Saturday, August 29, 2009

So, what does the world's most boring blogger blog about near the end of the month and at the end of the money, when her patience is thin, her time stretched, and her house in its usual "lived in by a tornado" look?

Well, if she is smart, she doesn't. She shuts up and goes and sits in a corner and behaves.

Then again, if I were smart, I wouldn't be writing the world's most boring blog, would I now?

So I am reduced to remembering a chance conversation with a former nurse (male) in a coffee shop the other day. He was talking about patients at the end of life on ventilators. He said he got out of nursing because he could not look these people, who had "living wills" stating they did not want this kind of intervention, in the face any more.

He noted that these so called living wills are violated all the time by doctors who want the patient kept alive, so the doctor keeps getting paid to "care for" the patient. He said these people's eyes haunted him, asking why they were being kept like this when they had left express orders saying "don't". The doctor would show up once a day, for 3 minutes, look at the chart, glance in the patient's direction, and never have to face them, then bill the insurance. Meanwhile, on him and the aids fell the actual care of people whose quality of life was deplorable, and who were ready to go.

I told him that really, these "health care directives", "living wills", even "health care powers of attorney" do nothing legally. The doctor gets to ultimately decide what happens, no matter the wishes of the patient. If the doctor wants the patient to suffer on, well, that's what will happen. If the family disagrees, they can go to court. That is a whole 'nother kettle of fish, of course.

Then there are the ones who are past looking you in the eye, who will never be themselves again, but "do everything you can to save grandma" says the family. Keep her on a ventilator for days because we don't want to have to grieve.

A third person, the one the nurse was speaking to when I joined the conversation, talked about losing his mom. He said, we knew she was ready, she had already said do nothing, so we kept her at home, and let her go. Her doctor knew, she was receiving care from her family and a home health nurse, and they just let go.

He said it wasn't easy, but they were at peace with it and so was she. Then, 4 months later, their dad, hale and hearty and riding his bike, hit a patch of water and slid and ended up getting thrown off, and seriously injured. They told the doctors not to provide extraordinary care when it became clear he would never recover. The loved him enough to let go, as they had discussed as a family. Much earlier than any of them wanted, but they knew what he wanted. In these cases, the doctor complied, too.

So, if we get this great mass of health care reform that is coming, ready or not, which will predominate? Will it be people's wishes, whether for or against extraordinary measures? Will it be whatever the family says? Will the doctors get to decide, and keep patients around, and in view of shrinking payments from insurance companies, will the amount they can make off these patients be part of the decision? (This is what the former nurse began with, that the doctors in the cases he had to care for were milking the system. I am not saying all, or even most, doctors would do this.)

Or will it be taken from our hands and be buried in a bunch of legislation? Or given over to a committee?

When the time comes, just let me go. Please. I hope it's a long time from now, after I get a chance to see lots of good things come to pass in this world. Because yes, boys and girls, even though bad things happen, lots of good things still happen.

When the time comes, let go.

Today is:

According to Hoyle Day

Day of Loose Talk -- Fairy Calendar

Feast of Augustus -- Old Roman Calendar

Feast of the Beheading of St. John the Baptist

More Herbs, Less Salt Day

National Sarcoidosis Awareness Day (Sarcoidosis involves inflammation that produces tiny lumps of cells in various organs in your body. Just so you can be aware. Now one more thing for us to worry about.)

National Whiskey Sour Day

Nativity of Hathor (Egyptian goddess of Joy)

Swiss Winegrowers' Fete

St. Sabina's day (Patron Saint of Housewives)

Urda -- Old Roman Calendar, the Oldest Fate

Birthdays Today:

Michael Jackson, 1958
Elliot Gould, 1938
John McCain, 1936
Richard Attenborough, 1923
Charlie "Bird" Parker, 1920
Isabel Sanford, 1917
Ingrid Bergman, 1915
Preston Sturges, 1898

Today in History:

Era of Diocletian (Martyrs), the last major time of persecution for the early Christian churches, begins with Gen. Gaius Aurelius V Diocletianus Jovius becoming emperor of Rome, 284
Japan mints its first copper coins, 708
The last Incan King of Peru, Atahualpa, is executed by order of Francisco Pizarro, 1533
The first Indian "reservation" is formed by the New Jersey Legislature, 1758
The first motorcycle is patented in Germany by Gottlieb Daimler, 1885
The chef of a visiting Chinese Ambassador invents "chop suey" in NYC, 1896
Speedy Gonzales makes his debut, 1953

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