff had fun almost all the way to the end!

  3. Martin R Says:

    I found a detailed Wikipedia article about those verices/varices.


  4. Jessmypet Says:

    Thanks, K. we’ll all miss him so much, *hugs*

  5. Rebecca Says:

    Thank you for writing all this down. Jeff will be missed greatly by more people than he had even met.

  6. Ella Rache Says:

    Jeff understood, I suppose, that there were people out here who he’d touched who’d need to grieve and, being mere voices out on the Internet and not guests in the home, would not experience his passing as we do with other departed friends. Thank you for giving us some closure. Our grief obviously cannot be anywhere near as painful as that of his family and close friends, but it’s still grief. It was good to finally cry this out some. We’ll miss him terribly. He was a good man.


  7. Derek Colanduno Says:


    I am so glad you shared this with us all, thank you.

  8. Mark D Says:

    Karen: As you know, I can not even begin to express the feeling of loss. We are all thinking of you.

    Mark, Dianne, Alex, & Ellie

  9. Joe Anderson Says:

    This is tragedy at its worst. Thank you for posting these intimate details of Jeff’s last few days. It does sound as though he was able to spend it doing some of the things that were important to him. It is an inspiration to me personally, even though I never met Jeff. I know it is to others as well. We certainly raised a glass to him and spoke of our loss last night in Atlanta – we skeptics in a pub.

    He will be missed.

  10. Glendon Mellow Says:

    Thank you for writing this post for Jeff.

    I felt I was just getting to know him, and enjoy his writing so immensely. I don’t know what to say but that I’ll miss him.


  11. World of Science News : Blog Archive : Jeff Had Some Good Last Days [Aardvarchaeology] Says:

    […] co-blogging under the pen-name Iatros Polygenos (“mongrel doctor” if my Greek serves me), offers a detailed account of our friend’s last days. Turns out that Jeff died during a trip to England where he was having a […]

  12. Jamie Says:

    RIP, Jeff.

  13. Zach Miller Says:

    Wow. It’s hard to read. I’m glad Jeff went peacefully, Scott and I miss him already. I send my deepest regards, Karen, and I hope to see you at the museum once we get the next Skeptics meeting organized…

  14. Blake Stacey Says:

    I only knew him from what he wrote, and what he wrote revealed both a sharp mind and a good man. I can only hope I go out so well — with courage and curiosity, not to mention cool shades and a strawberry shake.

    This may sound awfully callous, or at least indicative of terrible priorities, but I can’t help but worry about the writing he left behind. I pointed people to his blog entries on many occasions, and I’d hate to see the resources he invested so much time in creating slip away. (Would he let a little thing like death get in the way of education?)

  15. Glenn Davey Says:

    Until recently, BlueCollarScientist was just a guy I argued with on the Skepchick website, about a month ago. Didn’t think much of his ideas at the time. But reading his website after the cancer news opened my eyes.

    The guy was worthwhile and well-meaning, and obviously contributed to many people through his writing.

    I feel like I’ve been invited in to the hospital room to be with him as he passed, by him having this blog post written. It’s kind of humbling.

  16. biopunk Says:

    Thank you.

  17. R2K Says:

    Well that last trip sounds great, and also glad that the smart decision was made re palliative care and a dignified, human death.

  18. Tom Kaye Says:

    Goodbye Jeff. I am so glad we finally met the one time, I never thought for a second it would be the last. The world of science has lost a great champion.

    Rest well my friend.

    Tom Kaye

  19. Spiv Says:

    First off, thank you for writing this.
    Like so many others, I knew Jeff only by his written word (and a couple videos). Somehow I’m brought to tears over his loss. His strength of character shines through in everything he did, even in the short time his blog was up it quickly became one of my favorite sites to visit.

    I can’t say it any better than Blake Stacey:
    “This may sound awfully callous, or at least indicative of terrible priorities, but I can’t help but worry about the writing he left behind. I pointed people to his blog entries on many occasions, and I’d hate to see the resources he invested so much time in creating slip away. (Would he let a little thing like death get in the way of education?)”

    I for one would happily donate to a fund to pay for his hosting/domain name for as long as said fund could keep it in existence.

  20. jeff Says:

    That was really hard to read. Thanks for being strong enough to post it.

  21. Numenaster Says:

    Speaking as someone who’s a caregiver myself, it sounds like Jeff couldn’t have asked for a better person at his side than you. Thank you for sharing words that must have been searingly difficult to type.

  22. monado Says:

    Thanks for posting this. Meeting death with courage is a gift from him to us.

  23. News From Around The Blogosphere 8.18.08 « Skepacabra Says:

    […] Scientist” Medkeff just recently died of cancer.For those who are interested, here’s an account of his last few days recorded by a […]

  24. bric Says:

    I was at Down House last Friday with some friends, I can’t think of a better place for a pilgrimage, even at such a sad time.

  25. Mourning Blue Collar Scientist « Splendid Elles Says:

    […] finally passed away. Today I was reminded again of the loss of Blue Collar Scientist in a post on his final days of life, and damn it, what a splendid time it seemed he was having. But all good things come to an […]

  26. Amanda Says:

    Thank you for writing this. I am so glad that Jeff got to enjoy his life, right up to the end.

  27. Sondra Says:

    Thank you.

