Finding Truth: We Have the Tools
Mon, September 14, 2009 at 02:34PM
Cynthia Holladay in Principles, healthcare, responsibility, truth

Like many fellow citizens, I'm finding it increasingly difficult to follow a rational and substantial conversation about our nation's healthcare future. Instead of thoughtful arguments, we hear accusations. Instead of taking responsibility, we take sides. It's hard to stay centered on what's real and what we truly stand for.

I don't have a silver bullet -- only two items to share that may make a difference for you too.

Do not believe in anything simply because you have heard it. Do not believe in traditions because they have been handed down for many generations. Do not believe in anything because it is spoken and rumored by many. Do not believe in anything simply because it is found written in your religious books. Do not believe in anything merely on the authority of your teachers or elders. But after observation and analysis, when you find that anything agrees with reason, and is conducive to the good and benefit of one and all, then accept it and live to it."

--The Buddha, in the Kalama Sutta

Number One: Before relying on any talk news station, video, politician, relative or friend, search your own heart and mind in silence. Get away from your usual setting if possible. Don't think about what others have told you or what you are afraid will happen. Focus only on the facts that you know directly, your own experience of what happened -- not an interpretation of history or a prediction of a future.

Decide what you stand for, what you care about right now, that applies in any situation -- not just healthcare. Then remember and rely on your own truth and logic when investigating issues and speaking about them with others.

Number Two: A friend and colleague shared a heartfelt personal story with me this weekend that is her truth. The depth of her message moved me to share it with you...

Death Panels? I don't think so.

My 87-year old, tough-as-nails father passed away this year. Dad -- a World War II vet of General Patton’s army -- was renowned for this toughness, most notably in the end, for the fierce battle he waged to stay alive. His grandchildren called him Grandpa Bull; he deserved the accolade.

He fought for his life harder and more courageously than I thought possible. Racked by multiple illnesses (congestive heart failure, diabetes, crippling arthritis, diverticulitis, prostate problems and more) that progressively took more out of him, he soldiered on.

Up until the year before he died, you could see him out early walking with his four-legged walker before the Tucson sun got too hot. Walking for him meant willing himself to go a little farther, a few more steps. It was painful for him to do; it was painful for me to watch.

If you asked Dad why he did it, he would look incredulous and tell you that he had to, the alternative was worse. The alternative was to give up on life.

His pain was constant, his quality of life marginalized, his parents, siblings and peers all gone. He knew he was on borrowed time. He would come back in from those walks exhausted, sweat dripping off him from exertion and pain. Bill Smith was still fighting for life.

So why am I writing this? What’s so unusual about a willful, proud, 87 year-old WW II vet hanging on to his life? Well, this one was MY willful and proud father, who knew when it was time to stop fighting and to reclaim the dignities and joys still left in his life.

At midnight, roughly 6 months after his passing, I finally understood that he still has a fight in him -- a fight to make sure that the dignity and guidance accorded to him as he closed his life are available to every person living in the great country he fought for so long ago. That’s why I am telling his story.

In the year leading up to his death, he was in and out of the hospital so many times that I lost count. Most of the time he was in Intensive Care; several times we thought he would not make it. He fought on.

Finally, after too many stays in Intensive Care, with tubes coming out of every part of his body, unable to move or do anything himself, utterly miserable and in pain despite all being done for him, he told us he wanted to go home -- and stay there.

For those of you who have walked this path before me, you know that this is often not as easy as it seems. It is not simple. You are bombarded by information (often contradictory), options (too complicated to fathom), uncertainty (in everything you need to know), and decisions (with life and death implications). During all of this, you are pretty much exhausted and numb.

There were so many things going on during Dad’s last visit to Intensive Care. We wanted to know if the trajectory he was on could be changed. We needed to know what his options for care at home were. Inevitably, we needed to know the financial implications of the options presented.

We wanted to get our facts straight and find a way to present them clearly, with care, to our father. It wasn’t even obvious that he would survive our quest for information and support; Dad was in really bad shape.

The point of this? We got help. Doctors confirmed that Dad was very near the end of his life and there was no way around that. Medical Staff and Social Services worked with us to lay out all the possibilities and logistics.

Finally, with sufficient information and Dad improving enough for the most difficult conversation of our lives with him, we asked Dad if he was ready to speak with the doctor.

I will never forget that day as long as I live. My home is in the San Francisco area and I had returned there. My brothers arranged for the doctor to speak to Dad with them and our mother present. I joined by phone.

Far from a Death Panel -- these fine, caring, and informed professionals formed a team of support that represented the healthcare community at its finest. They represented a beacon of dignity and compassion that enabled Dad to control his life with pride.

Dad was discharged to home hospice care (mostly provided by Mom) that day. Completely bed-ridden, Dad lived for four more months. He exercised every day in his bed, fighting for more time.

He passed away while my sister and I were visiting -- without a hint that his death was imminent. His four children were there; I think he finally knew he could stop fighting. He knew we would be there for Mom. His last day was full of laughter and love; he passed quietly in his sleep, in a bed next to the love of his life.

I know my father would want you to know that the simple dignity that he was accorded should be a given for every person in this country. Dad was a retired government employee with great health insurance. He was lucky. Every American should have the same benefit. My father fought for this country. Now it’s our turn to fight.

Celeste Smith Bishop. [Email Celeste]

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