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Here is another article that challenges us to consider the question of what happens if someone is diagnosed with a terminal illness.  What choices does the person want others to make for them and what choices does the person need to make when confronting a life-limiting illness?  While the piece is somewhat a propaganda for Health Care Reform as the first paragraph clearly indicates, its message is still rather poignant.

I do need to offer some critique on this piece.  The author is speaking from a position of having almost faced died on a couple of occasions.  Most people don’t have that to draw upon when considering end of life wishes.  Now, I would not want most people to know what dying is like before going through the dying process, but those who have lived a miraculous life are at an advantage in the planning department.  Further, I do caution people that  plans we consider when we are healthy do not reflect our desires when death confronts us head-on.  I am not convinced that all her desires will be fulfilled simply because when death is near, priorities and desires change.

 

Let’s give health care reform a short rest.  I’ll talk about something more exciting that needs to have its simplicity restored – end of life.  This will lay the groundwork for future posts on how health care reform deals with this touchy subject.  For today, I want to set the tone for how we talk about death.

Americans spend a lot of money at the end of life, and all that money doesn’t make it any more pleasant.  Dr. Byock states modern medicine has become so good at keeping the terminally ill alive that the inevitable process of dying has become much harder and is often prolonged unnecessarily.  There are a number of factors that make death hard to address, which decreases how effectively we deal with it as patients, families, and physicians.  Top on the list is poor communication.

Having been through many deaths – family, patients, clients, and friends, I know a thing or two.  Having faced the possibility of my own death twice, I’ve been given opportunities to contemplate it more than most.  Gratefully, I used those opportunities to create an incredible life.  When death is staring me in the face, I’ll be happily ready.  For those of you old enough to remember the original “Poseidon Adventure,” I will be Shelley Winters, reliving the glory days of her youth while sacrificing her life for those around her without much thought.

In this country, we talk little about how we want to spend our last days.  What would we do if we get that terminal diagnosis?  What would our family do if we died suddenly?  It isn’t the practicalities that get missed so much.  It is the little things, and although I never did mind about the little things, I don’t want my family to have to worry about them in a time of grief.

To open this conversation, I am going to share with you my little things.  Maybe by sharing my wishes, others will take the time to contemplate and share with their loved ones their ideal way to handle some tough situations.  By the way, I am totally healthy at the moment unless something is going on I don’t know about.

Let’s talk about sickness.  If I am ever diagnosed with cancer, I would really have to know the odds to decide on treatment.  Right now, a doctor would have to tell me my chance of CURE is greater than 25% for me to undergo drugs with bad side effects.  Now remember, when oncologists say the chance of RESPONSE is 25%, that does not mean “cure.”  Too many people hear “cure” when the oncologist says “responds.”  Oncologists should be required to say the cancer has a chance of shrinking with treatment, because that is what response really means.

So if I am going through a disease or treatment that may kill me, I want to use my last days wisely.  Thankfully, I tell everyone in my life how much I love them, and don’t have a bucket list because I have made my life so full.  The rest of my days will be the same as now, except I will eat more, exercise less, and rent a house at the beach.  Depending on my odds, I will increase my intake of Maytag Blue Cheese, Burger King vanilla milkshakes, and Krystal Burgers.  So if you feel the need to do nice things for me, bring something along these lines to my beach rental.  If it is winter time, I would like Macallan 12 single malt Scotch or Grand Marnier.  In the summer, please make dirty martinis or rusty nails.  Just a little each time, as I don’t want to be too blotto to enjoy my last days.  Don’t give my husband too much food or alcohol, as he is required to be eye candy until I die.

If I can no longer speak for myself, please keep me comfortable.  I want lots of good drugs.  My biggest concern is keeping my mouth moist – I am addicted to plain Vaseline lip balm and I hate when my teeth dry out.  My skin is kind of dry, so moisturizer will be nice.  I like to shave my legs every day, and that might be a little too much so don’t worry about it.

Do not do anything that will keep me lingering – no feeding tubes, no antibiotics for infection, no surgery.  Whatever can happen to make it quicker so I can move on to the next great adventure, please let it happen.

If I get into some accident where I can’t speak for myself, many of you have heard my golden rule – if the doctors say I will never be able to wipe my own butt again, do not let them do anything to prolong my life.  If I can’t wipe my butt, it means either I won’t be able to use my brain or my hands, and for me, this is unacceptable.  My brain and being active are so important to me.

After I die, I want to be cremated, and my ashes spread somewhere beautiful.  If my husband is alive, he can pick the place and have us both released at the same time – hopefully his new hot babe will agree to it.  Maybe she’ll give me half his ashes and she can use the rest later.  If not, I would like to be released off the pier behind Jorge’s house.

And for the people I love, I am happy for them to get together and have a big party to celebrate someone who lived life fully with great intention.  Talk about how I challenged the world to be a better place.  Share stories about my unbridled honesty.  Laugh a lot.  Most of all, at least for a day, share with each other how you are going to live an incredible life so you can look at death without an ounce of regret.  I’m grateful I did.

Share your plans with others – it can make a difference.  This is a start to spending our financial and emotional energy in more productive ways and doing our part to fix the system from the bottom up.

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