Death

A friend of mind just lost someone. The hospital scene at this person's demise was frenetic and painful. The patient was sometimes awake, sometimes confused. The family didn't know what to do, but finally signed a Do Not Resuscitate order. Matters were not helped by the fact that the dying man was somewhat famous, known to be a curmudgeon, but clearly in no hurry to give up this world. The IV tubes, bladder tubes, heart wires, leg cuffs to maintain lower circulation all gave the scene a science fiction quality. The oxygen mask over the patient's face didn't help. He finally died with a moment of clarity and protest that left witnesses aghast at the irony of ending life with a fist raised in the air. He did not go gentle into the night. Matters were not help by the hospital staff which alternated with great caring and concern, and a nearly gestapo attitude of "This is what we have to do so let us do it."

Can this kind scene be avoided? Can we write living wills directing our care at a time when we are helpless to express our wishes or desires? I imagine myself sitting down to write directions on whether I want a DNR, when I would want a DNR, or what measures should be taken if I were deemed terminal. As a bedside medical psychiatrist who has been intimately involved in these scenarios, I really cannot predict the quality of my own death. Living Wills and DNR declarations don't even get close to the reality of end of life issues. Do I want DNR? Do I want gobs of pain medication? Do I want anti-delirium medication? Should I get chemotherapy if my quality of life is impaired? How do I know in advance if the impairment is irreversible. How do the doctors and nurses know.?

I'm reminded of the latest hoopla about legislation offering insurance for end of life issues. Sarah Palin stood and declared this was euthanasia, that it was equivalent to eliminating grand-ma. This preposterous posturing and faulty statement making is painful to see ingested by citizens and I wonder if my compatriots in this life really accept this woman's nonsense. End of life issues are difficult enough as it is. I think it would be wonderful for money to be made available to help families deal with the drugs, hospice care, and physicians needed to decide how best to help Grandma. People like Palin, grandstanding for political reasons and espousing rancid nonsense, work to destroy measures designed to help others during one of the worst periods of their and their loved ones' lives. I have nothing but contempt for thoughtless people who talk like this with no evidence to support their self serving egos.