The worst has not begun and today, I found it hard to go on.

[samhexum]

Most upsetting about the virus for me, beyond the ugliness of its symptoms, is the speed with which it takes its victims from mild discomfort to death. There must be many thousands of victims who have passed without having had the opportunity to make their final arrangements.

 

That's why I've actually considered chucking all my porn & toys so my sister doesn't have to feel uncomfortable when cleaning out my place. I won't have the time or energy to do it if I get sick. I'd barely have the energy now.

 

And it's such a lonely death, since loved ones can't visit.

[+ sync]

That's why I've actually considered chucking all my porn & toys so my sister doesn't have to feel uncomfortable when cleaning out my place. I won't have the time or energy to do it if I get sick. I'd barely have the energy now.

 

And it's such a lonely death, since loved ones can't visit.

I'm having similar thoughts. If I develop symptoms so severe that hospitalization becomes a consideration, I'll try my best to wipe my computer.

[+ sniper]

It's occurred to me that I live alone and don't think my siblings would be totally sure where to look for my accounts and stuff. I should probably put that together.

[+ pdxleo]

It's occurred to me that I live alone and don't think my siblings would be totally sure where to look for my accounts and stuff. I should probably put that together.

 

Three deaths of friends and family in the last year has pushed me to get my financial and legal affairs in order, but COVID has prodded me further, to get my personal effects into a state where no one cleaning up after me must deal with , ahem, unsavory, items. My move last fall into the condo, after Therese's death, brought about the disposal of much of my old porn stash, along with 35 years of National Geographic. Last month, I sold off what was left to OldMags, raising some cash from the hundreds of copies of Handjobs that I kept. Next to go is the last old DVDs, and when Powell's Books reopens, the remainder of the John Patrick anthologies go off to be sold. Whoever has to clean up wafter me, I don't wan to embarrass them.

[+ bigjoey]

When I downsized three years ago, I had a library of thousands of books. I kept a few but did not have room in my new home for all of them.

 

To my surprise, the University of Missouri at Kansas City took all of the gay themed books and magazines. They were especially interested in those old weekly Publications where there were mostly gay bar ads (and personals). I had some books that were long out of print and they especially liked receiving those. The books that they already had multiple copies were given to be placed in the gay student lounge and in a home shelter for gay youth.

 

I was happy they found new homes.

 

(I had already trashed my video collection but they told me they would have taken those as well?).

 

Bottom line: if anyone is downsizing or getting rid of old porn magazines, books, etc, if your library has a gay collection, contact them.

[+ sam.fitzpatrick]

That's why I've actually considered chucking all my porn & toys so my sister doesn't have to feel uncomfortable when cleaning out my place.

 

I've had a long-standing agreement with a friend that if I have a long hospital stay where my survival is in question, he will come to my condo and clean this stuff out so that my family does not need to do so.

[liubit]

I got rid of all my porn VHS quite some time ago, of my DVDs a couple of years ago, and I now have everything in a bunch of MP4 files stashed in my Dropbox. My partner knows and can do with them whatever he deems fit. In case he dies before me, I will have to make other arrangements. ?

[+ Charlie]

A month ago, I made a list with phone numbers and email addresses of everyone I thought should be notified if my spouse and/or I were to die during the pandemic, because I realized there is no one individual who would know all those on the list. I also wrote up obituaries for both of us, in the hope that there will still be newspapers left to publish them.

[+ purplekow]

Well today was back to the grind. Very surprisingly, I had ten new patients in the hospital and none of them are Covid patients. Two were tested and were negative and the rest came in for other reasons. It felt strange to see patients without all the gear and it took a bit of getting accustomed.

I had mentioned that on Saturday, one of my patients in the ICU was being weaned from the ventilator after 30+ days. It was by no means certain that it would work. 37 years old and healthy when he came into the hospital, he has been through every treatment and every kind of manipulation. His body has been wreaked by the virus and yet he is hanging on, He is still CoVid positive. He has a step blood infection, he has failed weaning in the past, he had been in a medical induced coma for a month. But his respiratory status had improved again after the last failed attempt to wean him. His kidneys and liver were still intact. He did not appear to have any heart damage. So early Saturday afternoon, they disconnected him from the respirator. He was getting supplemental oxygen by high flow through the endotracheal tube and once he was connected, there was nothing to do but wait. Either he would fatigue and need to be placed back on the ventilator, or he would be able to sustain his own respirations.

