Monday, August 10, 2009

A Logical End

The current news often guides my conversations with Marty. During the elections, we talked a lot of politics. If the Olympics are big, they dominate, football certainly is something we discuss. We talk about who died, who got married, all the kind of stuff we are inundated with on a day-to-day basis in this era of 24 hour cable news.

Health care and health care reform is certainly a pretty consistent topic of conversation we have. Marty watches the news and follows along with what's happening a lot better than one might think and we try and stay topical in our discussions. Of late, there has been an excess of hyperbole and outright prevarication regarding pending health care reform legislation, in particular  the "kill granny" portion of the bill just out of committee. The hyperbole states that all senior citizens would have to sit through "end of life" counseling every five years; that the government would actually encourage older folks to just go away and die. Of course the reality of the language in the bill is that Medicare would now pay for this essential counseling so physicians and members of a persons family would actually know what a person wants at the end of life. Quite a difference.

This is a conversation I have already had with Marty. This is a conversation I have already had with our Minister, Jimmie Johnson. This is a conversation I have already had with our kids. If you haven't had this conversation with your loved ones, do it, save them some wear and tear so they know how you feel about prolonging your life, let them know whether hanging on to the last bitter end is what you want or what they think you want. It's really not that hard, especially if it's still all really theoretical.

For Marty and I this talk is based more in reality than theory. There have been more than one occasion when people have looked at me and asked, "do you know how she would want to handle this"? "Do you know what Marty's wishes are"? Yeah, I think I do, today. But, that's why I continue to ask what her wishes are.

I always start the conversation with, "Now Marty, I'm not talking about putting you down today, but what do you want me to do if you get a lot sicker?" She always looks at me to make sure I'm really not going to "put her down" today and generally says the same thing, "if I get worse, let me go". She is really pretty clear about it. Again, it's all pretty easy when you are having the theoretical discussion, when it's reality, regardless of what someone else has said, you have to make some decisions that essentially suck big time.

I asked Marty one time if she was afraid of dying. Like many things she paused for a couple of minutes before answering. I asked her again to make sure she was still focused on my question. Marty said no, she wasn't afraid of dying, she said it's just another place and way to be and she was really kind of curious to see the next step. After listening to her, I'm not afraid anymore either. There are a lot worse things than dying. (Does this all sound like a really bad song).

The reality of dealing with her death was really crystallized one afternoon when Marty was in ICU at Providence not long after her second stroke. Jimmie happened to be with me that day. We were all queued up with other visitors to enter the ICU for visiting time but they didn't open the door at the regular time. We waited and waited until they finally met all of us at the door. The nurse met Jimmie and I and she immediately said they were having trouble with Marty's blood pressure, it was very low and they had been trying to stabilize her.

When Jimmie and I got to her room they had her feet elevated and they were pouring fluids in Marty to try and elevate her blood pressure. As I recall it was something like 85/49, really too, too low, or as my good friend Dr. Lauren would say, "swimming around the drain". Marty was pale and barely able to wake. I remember getting my face close to her saying, "don't you dare leave me now, don't you dare." There was a pause, recognition, and Marty said, "I'm not going anywhere". It was surreal, it was like it wasn't really happening, it was like I was watching some lame-ass TV medical show, but I wasn't. I was the one they were asking, "what are her wishes".

All of this is to say, I think I know what Marty wants. I think I know how I will want to handle the inevitable. The question remains will I be able to do what Marty wants and not what I feel, which is to hang on tight and tell her not to go anywhere right now. If Marty doesn't bury me first I think I will be able to do what she wants mostly because I know she is not afraid of the logical ending.

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