When Wildfang sits down with Rasmussen on Nov. 21, he wants to know how the disease will work its will on him. The physician tells him that his cancer can go in several directions. For smokers, as Howard had been for 70 years, pulmonary problems are common because the lungs have been weakened. The usual result for those patients is pneumonia, from which someone Wildfang's age usually doesn't recover. Also, the cancer can metastasize to bones, causing severe pain, or the brain, which can lead to nausea, behavioral changes and disorientation. Finally, the cancer can spread to a metabolic organ such as the liver or kidneys, a process that tends to be gradual and relatively gentle. The doctor tells Wildfang that, as the end nears, he can be kept sedated and on painkillers; in effect, kept in a coma and allowed to starve to death.