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Monday, May 16, 2011

Existential Dilemma

A few weeks ago my mother passed away. She didn't believe in going to the doctor and was adamant on not using medications if she didn't have to. Hell, we joked around about which nursing home she wanted to live in and what would she do after dad dies because statistically men die younger than women and my dad's father died in his mid fifties. She had a long family history of heart disease, multiple cancers, and Type 2 diabetes through several generations.

When her father went through his fight against heart disease and diabetes she watched him go through multiple doctor appointments, surgeries, and medications. He had heart bypasses, arterial plaque removals, and 2 strokes. The strokes left him unable to use the right side of his body without severe difficulty and a lot of physical therapy. He died in his sleep in his mid seventies from a ruptured aneurysm.

Her mother had a long hard fight with COPD that resulted in oxygen use, multiple daily breathing treatments, a ton of medications, a ton of doctor appointments, lung cancer, and eventually an untreatable brain tumor that finally killed her in her early eighties.

My mom died in her sleep from a ruptured aneurysm at the age of 61, peacefully, with eyes closed and no suffering to the great beyond. This leads to my dilemma. For all the good we think we do with surgical intervention, medications, and other therapies are we just making death painful and prolonged? Aren't we all supposed to go peacefully in our sleep instead of kicking and screaming to the very end?

How can I look at people and tell them the statistics and what to expect from treatments when all I want to say is that you will have many more years to suffer before you die a painful death? The healthcare industry is the patron saint of sadism that promises eternal life and wonderous results but only succeeds in torturing those who seek salvation and are willing to pay any price for any small glimmer of hope. It has become what snake oil salesman have preyed upon for years except now we take your money, give you the tonic, and poke you with a stick repeatedly until you finally die. I love modern society!

10 comments:

Anonymous said...

I've felt this way for a long time. 61 seems far too young to die, though, I am sorry for your loss. I feel like a hypocrit most days, because most of the modern drugs in the pharmacy I would never take. Most chronic disease states can be managed or prevented by one simple approach: diet and excercise. Take cholesterol for example. Do we really have hard hard evidence that lowering cholesterol prevents heart attacks? It will lower your "relative risk" of having a heart attack and certainly lower your cholesterol, but will that really prevent heart disease and heart attacks? Its a bit of a gamble, especially in people who have no heart disease, but high cholesterol. Drugs are no substitute for healthy living. I feel like a fool handing pills to people who have lost the desire to even live at times. There is so much despair in the world.

The Redheaded Pharmacist said...

With advances in modern medicine we have the ability to keep people alive for much longer than was ever possible before. But as those advances prolong life they can also prolong suffering as well.
One question that is just starting to be asked within the medical community is that while we are capable of extending life in many circumstances thanks to medicine the moral dilemma becomes the question of SHOULD we extend life if that extension includes severe pain and suffering?
Extending a life filled with pain and suffering raises many moral and philosophical questions that we must address as a society.
Sometimes the most humane thing to do is to simply let someone go. But that fact is difficult for loved ones to accept. The natural tendency is to try and hang on to a loved one for as long as possible even if that means putting that person through additional pain and suffering. I hope I will have the strength to say goodbye when that time comes in the lives of my loved ones and know that they are better off without all of that additional pain and suffering!

Anonymous said...

I'm sorry for your loss.

I really think it comes down to quality of life. If a drug regimen or a medical procedure can buy you a decade or more of life with a really good quality, why not prolong the inevitable? You only live once (unless you believe in reincarnation).
Each person has to weigh the pros and cons though. For your mother, it appears that a drug regimen would have greatly hindered her quality of life. I don't agree with it, but that is apparently how she saw it.

wellillbe said...

My dad went through 2 stem cell transplants before he died. KNow what he gained by going through that? The opportunity to know my daughter and for her to remember him. It may not be financially responsible for the healthcare system, but it was priceless for me to see him sing and play with her...

Frantic Pharmacist said...

My condolences on the loss of your mother. I know what you mean, I sometimes look at our pharmacy customers who are struggling with so many chronic conditions and wonder how they find the strength to go on. I don't know how well I would cope in the same situation. When do you say 'no more'? I guess we are all programmed to always look for that glimmer of hope -- this medication will finally be 'the one' or this surgery will finally fix everything and I'll feel better and have a 'normal' life. I hate to see anyone in a long, drawn out struggle. The best strategy I guess (if you're lucky enough to know your family history) is prevention, prevention, prevention --- starting in childhood if necessary. But yes, we pharmacists are right in there with the false hope mill sometimes...

Anonymous said...

I am so sorry for your loss. Regardless of how one passes away, it still leaves a huge void in your life.

Emlyan said...

It needs to be up to the patients....but I think the doctors need to be more upfront with expected prognosis. A friend with colon cancer was going to die, and her doctors were still offering her experimental treatments, surgery (which had been done before and not effective), chemo (which had been done before and not effective. Finally it was her who said enough. She missed her daughter's prom, her son's graduation from booth camp and god knows however many precious memories. Very sad - but sadder was watching her face alternate between pain and a morphine haze. It's not about the people that will be left behind, it's about the person suffering.

Humans die. Modern medicine, I think, has made us think that 10% chance an extra month or year outweighs the 100% chance of pain and suffering. Education is the key...

Anonymous said...

Well hell there is no good response for this post. A few years back my grandmother was in ICU on her deathbed, I gave the authorization to “pull the plug” she actually got well enough to go home, the first thing she did when she got home was revoke my power of attorney for her medical care, a few weeks latter she died in ICU on a ventilator. Moral of the story, none really, just thought I would share.

Anonymous said...

When my wife was told she had brain tumors she said she did not want to spend the rest of her days in a chemo chair. Then they said without whole brain radiation she would lose the ability to walk. So she had the radiation and the chemo. She lived for four more months like a zombie. I would hope I would not put myself through such an ordeal. But at the end I may think differently...

minimedic said...

Anon on 5/19 at 8:50-My husband's grandmother was diagnosed with a brain tumor last fall after a series of bizzare behaviors.

My sister-in-law (she's either a 2 or 3rd year med student, I can never remember) advised her 80-something, already frail grandmother to undergo radiation therapy.

She was placed in a nursing home, and never went home again. I saw her a few days before she died. I don't think my husband could have handled it, as I was once again reminded how ugly the proccess of death can be.