Wednesday, September 19, 2018

A Daughter Dies of Cancer

Nearly four years to the day she was diagnosed, her oncologist tells you there’s nothing more he can do.

You take her home and let her live her life. You put your own life on hold so you can drive her to school, to parties and to the performances she loves: She’s a musician, and you live to hear her beautiful voice.

She has one final scan. She’s been struggling for breath. She’s been extremely pale. She’s been getting fevers every night that spike as high as 103. You learn that the tumor near her left lung is now the size of a grapefruit. It’s close to her heart. The oncologist says he’s sorry. He does not schedule any more scans. He does not schedule any more ­follow-ups.

She lives for three months longer. With the help of hospice and palliative care, she is able to stay home. She goes to a final birthday party, meets her friends for a final lunch date. She texts her best friend the night before she dies: “I’ll see you this weekend.”

It is March 22, 2017. The outside world is gray and cold, covered with snow. You and your husband sit beside her in her bedroom and listen to her labored breathing. You tell her you love her. You tell her you’re proud of her. You tell her you’re sorry you couldn’t save her. You tell her it’s okay to go.

She opens her eyes — those big blue eyes you know better than your own — and sighs one last time. Then she’s gone.

Jaqueline Dooley in the Washington Post

Comfort Care Case Study

Wednesday, September 12, 2018

Hospice Workers Find Peace and Meaning

Michael Ollove writes in the Washington Post writes about hospice workers who find peace and meaning in their work.

It is hard to think of another profession with such constant exposure to dying. Yet, as intense and exhausting as hospice care is, you seldom hear any of the Western Reserve’s doctors, nurses, aides, social workers and bereavement counselors describe the job as grim, sad or dispiriting. Instead, they tend to portray the work as deeply fulfilling, gratifying and, perhaps most counterintuitively, life-affirming. And in working in the presence of imminent death, they all say they have witnessed sights that defy expectation or explanation.

“We see God working here all the time,” said Dee Metzger, 68, a hospice nurse in the Medina Inpatient Hospice Care Center southwest of Cleveland. “All the time.”

The annual turnover rate among employees at Western Reserve is a surprisingly low 12 percent, according to Judy Bartel, the organization’s chief clinical officer. To retain employees, the hospice offers them many outlets to combat burnout and what is called “compassion fatigue.”


The hospice caregivers gauge their performance by how they usher their patients to their end. “The most we can do is provide opportunity for our patients to have the best deaths possible for them,” said Dieter, 62, medical director of Western Reserve’s David Simpson Hospice House. “While everyone else is running away from it, we in end-of-life are rushing forward, saying, ‘We know what you’re going through. We want to help.’ ”

Tuesday, September 4, 2018

Sarah Lyall on Her Mother's Last Days and the Promise She Broke

Sarah Lyall promised to help her mother end her life but when the time came, it did not go the way either of them wanted.  She wrote about it in the New York Times.

I know what I’m supposed to do, because she has told me many times. One of the stories passed down as gospel in our tiny family is about how my late father, a doctor, helped his own mother — my grandmother Cecilia, whom I never met — at the end of her life. Her cancer was unbearable. “So he gave her a big dose of morphine to stop the pain,” my mother has always told my brother and me, as if reaching the end of a fairy tale. “It had the side effect of stopping her heart.”


But I am not a trained assassin. I am not a doctor. I am not very brave. I’m just a person who wants to do the most important thing that her mother has ever asked of her. I’m also a resident of New York State, where assisted suicide is illegal.

Sunday, September 2, 2018

Plan Your Funeral -- Now

A mortician urges us to acknowledge that death is inevitable and make our wishes known:
Every mortician I know has a bevy of similar horror stories—but they’re probably not the stories you’re imagining. They are not stories about zombies. Our stories are much worse because they actually come true. We can recount in detail the terrifying tales of what goes wrong if you die unexpectedly and your family is unprepared to make your funeral arrangements. I know most of you don’t think you’re going to die, but I’m here with some rough news: Death is the appointment none of us can cancel.
Most important--talk to your family and get the right forms signed:

First and foremost: paperwork! Without a legal document authorizing someone specific to handle your funeral arrangements, there’s an order of priority for people who are authorized to make these decisions for you. Your legal spouse comes first. If you don’t have a spouse, your adult children come next. After that are your parents and then your siblings. In fact, there’s a legal hierarchy that you can follow all the way down to your second cousins, if need be.
Luckily, paperwork is an easy way to supersede the next-of-kin list. You can specify exactly who you want to make your funeral arrangements and honor your wishes in a legal document. The most effective document to accomplish this is called a Durable Power of Attorney for Health Care (DPOAHC). This document also allows for your designated agent to make medical decisions for you, which makes it different from a regular ol’ Durable Power of Attorney. You can have one drawn up with a lawyer or you can simply get one online, but there needs to be an included paragraph that specifies you are also designating your agent the right to control your funeral arrangements.


Monday, August 27, 2018

Does the Soul Return to the Universe?

One of my favorite ideas about the afterlife is the transcendental oversoul, Emerson's idea that life is a brief interruption of being separate until we return to the consciousness that envelops and connects us all.

Wonderneed has an article exploring this idea from the perspective of science.  "Orchestrated objective reduction" is the theory that the quantum elements that make up our consciousness continue even after death.