A Difficult Topic

121202 Adirondacks in the snowEach morning when I think about what to post in this blog I try to keep it positive and light.  When I get up in the morning the first thing I do is make myself a cup of coffee and peruse the social media sites to see what’s happening with the people I care about most.  Daughter Amanda shared an article that I just can’t shake.  I shared it immediately but really feel like it deserves a wider audience.

The article was in the New York Post entitled “Diary of an Intensive Care Nurse” and Amanda’s comment was “The ugly truth . . .”  

I rarely blog about my children, I don’t want to embarrass them or intrude into their worlds but this is an exception.  Amanda went to school and earned her BSN from Elms College in 2009.  I’m not so sure her career path happened by choice or coincidence but she ended up working the surgical side of a cardiac ICU for a number of years.  She is a wonderful, highly intelligent, empathetic woman that anyone should feel relieved  at being under her care.  She is an amazing nurse. 

Over the years we have had many a discussion about the very things talked about in the article.  There were often conversations about the justification of the interventions used.  There is always the question why – was it family? money? physician hubris? In her position you can only do the best for the individual in your care, your job is to keep them alive at all costs.  You make them as comfortable as you can all the while knowing many times that the best thing would be to just let them go.  I worked long-term care for years, many of those years in hospice (I have to say some of the most fulfilling years of my life). Dignity in dying has always been a topic of conversation.  I have found more and more health professionals that will tell you that medical intervention is not for them.  That DNR tattoo thing is something I’ve even thought about – more so as I get older.

People need to have honest conversations about death and dying because that is where we are all headed.  We all dream of dying peacefully in our sleep but the reality is that death can be messy, it can be ugly.  I have to wonder though if some of that ugliness would be far less if we just let nature take its course.  I’m not saying we shouldn’t be proactive about our health.  There are some health concerns that intervention makes your quality of life so much better.  There comes a point though – a line – when intervention isn’t in anyone’s best interest.  I know from personal experience that once you file a complaint with a physician there is a moment where you get onto that roller coaster and have to stay on it until the ride is over.  You are no longer in control.  The most empowering thing I have ever done is tell a surgeon that I would consider the surgery he wanted to do but in the end I told him no.  I chose not to get on that roller coaster.  It was not life threatening but it did show me that just because a doctor tells me I should do something doesn’t mean he knows me well enough to make the end decision.  It is my life and health after all.

Read this article, then have a conversation with your loved ones about it.  It’s not an easy conversation to have but in the end it’s better to have the people close to you know your wishes before you are in a situation that requires entering the health care arena.  Hopefully you can find a strong advocate for your care.  I know I have one in Amanda.


3 thoughts on “A Difficult Topic

  1. This is indeed a hard conversation to have. I started volunteering for hospice this year and have found in my limited experience that this is the most selfish and rewarding thing I have ever done. People often say, “Oh I could never do that.” or “You are so kind and strong.” Not so folks. I have learned more about myself and life than I think I have been able to give in kindness and care. We all need to re-think what dying means and how we can learn to accept and make this as meaningful as birth. There is no escape for anyone so why not accept and be at peace with it?

  2. After many years of working intensive care like your daughter, I would say every word she wrote is true. You are right to share this and encourage everyone to have this conversation today while you can. Written directives are a good start but if your third cousin once removed shows up in ICU and insists on “doing everything” your directive will be useless. You need to talk to your family. All of them. And if that makes you uncomfortable, taping a short video of your wishes and storing them with your directives is a very clear message of how you would like your medical care should be handled.

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