Sep 28, 2009

How Should We Die?


At one point in my life I thought about what decision I might like to make if I were an old man well into my 80s and ridden with a most-likely terminal Illness. I thought that I would want to be hooked up to every kind of machine available and allow my life to continue through pain and the fogginess of pain meds.

Then I worked for a semester at Calvary Hospital a wonderful Bronx hospital for mostly terminal patients. My job as a volunteer was simply to visit people as a pastoral worker. We'd basically help them fill up their days with conversation and activities. It was hard work...very hard. There were days that I'd walk around the hospital afraid to enter one more room of someone who may not be there on my next visit.

But I also think I learned how to die as well.

I saw people afraid to die, filled with a lot of regrets, amazingly not because of things that they did but because of things that they did not do. A relationship still not mended, a chance not taken, words not spoken. It seemed that risk was always something worth taking and these folks made every overture that they regretted not taking the ones that they let slip by.

And yet, after airing those grievances to someone like me, a virtual stranger, I saw many patients become peaceful. Some time ago my mother had a struggle during major colon surgery. The doctors gave her only a 28% chance to survive. Both she and our family prepared for her death. I had readings planned for the funeral and began writing a death notice and a eulogy. I saw a woman who had a lot of fear of what might await but also I saw a hopeful woman, who often had vivid dreams of her own father and her joy at the possibility of reacquainting with him. I got the idea that anticipation of our breathing ceasing was what she feared but she also grew hopeful of life beyond this one.

We often cling to our lives, forgetting what Jesus said to us that those who try to save their life will lose it. We get caught up in saving our own hides and forget about how we should live and by living each day we also realize that we die a bit with each passing moment as well. Each moment is truly precious and we need to treasure it.

So as I read my early morning paper the other day...this story captured my attention:

In the last days of her life, Annabel Kitzhaber had a decision to make: she could be the tissue-skinned woman in the hospital with the tubes and the needles, the meds and smells and the squawk of television. Or she could go home and finish the love story with the man she’d been married to for 65 years.

Her husband was a soldier who had fought through Europe with Patton’s army. And as he aged, his son would call him on D-Day and thank him – for saving the world from the Nazis, for bequeathing his generation with a relatively easy time.

That son, John Kitzhaber, knew exactly what his mother’s decision meant. He was not only a governor, a Democrat who served two terms in Oregon as it tried to show the world that a state could give health care to most of its citizens, but a doctor himself.

At age 88, with a weak heart, and tests that showed she most likely had cancer, Annabel chose to go home, walking away from the medical-industrial complex.

“The whole focus had been centered on her illness and her aging,” said Kitzhaber. “But both she and my father let go that part of their lives that they could not control and instead began to focus on what they could control: the joys and blessings of their marriage.”

She died at home, four months after the decision, surrounded by those she loved. Her husband died eight months later.

The story of Annabel and Albert Kitzhaber is no more remarkable that a grove of ancient maple trees blushing gold in the early autumn, a moment in a life cycle. But for reasons both cynical and clinical, the American political debate on health care treats end-of-life care like a contagion — an unspeakable one at that.

Nobody was more frustrated than John Kitzhaber as the health care debate got hijacked over the summer by shouters and misinformation specialists. And no politician is more battle-scarred on this issue. He looks, at 62, still the Western man, with his jeans, his shag of gray hair, the face weathered by days spent trying to lure steelhead to the surface in the Rogue River. It has been his life work to see if at least one part of country could join the family of nations that offers universal coverage.

With his mother’s death in 2005, Kitzhaber lived the absurdities of the present system. Medicare would pay hundreds of thousands of dollars for endless hospital procedures and tests but would not pay $18 an hour for a non-hospice care giver to come into Annabel’s home and help her through her final days.


We have our priorities all mixed up. We spend millions on helping people to live and preserve their lives and rightfully so...but should we not also pay attention to how life ends as well? We indeed can help people die with dignity and love and without denigrating human life either. Euthanasia is never moral but saying "Enough! I want to live my final days being loved rather than being medicated" is such a beautiful way to look at life's ending chapter.

