My friend David sent me a link to an insightful, important article on how we die. More specifically, it's about how doctors die. You can find it at http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/ .
Last year my wife Pat and I dealt with 2 family deaths and one near-death.
Pat's mom Rose was 87. She was still very clear-minded and strong-willed, but her body parts were wearing out. She had been through heart surgery after a heart attack. She had a knee replacement that never healed quite right. Walking was possible but painful. She lived independently in her own apartment in New York until just a few months before she passed. She moved to Dallas to get away from New York winters and to be closer to Pat's sister and her family. A couple of months later, she had a stroke. She was taken to a hospital where the doctors told her they could insert a ventilator and keep her alive but she would probably never walk again. She declined. The family was summoned and everyone flew in overnight. She visited with them for a few hours, and then she died. Rose called the shots to the end. Hers was what I would call a good death.
My mom Marilyn was 85. After my father's death in 2002 she went into a deep depression, and eventually began showing signs of dementia. My younger brother lived nearby and took care of her. The dementia got worse, to the extent that when my younger brother moved out of the area, we felt she was no longer safe living on her own in Florida. We moved Marilyn here to Bellevue and into a very good assisted living facility near us. She received excellent care, though it was ridiculously expensive, but she liked it here. It was good to be closer to her grandchildren, and to Pat and me, but the dementia continued its relentless progress. She lived here for 4 years. In the last year and a half, she had no idea who I was, didn't recognize her grandchildren, couldn't speak, couldn't walk, and couldn't eat without assistance. She went on hospice in mid-September of last year, and died on October 11th. She spent the last couple of weeks on oxygen (for comfort) and morphine (for comfort), more or less asleep the whole time. I hope she wasn't aware of what was going on. It was exactly the opposite of what she would have wanted at the end of her life, though there was nothing we could legally do to make things any better for her. In fact, the last several years of her life were exactly what she had most feared. She slowly disappeared, losing herself as she lost all of us. It was what I would call a bad death.
On the same day that my mom went on hospice, I got a call from my sister-in-law in California. My 62-year-old brother had had a stroke. He was paralyzed on his left side, spoke with some difficulty, but was alive. He has since undergone intense physical, speech and occupational therapy, 4 hours a day, 5 days a week and is making significant improvements. He can now walk with a cane, speaks quite normally, and we are optimistic he will resume a more-or-less normal life. In his case, an extreme medical intervention both saved his life and significantly improved the (hopefully) many years he has left.
3 different scenarios, but each in its own way reaffirms the message of the How Doctors Die article. Medical intervention can be a miracle when done properly and at an appropriate stage in a person's life and illness. But for those facing certain and imminent death, it can lead to horrible and unnecessary complications, and often an end you absolutely didn't want. Those of us who are fortunate, will be able to determine at least some of the important details of how our lives will end. Others of us won't have that ability. Given what we've been through, that thought is quite terrifying.
Last year my wife Pat and I dealt with 2 family deaths and one near-death.
Pat's mom Rose was 87. She was still very clear-minded and strong-willed, but her body parts were wearing out. She had been through heart surgery after a heart attack. She had a knee replacement that never healed quite right. Walking was possible but painful. She lived independently in her own apartment in New York until just a few months before she passed. She moved to Dallas to get away from New York winters and to be closer to Pat's sister and her family. A couple of months later, she had a stroke. She was taken to a hospital where the doctors told her they could insert a ventilator and keep her alive but she would probably never walk again. She declined. The family was summoned and everyone flew in overnight. She visited with them for a few hours, and then she died. Rose called the shots to the end. Hers was what I would call a good death.
My mom Marilyn was 85. After my father's death in 2002 she went into a deep depression, and eventually began showing signs of dementia. My younger brother lived nearby and took care of her. The dementia got worse, to the extent that when my younger brother moved out of the area, we felt she was no longer safe living on her own in Florida. We moved Marilyn here to Bellevue and into a very good assisted living facility near us. She received excellent care, though it was ridiculously expensive, but she liked it here. It was good to be closer to her grandchildren, and to Pat and me, but the dementia continued its relentless progress. She lived here for 4 years. In the last year and a half, she had no idea who I was, didn't recognize her grandchildren, couldn't speak, couldn't walk, and couldn't eat without assistance. She went on hospice in mid-September of last year, and died on October 11th. She spent the last couple of weeks on oxygen (for comfort) and morphine (for comfort), more or less asleep the whole time. I hope she wasn't aware of what was going on. It was exactly the opposite of what she would have wanted at the end of her life, though there was nothing we could legally do to make things any better for her. In fact, the last several years of her life were exactly what she had most feared. She slowly disappeared, losing herself as she lost all of us. It was what I would call a bad death.
On the same day that my mom went on hospice, I got a call from my sister-in-law in California. My 62-year-old brother had had a stroke. He was paralyzed on his left side, spoke with some difficulty, but was alive. He has since undergone intense physical, speech and occupational therapy, 4 hours a day, 5 days a week and is making significant improvements. He can now walk with a cane, speaks quite normally, and we are optimistic he will resume a more-or-less normal life. In his case, an extreme medical intervention both saved his life and significantly improved the (hopefully) many years he has left.
3 different scenarios, but each in its own way reaffirms the message of the How Doctors Die article. Medical intervention can be a miracle when done properly and at an appropriate stage in a person's life and illness. But for those facing certain and imminent death, it can lead to horrible and unnecessary complications, and often an end you absolutely didn't want. Those of us who are fortunate, will be able to determine at least some of the important details of how our lives will end. Others of us won't have that ability. Given what we've been through, that thought is quite terrifying.
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