t is too late to save the nation’s health care debate from being sidetracked by the specter of government “death panels” determining who lives and who dies.
Former Gov. Sarah Palin’s bumper-sticker rhetoric created an amusing but unfortunate sideshow that has drawn attention away from more meaningful questions — like testing the economic assumptions that underlie paying for the overhaul.
But equating counseling for end-of-life medical questions to Nazi-style eugenics also threatens broader harm by creating misunderstanding of an important piece of modern medical care.
For baby boomers like me (a little older than the former Alaska governor), the end-of-life questions are real — if not for ourselves, then for our parents.
If you’re like I was, you think you’re ready — but you’re not.
My introduction to the process began in early February with the first in a series of voice mail messages from my three brothers in Los Angeles.
“Don’t worry,” my oldest brother said, attempting his most reassuring tone, “it’s probably nothing serious but Pop’s in the hospital. We need to get some things checked out and we’ll probably have him back home in a few days. You don’t have to worry about coming out or anything like that right now.”
Dad was home in a few days. But not for long.
Over the next several weeks, he was in and out of the hospital. Emergency room staff were able to stabilize his condition each time he was rushed back.
I kept my cellphone on. Soon, the words “don’t worry” disappeared from the text messages, voice mails and conversations. I flew from Denver to L.A. about the same time as my two sisters — one from Seattle and the other from Washington, D.C. — arrived.
Dad was stable and drifting in and out of sleep when we gathered in his room. He managed little conversation, what with the tubes in his nose and mouth. His communication was reduced to responses to our questions.
Feel OK?
Nod.
Hungry?
Nod.
You’ll feel better when we can get these tubes out.
Nod, nod, nod.
My father had been known for his speaking ability. Several months prior to his hospitalization, on his 90th birthday, he rose from a wheelchair to deliver a toast before about 40 family members in a dining hall. He amazed us with a lengthy soliloquy from Spartacus’ speech to the gladiators, which he had memorized as a boy.
But now my father could manage only a few words in a raspy voice. He was clearly in pain but his comfort, or discomfort, was a topic he was not given to discuss. That left the six of us, his adult children, to guess.
How much time did he have left? None of his doctors would say.
His heart was pumping his blood at about 25 percent the level considered healthy, his cardiologist said. He could be kept alive in a hospital. He could also go home and probably have to be rushed back to the emergency room.
“Think about what he really wants,” his doctors urged us.
We met with an expert on hospice care for hours. He explained in detail how my father would be treated under various medical scenarios. The recurring sentence was, “There won’t be any more trips to the emergency room.”
The implication was clear.
We talked. We wept. We vacillated. One camp was for stepped-up in-home care. The other favored hospice.
I moved from one camp to the other as we discussed and re-discussed every scenario we could imagine.
We knew Dad wanted to go home. Gradually we came to understand that “palliative care” — essentially focusing his care on making him comfortable — may or may not extend his life but would certainly make it better.
So we brought him home, knowing he would die there.
For about a week, he rested with one of my sisters by his side as hospice workers helped see to his comfort. Then he died.
I have never had any doubt that we reached the right decision. Without the hospital’s end-of-life specialists — a group some might call a “death panel” — I don’t know that the same would be true.
Luke Clarke, formerly an editor at the Rocky Mountain News, is a freelance writer living in Golden. E-mail him at lukeclarke@comcast.net.
