Wednesday, September 2, 2009

Health Care Stories: Denver, CO

Julia confronts the fiction of "death panels" with the real-life story of her aunt's passing.



I was named for my Auntie Julia, and, even as she turned 96, there couldn’t be a person more important to my family. Auntie had been preparing us all for her death since the '90s. To everyone’s surprise she continued to live regardless of the fact that the warranty on her pacemaker was long gone. Auntie laughed it off, took her medicines, and continued to enjoy as much of her life as she could. Always a warning on the phone that this might be the last time she speaks to us. It wasn’t a matter of guilt but a stern reminder of her unending love and a warning to live each day as if it were your last. We laughed it off. I remember telling her that I couldn’t imagine her ever dying, considering she had supposedly been on her last days more than half of my life. To my surprise she said she didn’t want to live forever and was getting a bit impatient to go to heaven.

Finally, one spring day she called my Dad. Julia was in New Mexico with my uncle and wanted to go home to die. She actually said she wanted to get into the state while she was living because it cost too much to transport a dead body across state lines. My great uncle solemnly wished her a good journey and promised he would be following in their RV.

Of course, the truth was that she wanted this to be the last time they saw each other, and Dale wouldn’t start the RV until she had already passed. Dale’s last memory of Julia was of her smiling and waving goodbye before she stepped into the passenger side of my Dad’s truck.

Once at my parents' home, Julia knitted and started on her living will. My father worked hard to insure that every wish of Julia’s was met, and Julia tried her best not to be a burden. She wanted a simple ceremony and wanted to be cremated and buried by my grandfather and her parents. She wanted us to drill a hole in her urn so that she could get out. But most of all, she wanted to die.

She was ready, happy, and almost excited for the new adventure. I remember talking to her for the last time. She laughed and chatted. We talked about how she was going to go, and I told her how much I loved her. On the other side of the phone, tears were in my eyes but Julia laughed joyfully and talked about how she had nearly broken my Dad’s little dog’s leg. Baby the Boston Terrier had leapt into her lap, waking her from a nap which gave her such a fright that poor Baby was sent flying off the chair.

“Now we’re both just a mess, Julia, poor Baby and me!” she exclaimed, voice crackling with laughter.

At hearing her laugh, I wiped my tears and laughed with her for a moment. “I am glad you are doing well, I’m so glad your laughing.”

“Oh Julia, you got to laugh. You just have too.”

My father stewed and fretted over her, trying to make her comfortable and helping her keep down food, even going so far as to sneak a touch of marijuana into the banana nut muffins. But, only two days later, my auntie asked my father for a glass of water and went to lay down in the bedroom. Almost as her head hit the pillow, she slipped into a deep sleep and never opened her eyes again.

If you were to ask my father, he would say that what he did next was the worst mistake he had ever made in his life. He called the hospital. The last days of my auntie's life were spent in a bitter dispute trying to uphold the wishes that she had expressed to my parents--failing only because the wording wasn’t just so and the form wasn’t quite right.

In the end they left Julia on a heart-rate monitor and a oxygen tube; they discontinued her feeding tube. Because nothing specially noted that she didn’t want to be attached to a breathing apparatus, she was forced to starve to death over a period of eight days.

A woman any member of my family would gladly go to jail for experienced a lingering and painful death at the hands of the health care system. As a family, we had to take turns talking each other out of giving her the quick and dignified death she deserved.

Obama has been criticized for admitting the real need of everyone having a right to choose how they will like to die, and under what circumstances they would like to see the end. If your elders are like mine, they know exactly what they want and deserve someone to helpfully smooth over the legal, ethical, and medical processes of them slipping on to the next life. I can only pray that when it comes time for my father to leave this world, there is a system in place that allows him to do so with the dignity and compassion he deserves.


Julia
Denver, CO

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