Tuesday, December 06, 2011


"We treat our pets with more respect and dignity then we do our loved ones"

It is untrue that young people don't think about their death. They do, but it is at an abstract level, like how a movie will end. The concept of death is there, but they usually have so little contact with it and are so alive that the concept is theoretical. Once you hit around 40, you start to realize death is real and imminent. Friends might have died, family members. You feel age starting to lay its heavy hand on you.

Some are so afraid of death they scramble for drugs, exercise, diet, and lifestyle that will push it away as long as possible. Boomers, getting old and gray, are fascinated with nanotechnology and anagathic (anti-aging) technology. Nothing will work. You are going to die. No one knows exactly when, but its coming some day, maybe soon.

What matters most is how you face that fact, and what's interesting to me is that the people who probably know more about death and the end of lives than most seem to have a far different attitude than those who do not.

Courtesy Small Dead Animals (via Stoaty Weasel) comes this story about doctors by Ken Murray:
It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen—that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).
Basically doctors have seen the hell people in this situation go through, how expensive it is, and how futile it usually is, and they want no part of it. First hand they've gone through all the steps, and no medicine on earth can make you live forever.

This isn't about someone who was underwater and passed out being recussitated (CPR doesn't always break ribs, but it can happen). This isn't about someone who got poisoned and was pulled through, or a heart attack that was survived. This is about people who are incredibly ill and dying being given a few more minutes of life at the expense of incredible effort and cost. This is about severe old age, the last stages of terminal illness, the times when you can't actually save someone, all you can do is make them stay alive just a little bit longer.

I don't want any part of that. Not now, not ever. I would rather go curl up under a bush like a cat and die than have tens of thousands of dollars wasted in agonizing efforts to give me just a few more minutes. This world is just not that great of a place to scratch painfully for a little longer, not for me. And honestly, its not reasonable for anyone to desperately scramble in that manner.

The cost to your family, the horrors you go through, the awful condition you're in just for a few more hours or days, that's simply not worth it. If you're dying, its time to die, not cling on like that.

Of course, the hard part is knowing when that line has been reached, sometimes it can be a bit vague. And I'd never command someone else give up, or order their care cut off. I simply think we as individuals need to stop demanding everyone give up everything just so we can live just a little bit longer when the end is inevitable. That's where most of the expense in many people's health care comes from and they never pay a dime of it because inevitably, they die.


Philip said...

That's why there's things like living wills, medical power of attorney and do-not- resuscitate (DRN)orders.

Anonymous said...

ed in texas
There's a problem with DRNs. It's called 'ignoring them'. My mother was in dialysis, her heart stopped, and the people at the dialysis clinic ignored her DNR, did CPR (broke ribs) and had her air lifted to a hospital (Marble Falls to Austin, about 60 miles). So when we arrive at the hospital, here you have a 93 year old diabetic with heart trouble, the dialysis machines won't run (because her heart has started a flutter), and circulation is failing in legs, so the doctors are talking about possible amputation. They ask her, what do you want us to do. She says, "turn off all the machines". The doctors shut it all off. My oldest brother asks "Mama what do you want us to do". She says "I'd like a banana split. Do know how long it's been since I had a banana split?"
We tore up Austin Texas trying to find banana splits at 10am on a Sunday. Done. "Take me home" Done. And done.