Bring Back Pneumonia

by Dean J. Seal

This is about my own personal viewpoint on end-of-life issues. Having spent some time around people when they reach the end of life, I have developed an interest in how people handle it. It's more than professional curiosity.
I heard a radio story the other day about a woman who was 92, in her own house still, but her body was starting to wear out. She was getting nursing visits, but she was worried that her insurance was going to run out (surprise! Having insurance doesn't solve every problems!. They asked her if she was going to live with family; she said there were a lot of kids there, so it would be inconvenient for the family. But she also said "...they don't want me to be exposed to pneumonia."
There was a time when pneumonia was called "the old man's friend" because it was fast, painless, and you usually transitioned while asleep. Isn't that the way a lot of us want to go? But her prospects were thus: living alone, isolated from children and grandchildren, fading in independence, worried about being a burden to the kids, worried about money, worried that resources would run out before her time did.
When we talk about these issues, the radically paranoid will insist that any such discussion is really about suicide and euthanasia. And it's not. It's about planning, freedom of choice and making your own decisions. Some people are suited to fight the good fight; my wife's grandmother is 102 and she says "the only thing that still works is my mouth." So she spends a lot of time on the phone and has a very active social life. But she has been saying for ten years that she is ready to go. I knew another woman who made it to 101, and she said "God don't want me and the Devil don't want me." She died trying to escape from the hospital they put her in when she broke her hip.
In the hospital, nurses and chaplains have said several times that it is the Christians who are afraid of dying more than anyone. Native Americans are the least afraid, because they consider it to be a natural event (is that primitive? Or advanced? I consider it to be the latter).They describe it as moving across a line, and it doesn't remove the deceased from their presence.
Why are Christians so afraid? Is it because they have been raised in fear? That a loving God will send them to hell for some slight, some unrepented morning where the paper and a cup of coffee seemed like a better Shabbat than church?
A study on lying says we average 3 lies every ten minutes in a conversation, and that the ability to lie is marked as a sing of maturity, of being able to cope with he person you are talking to (MPR). Is God sending us to hell because we told someone they look great when they don't? Or I'm fine when I'm not?
I do not want to be one of those whose body outlives their brain. I helped wheel 35 people like this into a room for a chapel service they mostly had no response to, and then wheeled them back out. Dozens and dozens in one building.
A conservative Rabbi told us in chaplain training that "life is sacred, and it is important to do what you can to sustain someones life. But- there is nothing sacred about prolonging someones death."
Medtronic tried to launch a line of heart stents in China, and it didn't go very well, because most of the patients decided not to rob the next generation of those resources to bring a few more years of ill-health. In the USA, I heard an unverified statistic that we spend 40% of our health care money extending someones life for less than another year (someone should look this up). I know my dad had a quadruple bypass which gave him another year, and a lot of pain. A great deal of pain. I asked him later if he would do it again, given the choice. "NOOOOO!" he said without hesitation.
Anecdotal evidence about people who have been revived with a defibrillator indicates they never really come back all the way. The question when going into intensive intervention like chemotherapy and heart surgery is, what kind of quality of life is being restored? Are you doing something For somebody, or doing it To somebody? Only you can answer these questions going in, for yourself or aq dearly loved person. But these are the questions, and rather than deal with them on the fly, in crisis, it is much better to meditate upon them and discuss them with the people who will be making those decisions for you when you can't.
Here are my final instructions: Do not resuscitate. Do not defibrillate. Do not allow my body to absorb nutrients after brain death. Do not give me chemo if it is going to be less than a 20% chance of recovery. If a miracle happens, great. Otherwise, I would dbe glad to depart from this veil of tears at the appointed time. I love my family, and we will miss each other, but I don't want to be taking their life away in order to hang desperately onto mine.
I have no fear of death. When we die, we go to God.