This is the fifth in a series of eleven articles to educate and prepare ahead of time for loved ones or self for the end of life - It is intended to bring awareness to the possible scenarios and encouragement to make plans ahead of time to avoid the stress and emotional discomfort and possible inability to make those better decisions - Comments are welcomed and will be available for viewing upon approval
A better approach is to focus on the desired outcome. If you are ill, what type of lifestyle is acceptable to you? Talking about “how we want to be” instead of “what we want to have happen” allows the family and health care providers to decide on the appropriate treatments.
Doctors Do Die Differently - How We Make Certain By Carolyn McClanahan
I explain why doctors choose to die a different death than non-medical people. The next four articles are what to do so you can plan for a more peaceful end of life too.
Recently, there was a great post by Dr. Ken Murray titled, “Why Doctors Die Differently.” Dr. Murray eloquently discusses the decisions physicians make for themselves at the end of life, and our hesitation in bestowing “our views on the vulnerable.” He ends with a story of his non-physician cousin choosing the non-aggressive path after a cancer diagnosis, illustrating that more people can make this choice.
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In the Twittersphere, there has been much discussion about this article. Matthew Herper, a wonderful journalist for Forbes and a man who likes his data, has stated, “I still want to see real data on whether doctors actually do die differently than everybody else.” The original post by Dr. Murray didn’t have reference to data, although the subsequent article in the WSJ did cite that physicians are more likely to have advance directives.
To do a study on whether physicians die differently wouldn’t be controlled, pass an ethics committee, or it would be picketed by the “No, you can’t go peacefully in the night” coalition. However, I can provide a small, informal study of the clients in my financial planning practice, most of whom are physicians. In my practice, not only do doctors plan to die differently, their families die differently also.
One requirement of becoming a client in our practice is the desire to address all parts of a financial life plan, which includes end of life planning. Age, marital status, fear of death, or body habitus does not matter – we all die, and our firm helps people prepare for that event in advance in a kind and loving way.
When discussing health care directives, most people focus on the actions that occur at the end of life and not the desired outcome. For example, “Do you want to be hooked to life support?” My favorite – “Do you want CPR, which for the most part doesn’t work at the end of life, will crush the bones in your chest, and when all is said and done will be just another charge on the “superbill” the hospital sends to the insurance company after your death?”
A better approach is to focus on the desired outcome. If you are ill, what type of lifestyle is acceptable to you? I had one client who said, “As long as I can use my brain, even if I can’t move, I want to be kept going.”
To translate this into medical terms, she was okay being a quadriplegic, but wouldn’t want to be kept alive if she was in a persistent vegetative state. Talking about “how we want to be” instead of “what we want to have happen” allows the family and health care providers to decide on the appropriate treatments.
Regular readers of this blog know my Golden Rule – If the doctors say I will never be able to wipe my own rear-end again, then unhook everything quickly, and hasten my journey if possible.
To translate this into medical terms, I would not want to live as a quadriplegic or be kept around if my brain would never have the ability again to write this column. If this happens, don’t put me on any kind of support. Stick two dozen large Fentanyl patches on my body, and be sure to pull them off right after I die before the hospice nurse comes to clean up so no one gets in trouble.
After my non-physician father had surgery for a newly diagnosed lung cancer, he was told they couldn’t remove it all, and that he needed chemotherapy and radiation. Having been through the death of my mother from cancer the year before his diagnosis, and knowing the odds of his prognosis, he decided against further treatment. His doctors were indignant about his decision and said, “You’ll be dead in six months.”
He had many reasons for not undergoing treatment – the poor prognosis, the torture of the treatment, and he missed my mom. And there was one thing he said to me I found most incredible, “I brought this on myself. Why should everyone else have to pay for this?”
What happened after he turned down treatment? He lived a pretty decent three more years and hospice was a blessing at the end. That might not have happened if his doctor daughter hadn’t explained the true prognosis and stood up for him against his aggressive doctors.
We all need to make the right decision for ourselves, revisit it periodically because our desires change, and communicate our thoughts well with the ones we love. If this conversation is a regular part of our lives, we will more richly appreciate “now” and be better prepared for the inevitable “later.”
As for the data Matthew desires – About one quarter of our clients choose me as their health care surrogate or the back up to their spouse. All clients have documented their wishes. We’ve made a pact that I will carry out their desires and stay within the letter of the law. We should all have loved ones in our life who will do the same.
Questions, comments, feedback you can reach me on Twitter @CarolynMcC or at Carolyn.firstname.lastname@example.org.
_We added a Wise Words page to our blog in hopes of contributing encouragement and inspiration during positive happy times as well as emotionally hard times --
Frustration - anxiety - and disappointment can easily creep in and take over our positive outlook with the waiting of the fruition of this investment and especially if one is experiencing a financial crisis or an emotional trauma --
A strong mental attitude is a great tool when faced with either of these - Wise Words are a great aide in strengthening the mental attitude --
Please take a few minutes to read over the quotes and allow them to sink in so you can ponder on them and be encouraged and strengthened by them --
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