Monday, August 24, 2009

Pullin' the Plug

Some of you will think me heartless and cruel (some of you already do, so this won’t be a leap), but with this ongoing discussion of health care, I have been thinking a great deal about issues of life and death. In particular, I have been focusing on the whole controversy about “pulling the plug on Grandma.” Now don’t jump to conclusions, I am not about to pull any plugs, but for people who have been caring for elderly parents, the conversation is very complicated. Additionally, and almost without exception, they have made friends promise never to let them get to a place where they are no longer able to care for themselves. Back to my first sentence. When asked, I have agreed to honor their wishes -- if they do the same for me – which some will think, is heartless. I disagree, because there is no way I would want someone I love to suffer pain or humiliation on a daily basis.

Here’s my problem with the whole discussion of “pulling that plug.” I don’t think it’s a question of pulling a plug. I think the real issue is making the decision to plug someone IN, in the first place. When you are simply prolonging the inevitable and increasing the length of the suffering, why would any reasonable person choose a plug. In a pretty heavy discussion with my mother, she has made us promise that there will be no plugs. She says that she talked to many friends who signed DNR’s (“Do Not Resuscitate,”) and then their kids wouldn’t let them die with any dignity. She says she is not afraid to die, she just doesn’t want to be in pain. She does not want to be plugged into even one tube. Her desire is to be drugged and at peace. And that sounds good to me.

Plugs should be a personal decision like what kind of gum to chew or wine to drink. Plug or unplug should be decided by the individual – not by sister Gussie, or brother Jed.

And speaking of life and death decisions, rumor has it that Bernie Madoff is dying of pancreatic cancer. He has been seen baking in Native American smoke huts (who knew they had such accommodations in prison), and also hanging out with homosexuals. (The NY Post insists it is true). I’m not certain I understand what one has to do with another, and I’m also not sure even that if I did understand the connection, I would comprehend the relevance—but there are those things that are way beyond what I am capable of comprehending. Which is not supposed to be the point of this paragraph. The point is, along with promising my pals not to insert a plug, I promised I would not put Grandma and Bernie Madoff in the same paragraph..

There is talk that Bernie was quick to confess and not divulge how or where the scammed 50 billion was, because he knew he was not long for this world – or any other world for that matter. On the other hand, and under ordinary circumstances I would say, "well let him die in peace." (After all I did say that no pain and at peace is the way to go). But not with Madoff. I think that he needs to suffer. I think that they should give him chemo, make him swallow pills, do surgery, -- keep him alive at all costs. Unleash the plugs! There should be no DNR for him. He should be made to live for another 50 years, and he should be in pain for as many years as he lives. (This could be what I was referring to as the ‘heartless’ part).

Anyway, I know that my feelings are not necessarily consistent. There are no rules about how people should live and how they should die. Which is exactly the point. No one, but the person whose life it is, should determine when life is worth extending and whose should come to an end. My mother would disagree. She would say that “only God knows when your time has come and no ordinary human should do any second guessing.” We’re just sayin’…..Iris


Anonymous said...

I believe when in doubt you always choose life. However there does come a point when it is ridiculous to revive and recesitate...for what to delay death for a week or more. If someone wants to be let to pass rather than be kept alive by the machines that keep the oxygen going, the blood flowing, and the heart pumping....that is not natural. That is artificial life and there we may find some common ground. The middle is lost today in the extreme left and right of the political world and media. Common sense is somewhere in the middle.

MRH (Italy)

Anonymous said...

The government has had its hand on Medicare for quite a while, dearest one. Also, Tri-Care for military people, the VA for vets and now considered a first rate innovative health care resource. Who knew? There's also the federal government plan which includes federal prisons and Members of Congress, of course. OPM allows the VA and federal prisons to negotiate cheaper drugs. When I hear some wing-nut Congressman start screaming about the scary spector of BIG GOVERNMENT I wonder, as Barney Frank asked recently, "what planet are you from? I've had Medicare for a few years now and have had no problems. so, don't worry. Be happy.

Anonymous said...

I'm in the military and you have no clue how bad the VA is. My wife is going through the VA processes now. It is not even close to first rate. It's a nightmare. My Tricare is funded off the backs of business and people that create wealth by producing tangible goods. Tricare has major problems and if all of America had Tricare we would run trillion dollar deficits every year. Government does not produce one single dollar of wealth. I am, as a member of the military as well as any other government funded and or paid person (politicians, public school teachers, municipal services, entitlement programs, etc) or program are in fact a drain on our government and suck the money dry from those who actually make money that is taxed to provide my income and my tricare. So take a course in economics and learn about how the dollar has lost value as we print more money with nothing...nothing to back it up.

Why do you think Social Security will be broke in 2041 and medicare is broke now? How about we fix or eliminate the programs that are in the red first before we create new ones that will be in the red tomorrow too.

Anonymous said...

Correction..replace "government" with Country when I wrote "drain on our government" I meant Country.
Life is beautiful in Italy.


ACZ said...

Having recently returned from my father's bedside as he went from confirmed terminal diagnosis to dead in the matter of three weeks I can offer some thoughts on walking this philosophy.

Dad declined the "palliative chemo" offered was discharged and was able to stay home. That was a plus. For him.

About a week into the simultaneously perilously fast, and achingly slow process of dying he developed a chest infection.

We decided not to call for antibiotics, but it was extraordinarily difficult to watch this relatively minor illness further burden his failing body.

We doubted that decision to do nothing 100 times a day, and clung to it grimly, uncomfortably, as wrong and right as it felt.

The point, I guess, is that it's extraordinarily hard to do. Not so much the decision not to plug in in the first place, or not to call for resuscitation at the end. It's the little stuff, the small steps and setbacks on the way to the end that are hard. Brace yourself is the best I can offer by way of help.


Anonymous said...

Bernie Madoff? Put him in a room with his victims, and we'll see how quickly his 'plug' is pulled!

Walter Briggs