living your best to the end

Extreme Measures: Dr Jessica Zitter on a Palliative mission

“I’m going to call 911: a doctor is torturing a patient.” So said Nurse Pat Murphy to Dr Jessica Zitter  – just as Zitter was about to plunge a syringe into the neck of a patient with a host of health issues. Tho the 911 call wasn’t made, it was a turning point for Zitter – who trained as a critical care doctor, and for whom going gently into that good night felt like she was abandoning a patient, a failure. That encounter with Nurse Murphy led her to completely change her own medical ‘mandate’ – becoming a Palliative doctor – the specialty that embodies the philosophy of ‘patient-centered’ medicine. I first ‘met’ Dr Zitter in a New York Times essay in which she admits on her first night on call as a Palliative doctor she hadn’t yet completely relinquished her ‘critical care save the life at all costs’ ‘tude. A healthcare team in conflict The patient ­– a Holocaust survivor ­– was sleeping peacefully. She’d been admitted with pneumonia, but it hadn’t responded to treatment. As she got sicker and her breathing harder, she was made comfortable. The doctor attending the patient told the team gathered that she had clearly said she didn’t want a breathing tube, but the respiratory therapist wasn’t comfortable not intubating: “I’m not really sure she ‘got it’ she was pretty out of it.” Zitter was also unsure. The compromise was to strap on an oxygen mask overnight and re-assess in the morning. The morning found the patient ‘delirious and terrified, her mask off center and totally ineffective.” Confirmation of commitment to Palliative Care...

A mother, a daughter and Ovarian Cancer: “Love you so much.”

When Karen Greve Young gave me the hot-off-the press copy of ‘Love you so much: a shared memoir’ she explained: “Sometime into my mother’s treatment for ovarian cancer, we decided we wanted to do something meaningful.” Told by both daughter and mother, the title of their memoir is Victoria Zacheis Greve’s standard email sign-off. Email proves its worth in this memoir: over the four and a half years from diagnosis to death, email connected mother and daughter who were living half a world away, and email connected Karen with her father, brother, aunt and friends. These practical, poignant, personal exchanges offer a real picture of living under the cancer cloud. But they also show how life must go on, including falling in love, marriage, graduations, promotions, retirement, across-the-ocean and back travels, and infertility. In an example of the strength they drew from one another Vicki – whose survival strategy includes trying to be unfailingly positive and determined ­– writes Karen: “Keep up your spirits. If I can lick cancer, you can conceive a child….Love you so much.” Throughout the memoir love, support, respect, tenacity and humour ring true: Vicki addresses emails ‘Dear pushy little sister’ and, depending on the context, signs off as MOB (mother of the bride) and CA (co-author). Also shared is the grim reality: “All I want to do is to feel better and live to see my grandchildren – I truly don’t think either one is in the card for me. In the meantime, I’m trying to live as normally as possible with a deepening depression and flagging energy.” Karen’s correspondence, her narrative and the...

Men writing about The End of Life

Men writing from the inside out about life’s end. In the picture in The New Yorker, sitting with his dog, on a bench by a park, Roger Agnell, looks none of his 93 years. Famous for his sports writing, ‘This Old Man’ is Agnell’s reflection on life, starting ith what is and isn’t working- kind of a Medical History but with the life that was going on around the health issues. The lower-middle sector of my spine twists and jogs like a Connecticut county road, thanks to a herniated disk seven or eight years ago. This has cost me two or three inches of height, transforming me from Gary Cooper to Geppetto. My left knee is thicker but shakier than my right. I messed it up playing football, eons ago, but can’t remember what went wrong there more recently. I had a date to have the joint replaced by a famous knee man (he’s listed in the Metropolitan Opera program as a major supporter) but changed course at the last moment, opting elsewhere for injections of synthetic frog hair or rooster combs or something, which magically took away the pain. I walk around with a cane now when outdoors—“Stop brandishing!” I hear my wife, Carol, admonishing—which gives me a nice little edge when hailing cabs. In the New York Times, James Collins (author of Beginner’s Greek – a novel) title had me gearing up for a grim diagnosis: My office supplies are going to outlive me But, no! No health issue prompts Collins. Instead, it’s when he takes stock of the sheer number of staples in his office he...