Wednesday, June 29, 2011

WHAT'S TO BE DONE (OR NOT DONE)?

A friend has been visiting his mother in a hospital ICU. She's old and frail and may well be dying.

He wrote this to me:

I was thinking of your blog yesterday as I sat in her room waiting. A load of technology--wires, tubes, machines--being applied to her body by a pack of mortals. Not one magician or demigod in the crowd. Staff tripping over tubes as they add yet another medication and IV pump. Apply another mask and sticky crap to her beautiful face. Piles of discarded supplies. Top down control, nurses know what to do but can't until they obtain an "order" which requires tracking down the overloaded doctor.

It all feels so bumbling. Not that I see the people as incompetent. On the contrary, I experience them as skilled and caring. The bumbling and fumbling comes from trying to fix something that may not be "fixable." Maybe I just don't get it. It's painful to watch Mom suffer. It's hard not knowing where it ends or where it goes to next. 

So he's suffering, too. If he asked for advice, what would you say?

3 comments:

  1. I'd tell him get your mom ready for hospice and then tell him what John Prine would tell him...to take your mom and:

    Blow up your T.V. throw away your paper
    Go to the country, build you a home
    Plant a little garden, eat a lot of peaches
    Try an find Jesus on your own

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  2. Not sure. But this is useful for me: "The bumbling and fumbling comes from trying to fix something that may not be "fixable.""

    That's a profound insight in a medical system that focuses on fixing. System not so good at simply allowing humans to flourish. We're expected to do that on our own, outside of the hospital. That all makes a lot of sense when you are a teenager just coming in to set a broken arm. But sometimes, especially at the end of life, it seems like the focus on fixing may come into direct conflict with human flourishing.

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  3. Mom passed away peacefully after electing to discontinue treatment.


    Mom had thought about her end of life. She had discussed it with her children and left written instructions. I was surprised and pleased at how fully the hospital team accepted and suppported her decision to end treatment and let go. There was excellent communication from the doctor, making sure that he understood what was being asked and that Mom understood what she may experience.


    The staff made it as comfortable as possible (in an ICU) for her family to sit with her round the clock. They brought us food and blankets. I was deeply moved by some things said by the nurses. Not platitudes, but personal experiences and feelings.

    With the ventilator tube removed, Mom's final pleasure was to sit up and eat a few bytes of peach yogurt.

    I was happy for my Mother and me that a hospital that fights to keep people alive can also embrace a natural death when the time comes.

    So we moved from the science of life saving intervention to the ancient humanity of sitting vigil with a dying loved one.

    My experience was that something is right in the hospital we were in. There was no problem transitioning from the bumbling intervention -- we've only been doing that for a hundred years or so -- to the ancient practice of comforting and witnessing the dying, something we've done for milleniumn.

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