Have you thought much about your final days, final minutes or even thereafter? I, probably like most other people have already attended more wakes and funerals than I’d ever want to. But as the great philosopher Yogi Berra said, “You should always go to other peoples’ funerals or else they won’t go to yours.” Then again, I’m pretty sure that I don’t even want anything like that. Thousands of dollars on a casket? For what? A nice box and pillows for a bag of bones? Thousands of dollars on flowers and a funeral home and all the trappings. C’mon, what a waste. Let’s put that money to much better use, spend it on the living.
There’s a similar sentiment to end of life health care. I recently stumbled across an article in the Wall Street Journal about how physicians die differently. Ironically enough, it’s not that doctors get better end of life care, they actually often opt for less.

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient’s five-year-survival odds—from 5% to 15%—albeit with a poor quality of life.
Charlie, 68 years old, was uninterested. He went home the next day, closed his practice and never set foot in a hospital again. He focused on spending time with his family. Several months later, he died at home. He got no chemotherapy, radiation or surgical treatment. Medicare didn’t spend much on him.

I’m not going to say I would make the same choice as Charlie. That’s an extremely difficult choice to make and maybe it depends on where you are in life. Maybe that extra couple months means getting to see a first grandchild. It could mean any number of things. However, how often do we see people hooked up to machines and tubes and all the latest and greatest inventions in the world of medicine to keep someone “alive”? Is this really how we picture our last days? Hooked up to breathing and feeding tubes in a hospital room? I’m guessing most people hope or expect to just drift off to sleep one night and peacefully continue on. Unfortunately, it rarely happens that way. Quite often, it’s our own fault.
Have you spoken to your spouse or other family members about what you want to be done for you? Have you given someone else (or multiple people) the ability and right to make these decisions for you if you’re unable? It’s always best to make these decisions when you’re clear-headed and not stressed. I have one such example.
I was very close with my own grandmother. She was getting into her 80s and had failing health. She had a number of issues going on, not the least of which was untreatable leukemia. Similar to Charlie described above. She worked her career as a nurse and has seen that quite often “the cure is worse than the cause” and decided she’d just ride it out. She also decided to keep that condition from our family for most of the rest of her life.
One day, she called and asked me to go to the doctor’s office with her where she needed me to sign some paperwork. She wanted me to be second in charge (after my mother) in making end of life decisions for her. She finally explained her condition, along with her physician, and said she didn’t want any more life saving procedures. She signed the “Do Not Resuscitate” orders. She even half-jokingly threatened to haunt me from the afterlife if I let her die after being hooked up to machines for weeks for months. I believed her. I accepted my responsibility, signed the paperwork and kept a copy.
Less than a week later, with my mother out of state, I got a phone call at 6:30 am from my grandmother that she wasn’t feeling very well at all and was going to the hospital. She asked me to meet her there. This one sounded different, she sounded worse than normal. Just in case, I brought all the paperwork with me and I got there a few minutes after 7. As soon as I got to the ER and explained why I was there, the nurse said my grandmother was being prepped for surgery. I immediately got to her room where a surgeon was just wheeling her out to the operating room and explained to me that she had massive bleeding on her brain from the leukemia and needed emergency surgery now to relieve the pressure. With surgery, she might survive but without it she definitely would not.
I handed the paperwork to the surgeon, he read it, asked if I was sure, I said yes, and that was it. A few hours later, she was gone. About the only positive thing, or at least the only reassuring thing that happened all day was that her original physician, the one I’d met with less than a week before stopped in to see my grandmother and me. He offered his condolences and just looked at me and said, “You did absolutely the correct thing.”
There was no extended suffering, there were no heroic measures, there was no stringing it out artificially. Her time had come and she made her choice, I was merely the spokesperson for her.
So take a read through the linked article, give it some thought, and help the people who will be put in the same spot. Let them know what decision you want to make, so they will not have to decide, in a stressful and emotional situation. Give them the reassurance that they too are making the right decision.
Addendum: If you’d like to read more about this need for decision making, Jessica David (@JDinRI) sent this additional article along: http://hbr.org/2012/01/tackling-social-problems/ar/1