Taking Responsibility for Death

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In the op-ed section of the Sunday Times on March 31st there was an article by Susan Jacoby called Taking Responsibility for Death.  She begins the article standing by her 89 year old mothers hospital bed and her mother asks the doctor if there is anything he can do to give her back the life she had last year when she wasn't in pain every minute.  Unfortunately the answer was no and because of that she left the hospital never to return again until her life ended. 

Her mothers worst nightmare was that she might be kept alive by expensive and painful procedures when she no longer had a functioning brain.  My mother had the same fear.  Her biggest fear that she would have a stroke and not be able to function in the way that she was accustomed to.  She didn't think that it would be brain cancer that would catch her by surprise. 

Jacoby brings up a topic that nobody really likes to talk about.  That we spend ( yes we as in Medicare ) the majority of money on health care on the end of ones life trying to keep them alive instead of spending the majority of it on preventative treatment from the time you are born.  As my Mother used to say, it is just crazy. 

My Mom found out that she had brain cancer and died six weeks later.  In that six weeks she had brain surgery, chemotherapy, hospice and spent a few weeks in the hospital.  The bills were extraordinary, more than she probably spent on health care her entire life and we didn't pay for one cent because of Medicare.  That's crazy.

I have always been pragmatic about things which is probably why my Mom put me down in her will to be responsible for her medical decisions.  Growing up she would always say to us, "if I get like that ( as in serious ill and not being able to live the life I want ) then just kill me".  She meant it too and she repeated those words often.  Although my parents have been divorced since I was in High School, my father is a believer in the same mantra.

After my Moms surgery the cancer grew back quickly and larger in a very short time.  New doctors wanted to have surgery again.  I asked the doctors the exact same question that Jacobys mother asked her doctor.  Can you tell me that my Mom will be able to go to the movies, do the crossword, read a book, talk about any topic (particularly her love of politics), take care of herself and walk home from the museum by herself.  The answer was no but we could possibly extend her life so she could just sit on the couch and you could be with her.  To my Mom, that was not a life.  BTW, if she had expressed the desire to have that no matter what, we would have done it and it would have cost the tax payers hundreds of thousands of dollars for those few weeks or perhaps that month. 

We all came to the conclusion to let my Mom go, let her go with dignity and not with invasive medical treatments so the doctors could learn from her and her brain cancer.  It wasn't hard to make that decision because I knew that she wouldn't have wanted it any other way. 

The line that the NYTimes pulled out from the article and bold faced it on top is "we value personal freedom but fail to make choices about our health".  As the Supreme Court ruling is still out there about our health care, as Americans we should give some serious thought to the end of our lives, the cost and the pain and of course it depends on our age.  If my Mom was 40 she should have fought as hard as she could to keep alive but she wasn't, she was 72…young but a full life. 

The good news is she was insured.  When people say that they don't need insurance because they are healthy….my Mom thought she was healthy too until by some random dealing of the cards when she happened to get brain cancer.  There is no doubt that everybody should be insured (the definition is to make sure we are insured so if something happens we have insurance ) but there should be some serious questions about the end of our lives, the cost and getting through the end with dignity so our families can remember each individual as who they were not an object for the medical community.