living your best to the end

modern medsModern Medicine can keep you alive

Machines, medications and man-made parts: modern medicine continues to find and develop life-saving and life-prolonging interventions.

Advancements in heart research include:

  • Bypass surgery
  • Man-made implantable cardiac devices like pacemakers

When organs fail, there’s dialysis for kidney failure, and transplants for kidney, lung, liver and heart. Cancer continues to be researched, and survival rates and life expectancy has greatly increased. For neurological (brain) illness and injury, medications and interventions are emerging, and rehab helps with increased function. Even infections – which were regularly the cause of death in past generations – are now treated with antibiotics.

However,  as the body winds down, so-called ‘Heroic Measures’ may do more harm than intended.  CPR (Cardio-Pulmonary Resuscitation) Breathing Machines (ventilators), Feeding tubes and specific medications can be considered  Heroic Measures or seem more like Futile Treatment. When making decisions about any of these, it can help to understand the longer-term results and possible complications.

Things I’ve learned from dying

Living, knowing you are going to die Drawn, as I am, to learning ever more about how we die, and how ‘one’ dies, this David Dow title, “Things I’ve learned from Dying ” had me at ‘hello’ Dow – who is very much alive – is a death row lawyer in Texas . He writes beautifully about, and pours insight into the humanity of those on the row. But that’s not why I found his book so important and compelling: it’s the parallel story that I fastened on: Dow’s story of Peter – his father in law –  who died within a year of diagnosis. Throughout the sickness, its treatment and decisions about, Peter shares with Dow some light, along with the darkness of regrets, disappointments, conflicts and depression, and self-awareness. These emotions and reactions along the journey, tell an eternal story: Not wanting to lose a loved one, perhaps at the cost of the loved one’s quality of life As Peter says: “You all want me to stay alive, but that is because you want me to be in your lives. Of course that flatters me, and makes me happy and sad, but that desire does not give you a ballot, and even if it did, it is wrong to cast a vote that treats me as a means to your ends. I want to die with dignity, and you are all determined to thwart me.“ Peter is the loved one, torn between his own needs and those of his family: “For [daughter] Katya, either I am here or I am not. For me the line is elusive....

Doctor learns from his mother: the patient

Health care professionals see healthcare differently when it gets personal Dr. David Lee Scher has 25 years of clinical medical experience as cardiologist and cardiac electrophysiologist, hospital department administrator, clinical trial investigator, IRB Chair, and Medicare committee representative.         You’d be forgiven if you assumed he’d have few surprises in store in treating patients, so when his 78-year old mother was diagnosed with both lung and pancreaticcancer, he fully expected her to freak right out. Not so. “She’s fine with the cancer and treatment. What she really hates is the loss of independence that comes with the oxygen tank she’s attached to. She calls it her ‘dog on a leash I have to walk around with.’ It made me sensitive for the first time that the small things affecting activities of daily living might mean more to a patient than facing a terminal illness.” Until recently, Scher’s mother worked, and was actively involved in medical decision. Another adjustment: she’s now delegated most of those decisions over to her son, who always keeps his sibs in the loop. “My mom recognized that the chemo’s affected her thinking and processing abilities.” As the doctor amongst three sibs, David is entrusted with the medical aspects. “My twin, who lives nearer, takes care of some of her day to day needs and our younger sister who’s in the business sector oversees important financial decisions.” Dr. Scher recognizes how lucky his mother is to have that available expertise and division of labour; “I know there are often fights and frustration amongst sibs who may not have any of those skill sets...

Dignity Therapy at Life’s End: Thank you Dr Harvey Chochinov

Dignity Conserving Care asks at life’s end: ‘What do I need to know about you as a person to give you the best care possible?’ To give an answer as a person, rather than as a health condition is a focus-changer for providers and for patients alike. As a patient – albeit feeling my healthiest –  I wouldn’t be able to answer that question without some serious soul searching.  However,  thinking about this, when depression dropped its darkness on me, I told my GP of almost three decades: ‘I so hate not feeling energetic or optimistic’. I could do that because she’s come to know me as a person. But at life’s end, will she be there with her specific knowledge of what makes me, me? My family knows me both energetic and optimistic, and fatigued and depressed. But I’ve not told my family it’s one of my worries at life’s end – oxymoron tho this may be – I don’t want to die depressed. I am aiming for a joyful departure. I feel more confident in this, knowing about Dignity Therapy: Thank you to Winnipeg’s Dr Harvey Max Chochinov  – a psychiatrist who has been forever interested in how people cope with and manage chronic debilitating and often terminal illness: Dr Harvey Chochino Dr Harvey Chochinov: “My older sister was born with and lived with Cerebral Palsy, so I was a brother who grew up knowing something about chronic life altering conditions.” Moving forward in his career, studying at Cornell, Chochinov found that in his day to day working largely with cancer patients… “what patients encountered coping with chronic, deteriorating...

I want to die in my sleep like my grandfather… not screaming and yelling like the passengers in his car.

Will Shriner

Comedian

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