Allow Natural Death

Archive for May, 2012

Always the exception….

If I sounded too certain yesterday that a practical and honest physician cannot be found when a frail elder is experiencing a health crisis – I know that it can be different sometimes. There are those physicians who are able to ask the right questions and clearly here the answers. When an elder or their loved one(s) is ready to allow natural death, their choice may be supported by the institutions and the physicians who work within them. It can and does happen that a palliative care physician may be a part of the health care team or another physician who honors the right of all patients to achieve the death of their own choosing while prioritizing the comfort of the frail elder. These folks have been my colleagues and they practice with an approach that is sadly in the minority. But they do exist. There is always the exception.

Letting Go, but Slowly

When my first child was born, I was smitten. Since I tend to the extremes of emotion …I was extremely smitten. Admittedly, hormones were assisting the process of bonding to that baby boy in a way that scared me more than a little. But what scared me far more was the thought that this little one…my little one, would someday grow up and leave. The thought of his growing and going produced an instant and profound ache in my chest every time. It was hard to breath and harder still not to weep. (I said it was extreme). While feeling incredibly strong and capable after his birth at home, the idea of this baby growing strong and capable himself, in order to leave home…was intolerable. It was a topic best avoided entirely. In conversation and in my own thoughts, the thought of losing(?!) my child was unimaginably heartbreaking for me. Thankfully, the hormone storm decreased in its intensity, allowing me to regain my sense of humor and to see the absurdity of my own lofty expectations. But it would take a long time to grow this baby to the desired adult outcome… for which I became truly grateful. Surely it would take just as long for me to get myself ready for him to go.

The process of growing a child was, for me, a very serious undertaking, accompanied by lots of  listening and reading and thinking. ..okay maybe too much thinking. But the thought that the normal and natural outcome of all my hard work and love, would only lead to a good bye to him and our life together, was excruciating until I managed to accept the normal and natural. He would grow to adulthood, if all went well, of course. He would be strong, (and wise too as it turned out). He would be confident and courageous and loving and he would go and make the world his own, on his own. Without me. This was no tragedy. It was life. I learned to let go… but slowly.

As I talk with my mother and father these days,  I am again letting go, but, slowly. I am grateful for arcs of human growth that allow the distance from infant to adult, and from elder to frailty and to death, to occupy such a looong span of time. I am glad that I am being given a long period of time to observe the slowing of all that they do; the growing list of things they can no longer do and the fact that more function will be lost as they grow closer to the end. It is my job to accept that they will die and to remember that they will not always be of this world. I love them better for knowing this. I am grateful for Our Creator’s way of designing this life so that I am able to learn the letting go… slowly.

Letting go is an imperative for loved ones of those elders who wish to be allowed a natural death. The undesirable effect of hanging on to a dying loved one becomes apparent when it is time to make medical decisions. If we can’t let go, we will slow the process of dying in a way that causes suffering to be prolonged while it robs the end of our loved one’s life of dignity and peace. Any resistance to the fact that the loved one’s body is trying to die, will likely be ceased upon by physicians who has the power to needlessly extend the awfulness that most often will accompany a hospital death. A long list of medical procedures, tests, painful interventions and tubes for every available orifice can be brought to bear on a frail elder nearing the end by a treating physician. Whether for reasons of avoiding liability or simply because they are programmed that way, physicians will do all that they can to maintain life; its quantity at least, if not its quality.

It is known that the manner of care received at the end of life is most often decided by the physician in charge and the institution where you and your loved one may find yourselves. Those desiring a peaceful death who find themselves in an emergency room will be assisted in achieving their own good death by loved ones who are ready to let go and allow natural death. Do it with courage and love.