In Mitch Ablom's award winning Tuesdays With Morrie, Morrie gave us a glimpse of how I now begin to look at the end of my life. To paraphrase, Morrie said that babies relish someone taking care of all their needs. They splash in the bath and love getting powdered and even seem to enjoy having a diaper changed. We revolt against all of this as we leave this life, quite the opposite tendency than we had when we entered this world. Would it not be more appropriate to become once again a little baby and relish the care that those who give it to us offer? What choice do we really have?

So the question for you today is how would you prefer to spend your dying days? What do you think you'll regret? What might you look forward to? And what are you doing today to prepare for our journey home to God?

Tomorrow: My Thoughts on Funerals and Wakes

7 comments:

god googler said...

Via facebook:

From: Paul Thomas Daly

I was talking to a doctor friend who said to remember there is a difference between health care and sick care, or in this case end of life care. Anyone who decides to skip the hospital, tubes, chemo, etc. and die at home is brave in my book. But, I don't want the govt. making the decision, that should be left up to doctors and families.

god googler said...

Paul, I agree but I also think if it's someone's choice to die at home health care should cover what they need in terms of hospice, etc.

god googler said...

Via Facebook:

From Butler Miller:

Paul, not to be argumentative, but who is the paying the bill in the scenario where no one gets between you and your doctor? If you (or your private insurance company) is, I have no problem. If I, the generic taxpayer, am, then I want to make sure that the money is well spent. Hospice/homecare is pretty cheap, generally speaking, but if the MD prescribes expensive courses of action, that is a different story. Medicare/Medicaid-wise, we cannot keep on like we are doing, the taxpayers are not paying enough for it and in about 2019, it will either be bankrupt or in the red, I forget.

god googler said...

Via Facebook:

From Connie Lane Neuman

My mother gave my brother Pat, my daughter, cousins, Sr. Toni down the street at the convent, neighbors, friends, a lovely young lady 24-hr caregiver from Bulgaria and me -- the gift of her dying over 3 weeks in February 2000. Mom was at home on hospice in a hospital bed in the dining room, her heart shutting down. We shopped, cooked, played freecell. Pat read to her the story of St. Mary MacKillop, the first saint of Australia. Sometimes she'd sit in her wheelchair. Her sharp mind was leaving; going into dementia. She'd wake up, see our living room mess of newspapers, books, computers, beer cans, sox. She'd shudder. We'd jump up, clean up quick. Connie Lane NeumanOne morning she said: A cute outfit. I said: Yes, Daniela has on a cute outfit. A cute outfit, she said again. Oh, YOU want a cute outfit. I showed her an array of her colorful pantsuits. She chose one, fuschia, I think; we dressed her. Would you like to take a ride in the car? Pat asked. Yes. We bundled her tiny body in a camel coat, navy blue tam, put on sunglasses. Pat carried her to the car. Saying little, we toured the snowmen and snow ladies of Milwaukee. 5 days later she went home to God. To God be all the thanks and praise!

god googler said...

Connie--

What a beautiful story. I remember one of my friends wheeling his father to mass even though he could no longer speak or function well.

NC Sue said...

I've worked as a nurse for 35+ years, and I've been at the bedside of the dying more times than I can count. I am not afraid of being dead, but after years of experience caring for the living... and the dying... I'm afraid of what I might have to go through between now and then.

There comes a time when it may be appropriate to embrace death - NOT out of depression or desperation, but out of a recognition that our earthly life IS finite, and rightly so.

There are times when the greatest gift we can give to those we love is permission to die in comfort surrounded by those we love. Read my earlier post at http://acts17verse28.blogspot.com/2009/04/janice-and-matt-true-story.html to see what I mean.

"Eternal life" doesn't mean that our current bodies continue forever. It means that our souls continue after the death of our earthly bodies. I pray that the transition I make... and that YOU make... will be gentle and surrounded by love.

Fran said...

So many priests and religious sisters that I know have no extraordinary end of life plans. To simply go meet the Lord, not assisted but by nature is the thing.

I watched my mother die a peaceful death, the 18th anniversary of which is today.

All I can say is that I pray that "the angels come to greet you" and me and all others as we enter paradise.

So not to prolong nor to speed, but to do what is called for, that is the thing.

I love this post, thank you Mike, thank you.

Googling God

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