Going Gentle Into That Good Night

[NoahSD]

I agree with Anacardo.

My grandmother is basically just a living carcass--she barely moves at all, and the only response she gives to anything is really really slow, weak chewing when someone puts food in her mouth. Everyone on her side of the family is an atheist, so we frequently talk about how ridiculous it is to keep her alive, but we don't act on it.

[yad]

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I agree with you that it's up to her. The idea I guess I'm objecting to is that we're all "supposed" to die at a certain point. Nana may not be contributing to the GDP, but I don't think that makes her life less valuable.

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Of course her life has value. But that's not the question. There is only so much money that society can afford to devote to health care. The question is: Would it be better to divert those resources away from your Nana and towards some uninsured 25-year old who just got diagnosed with a treatable form of cancer? Or should we spend them to give your grandmother another year of life, while leaving the 25-year old to die untreated?

Obviously if you answer yes, there are pretty huge practical issues that would be involved in implementing such a shift, and it's not going to happen anytime soon in this country. But I think most people would still say the answer is yes.

[ChicagoTroy]

There is all sorts of end of life care that is designed not to extend life, but to minimize discomfort during someone's last weeks/months. Regardless of whether she "should be dying," there is medical care that it makes perfect sense to be providing.

[MrWookie]

LFS,

Are you advocating Nana get traditional cancer treatments like chemo, surgery and radiation (potentially non-traditional ones, too), or are you just trying to get her some treatment for some of her symptoms (pain, etc.) on her way to passing? If it's the latter, I think this is how I would deal with the situation, and I support you. I also don't see why Cardo disagrees. If it's the former, it seems like the length of life added (if any, and you might even reduce it) is not worth the additional pain you add at this point.

[Anacardo]

If it's the latter, I don't disagree at all.

[donkeylove]

Having had cancer twice, I can say with certainty, that I would never try to prolong my life at 65, let alone 90. At 28 and 31 I had a big upside to fight on. What's the goal at 90? A few more years of what is already, at best, an uncomfortable age. I don't have children or grandchildren, so maybe there is a joy at spending time with them that I don't comprehend, but it still seems pointless. If medical professionals could promise me that right around the corner is a breakthroough to add 30 quality years, then yea,fight it. Otherwise, at 90, I won't rage against the dying of the light. I'll gladly go gentle into that good night.

[7ontheline]

I agree with previous posters that often it's not the old patient who is fighting to extend every last minute of life. It's the (selfish and short-sighted, IMO) family members. This of course is not talking about palliative care, making someone comfortable as they die, or non-heroic measures that can actually lengthen life which still has a good quality. When I worked in a hospital as an intern I saw so many people on ventilators, old people who kept coming in and out of the hospital every month with a new pneumonia or heart problem or whatever, etc. It was unbelievable to me that their families would argue and push to keep these people going. For what? No wonder health care in the U.S. is so expensive. As Arfinn noted, in a socialist system (which I am not really advocating) this isn't a problem because it doesn't make financial sense to spend a ton of money on these really old people. It does them no good anyway, for the most part. It's not like after they get a little better and go back to their nursing home they are all of a sudden happy and leading rich, fulfilling lives. They mostly lay around waiting to get sick again.

[MicroBob]

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I'll gladly go gentle into that good night.

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I just don't see how anybody can know they will feel this way at 90.

[7ontheline]

Microbob,

I haven't really met any of my patients at 90 who didn't feel that way. Not that they were looking forward to death by any means, but 90 is pretty damn old. Even the healthy ones have trouble getting around, are generally on a number of medications, etc. They tend to have a pretty accepting attitude about it. There are of course typical cranky old bastard exceptions, but they tend to die younger anyway.

[donkeylove]

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I'll gladly go gentle into that good night.

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I just don't see how anybody can know they will feel this way at 90.

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I almost felt this way at 30 with a lot of life ahead of me, so I think I'm qualified to say I will feel it at 90. I wasn't talking out of my ass. I have been there with the tubes sticking out of me,nauseous,in tremendous pain,having poisons injected into me to save my life. Hair falling out,avoiding the mirror because you don't even want to see yourself. Your family suffering almost as much as you because they have to watch. I had 8 surgeries before I was 32 and each one takes a little more out of you. The op said pancreatic cancer was the most likely culprit. Have you ever seen that up close and personal? I have and it's no picnic. Thankfully it's usually swift. I can say with certainty I wouldn't want to go through that at 90, and your stupid comment strikes me as most likely made by a 20something who has never been truly sick.

Edit-I just checked out your blog and see your definitely not a 20 something. Still a dumb comment.