Our entire medical system is designed for heroics. Its raison d’être is to stop death at any cost. The problem is death eventually comes to us all. While for the young and the healthy aggressive medicine makes sense, this is not necessarily true for the elderly. For them, treatment may offer high risks and limited rewards, resulting in diminished quality of life.
The NYT reports on a movement called “Slow medicine” that is a response to this type of medicine. Slow medicine is designed to encourage the elderly to think through the costs/benefits of medical action. Its goal is comfort not cure. The truth is for the elderly many procedures that may make sense for those younger, might carry side effects that diminish their quality of life, and may even hasten their end.
Kendal at Hanover is a retirement community that is affiliated with Dartmouth Medical School. It has become a laboratory for the slow medicine movement. Patients at Kendal may refuse hospitalization, tests, surgery or medication. They are encouraged to take their time and weigh the options before making a decision. The truth is many illnesses are the result of the decline that is necessarily a part of aging. Some illnesses will inevitably lead to death. Unnecessary heroics only prolong the dying and not the living.
As I wrote earlier, W. never recovered from having his second leg cut off, and died on February 26th. His funeral took place several days later.
Despite providing the funeral home with a written draft of the obituary, the obituary was riddled with errors. But that wasn’t all. Only after the service was over and it was time to view the body did the funeral home get around to telling the next of kin they could not bury the body that day. According to them, the doctor had neglected to sign the death certificate. They would take care of it the next day, they promised. Nothing happened the next day, nor the next. Finally, on Tuesday the burial took place, 5 days after the funeral.
It was all a lie. The folks at the cemetery informed the family that even without a signed death certificate, the burial could have taken place as scheduled. It turns out that the funeral home had called them on the day of the funeral to say that the family had changed their minds.
I am baffled by this. What reason could they have for delaying the burial? It couldn’t have been financial, since the family had paid cash to the funeral home for an inexpensive package, and had paid the cemetery separately with a cashier’s check. If anyone out there has suffered similar problems, I would be interested in hearing what they have to say.
I got this article about death and dying from the blog Sethedaughter
The slow death that passes for life
Bad faith, said Sartre, is to regard oneself as a thing compelled by circumstances.I used to think that I would like to go out fighting, swinging wildly at death. That for me would me my moment of validation and the moment that I was most alive. Since then I’ve learned there are many ways to die, including the walking death that passes for many of our lives, which is a prolonged dying.Y. died on October 20, 1994. Her struggle is over. She is beyond caring. She must have wondered those years as she suffered the indignity of a respirator tube stuffed down her throat, and bags attached to her body to dispose of her bodily waste, why me? I was good. I was cheerful. I dreamed dreams. When the dreams didn’t come true, I still smiled. Even in the face of overwhelming pain and the indignity that comes from a long dying. Why me? My unborn babies dried up as my body withered. The love I had to give to a lover lay bottled up in me. There were no takers. Why me?
I wrote, the day after her death. I am sad not because the struggle is over, but because there was a struggle. And it was so long and so hard.
Y. was diagnosed with cancer of the lymph nodes at 17, still barely a baby. The cancer did not kill her, but the radiation used to treat the disease did. In between the diagnosis and her death, she went to school, worked and had fun, even as she periodically had to be hospitalized. Several years after her diagnosis, she went into the hospital, her usual, cheerful, vibrant self. She came out with a respirator stuck down her throat, no longer able to talk, consigned for a while to a nursing home. Her mom brought her home from the nursing home even as her condition worsened. Two years after that surgery she was pronounced dead. Prior to her final death, she died several times, but was resuscitated by well meaning doctors.
Since Y.’s death, I have come to subscribe to the notion of being gently eased out of life, my recognition of my existence no less valid. As I write this, I am reminded that my life has been reduced to the size of a small house; two cats and a television set my primary company. It is the walking death that I have most been afraid of. It persists because of my own bad faith.
