Allow Natural Death

Archive for January, 2012

Just say, “I don’t know.”

I hope no one misunderstands when I say, “I embrace the mystery of life.” I say it because I really mean it. I am certain that the list of things I will never understand is infinite and I am accepting that calmly. ..or I try to, since I am endlessly curious. Especially at the reasons why we humans do the things we do. Most often as I get older I just say to myself…”Slow deep breath. Slow deep breath. Slow deep breath.” It is all I can do.

My experience of twenty plus years on the front lines of our Medical Model of care in hospitals tells me that the number of times when we really know what is going on with a patient (what’s wrong? why did it go wrong? why now? what can fix it? or how did it fix itself?) are fewer than the times we don’t have a clue. This, despite the fact that the words” I don’t know” are rare indeed. And that leads to suffering and overuse of resources.

Slow deep breath.

Slow deep breath.

Slow deep breath.

Do we really need physician assistance to achieve death with dignity?

Here in Vermont, our legislators are back at work on all the many possibilities and challenges that face our small, but forward thinking state. It isn’t yet certain that the issue of Physician Assisted Suicide or Death with Dignity (depending on who’s talking) will reach them this term. Our leaders are wise to certain a positive outcome for this bill before even bringing it to a vote. I support the opportunity this bill’s passage would present to return some control of the terminal suffering to those who would choose to end their lives. It is a choice that I have always believed is a valid and rightful one. A recent Letter to the Editor was printed in The Rutland Herald a few weeks ago, that urged us to think about this issue further, as it made clear that it should NOT become law. That letter was written by a group of physicians who quoted Pope John Paul as he lamented that what was once “considered criminal activity” is   “gradually becoming socially acceptable”. Their choice to cite the highest authority of the Roman Catholic Church goes far in explaining their opposition to physician assisted suicide/death with dignity.

I didn’t require exhortations from this physician group to provoke further thought on this topic. I already knew exactly how pro choice I had become (completely) after years of practice on the front line of care for frail elders. But I did realize that the most important part of this discussion should be that we do not need a physician’s assistance to exercise choice when we decide that we have had enough. Enough of the symptoms that accompany advanced disease and the invasive, intrusive and seemingly interminable interventions that prolong lives no longer worth living( an extremely personal decision) and well on the way to their ultimate end. The more I think, the more I realize that it is physicians who most often orchestrate those efforts to prolong life even as we grow weary of them. Most of us have come to rely on the advice, opinions, treatments and prescriptions that physicians dole out whenever we consult them. Perhaps we need to rethink this reliance on health care professionals who have come to define our lives ever more so as we grow nearer to the end. Research has repeatedly shown that end of life care is dictated by the physicians and the institutions on which we rely when death nears. It seems then, that we would be far better served at the very end of our lives to forego the physician assistance and thus  increase our chance for a death with dignity.

Here I am again…

After many months away, I am back. I was only away from the actual writing about frail elders at the end of the life…but never far from the    looking, listening, and learning that I suppose I will always do when it comes to topics that effect frail elders and their loved ones. I stopped writing when it became too difficult to do so. It was difficult for my heart as I watched folks around me becoming the “old Old” and the efforts of their loved ones to take good care as they were doing so. It was difficult for my heart to listen to public conversations advocating decreased spending of our country’s financial resources on the needs of elders. It was difficult to listen to public conversations about health care, especially those where the audience vocalized cheering support for allowing a person with no insurance to die without care. It was difficult to listen to friends working on the front lines of health care to hear the stories of suffering and waste that continue to harm patients, families, and employees. It was difficult to listen to leaders of health care organizations becoming desperate in their attempts to control spending in the face of growing and equally desperate needs of those they sought to serve. It was too difficult to continue, but it has proven impossible to stay away.

So here I am again, but with some important differences in my approach. I return to this writing with a resolve to stop being so damn careful in how I say what I have to say. I will no longer take the tone of the Grateful Apologist…though I am still and always grateful to many who share their own stories with me. I will no longer seek to explain and excuse the useless suffering and waste that I see in the systems that control the end of most of our lives and those of our loved ones. It is not reasonable to expect me to explain away the actions of institutions that are overly regulated and underfunded while they remain silent about the  suffering that is caused, as they must, in order to receive the $$$ that insure their continued existence. That is what made this writing too difficult.

But this year will be better. I will try NOT so terribly hard to choose my words carefully in order not to offend. I will try NOT so terribly hard to disguise my own anger and frustration with the systems that control those parts of life that should remain under  our own to control….how we die. Because, as I have always known, I am not the only one who is angry and frustrated and seeking alternatives to the prevailing attitudes towards advanced aging and certain eventual death for us all. This year I will try terribly hard to tell my truth about frail elders at the end of life because …I am not alone.