  28. Mark Roberts Says:

    Thank you, Karen. I’m glad I got to meet Jeff. He was lucky to have you.

  29. pradeep Says:

    Thank you for sharing this last aspect of Jeff’s life.

  30. A final post about Jeff Medkeff | Bad Astronomy | Discover Magazine Says:

    […] My friend Jeff Medkeff died on August 3rd. There are a few posts here about him, but Jeff’s final request was that a blog post be written on his cancer blog, Yucatangee Eventually Shuts Up. […]

  31. David Hall Says:

    Still hard to believe BluecollarScientist is gone. I knew him briefly and only through reading his blog. Never had the guts to jump in and argue.

    The world is an emptier place now.

    My condolences to his friends and family.

  32. San Hess Says:

    Thank you

  33. Justin Says:

    Thank you for sharing. I only wish I could be as wise and strong as him during my own death.

  34. Star Stryder » Blog Archive » Blue Collar Scientist, Your still my Twitter Friend- by Pamela L. Gay Says:

    […] I just logged into twitter through it’s actual website so I could edit who I was following. Scanning down the list of names I saw the friendly, sunglass wearing face of BlueCollarSci. My heart stopped for a moment. In real life BlueCollarSci was Jeff Medkeff, an astronomer (he called himself an amateur, I’d argue with him), a computer person, an EPO specialist, and a blogger (and more). I never met Jeff in person, but we commented to each other and followed one another’s tweets and blogs, and I’d come to respect him through these new media interactions. Last spring Jeff was diagnosed with cancer. I’d hoped to meet him before he died – we have a mutual friend who was going to bring us together. Sadly that didn’t get to happen. Jeff died rather suddenly of unexpected complications to his cancer. Many tributes have been written to Jeff, and I’d encourage you to read them here and here. […]

  35. Lovely Adventures » Blog Archive » Our awesome and most loved photographer Says:

    […] https://yucatangee.wordpress.com/2008/08/10/his-last-request/ […]

  36. Martin R Says:

    Iatros, could you please e-mail me? Jeff and I collaborated on a book review shortly before he fell ill. It has been accepted by a major magazine. I’d like you to look at the proofs, please.

  37. Thadd Says:

    Hey, I’ve been out of the loop a bit, but I am really upset to hear about Jeff, he was always a great blogger, and really cool the times I was able to talk to him. He will be missed.
    What will happen to Blue Collar Scientist as a blog? I know Jeff had talked about it as a place to add many new bloggers, will this happen, or will it be shut down?

  38. methodicjon Says:

    I found this via a post on universetoday.com, very sorry to hear, but Jeff lives on thanks to you. I now know his name and story half the globe away.

  39. Marcia Hall Says:

    Dear Karen,

    You’ve done a beautiful job of honoring Jeff’s last request.

    As you know, Jeff was my eldest nephew. He is missed by his family to an extent that might have surprised him. The day after Jeff died, and without knowing about Jeff, his grandmother passed away. On a beautiful August day, under a canopy of old oak trees, family gathered at the cemetery in Jeff’s hometown (Cuyahoga Falls, OH) for a simple but meaningful service in honor of both Jeff and his grandmother. It was said that Jeff had three loves: his wife, astronomy and photography. It was a service of which even a skeptic would have approved.

    As I’m convinced we all do in one form or another, Jeff made a difference. He cut his own paths and forged his own trails, and he lived life on his own terms. I hope that he was happy. Thank you for adding love to Jeff’s life and for remaining steadfast and comforting to the end.

  40. John L. Medkeff Jr. Says:

    Karen, I’m from the Delaware branch of the Medkeff family.

    Jeff and I met once when he was in the area doing family research, just before you moved to Arizona. I was glad to have met and known Jeff. Happy that I had the opportunity to show him some family sites in the Rockland, DE area. Happy to have shared a mutual interest in Metcalf family history.

    Please accept my deepest condolensces. May the days ahead bring you comfort and peace.

  41. Rolf Says:

    I have been a fan of Jeff’s ever since he started publishing descriptions of his work with robotic observatories. Tonight, I stumbled upon his youtube videos and his blog and found my way here. I am one of his many readers who were inspired to do research in astronomy and I am very sorry he is gone.

  42. Marcia Hall Says:


    How are you doing, Karen? I’ve been thinking about you more this week than usual. I’m wondering what kind of a Christmas you had, which is not altogether as dumb a question as it might seem. I hope you were with someone, or in touch with someone, who cares about you.

    For the third year in a row, we didn’t celebrate Christmas on Christmas Day. We’re in the middle of redecorating and had a wallpaper man here to do the kitchen on the day before Christmas. We’d been so busy that we hadn’t had time to get the tree up or to wrap presents, so we’re going to delay it until New Year’s Eve. Some year, we’ve got to get it right!

    Sarah Palin sure put Alaska on the map if it wasn’t before. I’m wondering what you and Jeff thought about her. That was cool that Jeff got such a good snapshot of her.

    I would welcome hearing from you, but you may not be interested in keeping touch. I hate bothering you here, but I have no email address for you. If you’d rather not correspond, I will certainly understand. I guess something happens when you get to be my age. You learn that the most important things in life are love and compassion and the putting aside of old grievances, but then, I doubt I’m teaching you anything you don’t already know!

    Be well.


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