 

This is usually a very tense time in patient care, but in a patient who had been on a ventilator for as long as this patient, this was a critical time. The drugs from the medically induced coma will need to be stopped if he can breath and only then will we start to learn if he will have a return of mental functioning. The tube has been in place for thirty days and he will need to be tested to see if he can swallow and talk and if he is able to control his oral secretions. His musculature has been ravaged by inactivity and the process to return to even minimal functioning will take weeks of work. All that lies ahead if, and it is a big if, he can breath on his own.

 

This morning I encountered the ICU specialist who has been caring for this patient. I congratulated him on having successfully gotten the patient off the ventilator, off the high flow oxygen and onto a simple nasal cannula. I said that he must feel that his efforts of the last month had paid off. He said that it was just his job and it was nothing special.

 

Then he turned to me and said that every day for the last month he had gone in and greeted this patient, as he does with all his patients no matter their level of functioning, with a good morning or a good evening. This morning, two days after the tube came out, one day after it was clear that he could swallow again and hours after his oxygen was lowered to a simple nasal cannula, he told me he went in and said good morning and the patient hoarsely said good morning back.

 

With that his voice broke and he turned and walked away. I think he may have been lying about it just being his job and nothing special. Intensivists deal with the sickest patients in the hospital and many of their patients do not do well. They are trained to keep an even demeanor. Successes cannot get you too high because failure is certain to follow and the fall from heights to depths can be too much even for these experienced doctors. But once and again, the words say one thing and the crack in the voice says another. Later in the day I read this doctors note. It read something to the effect of: He is alive. He said good morning when asked. No other history was available. The first three words of that note were totally out of character and they were as much of celebration as his doctor would allow himself to have. My guess is that he did not even sing along with Fight Song when it played over the loud speaker in response to the disconnection of this patient from the ventilator.

 

This afternoon, the nursing staff washed and combed his hair, shaved his beard, changed the sheets and sat him up in a chair. They called his wife and for the first time in a month, she saw him up and alert and responsive to her tears. The nurses told me that he strained tightly to say: Honey Don't Cry. I am Ok. He did not say anything else, but really what else was there to say?

Edited May 4, 2020 by purplekow

[+ FreshFluff]

A month ago, I made a list with phone numbers and email addresses of everyone I thought should be notified if my spouse and/or I were to die during the pandemic, because I realized there is no one individual who would know all those on the list. I also wrote up obituaries for both of us, in the hope that there will still be newspapers left to publish them.

 

Charlie, I've noticed that you handle these things with remarkable equanimity.

[+ Charlie]

Charlie, I've noticed that you handle these things with remarkable equanimity.

I have always been an admirer of Marcus Aurelius.

[+ purplekow]

I have always been an admirer of Marcus Aurelius.

I always liked his movies, especially Roamn Holiday with Andy Hepburn.

[+ purplekow]

Today was an interesting day. Spent an hour on the golf course this morning. Wait, a doctor on a golf course, its unheard of, well on a Tuesday anyway. Wednesday is usually doctor gold day. I was on my way to work and I have been taking slightly different routes than I usually would because the traffic is light, some routes are more scenic and due to the decrease in cars, the trip is not any longer. Well this morning, I took a new route and about half way there there were workers doing tree trimming and the road was closed with a detour marked. Now they do seem to be doing a lot of road work here, which is probably a good idea. It keeps people working and it is not as inconvenient as when the traffic is usual. Well I took the detour and it went through a golf course. This was only about 8 minutes from my house and I never knew there was a golf course there. It was a nice day, I had the oldies station on and was singing along and just relaxing and trying to have a bit o peace on the way to work. The phone rang and I briefly looked to press the dashboard to answer the phone call and in that moment, I now know, I missed the sign that indicated that a turn was needed to continue the detour. So oblivious, I continued to drive. It seemed like an unusually remote detour and I realized that I was probably off course. There were people walking, but when I pulled up to ask how to get out, the response was basically a shrug and a sorry. I continued driving. I made a turn that I thought was about to take me back but it just didn't. 45 minutes later, I happened upon the detour sign and followed it and eventually wound up just where I had started. So my usually 20 minute ride to work took more than one hour and 15 minutes. It was a welcome break. Usually I would have been cursing or at least anxiety ridden about being late, but this seemed like a well deserved respite. I suppose I could have used Google maps, but that would presume I know how to use Google maps, which I only kind of do.

My resident team did not seem disturbed by my absence, Today was a changeover day and so I had a new group and they took the time to catch up on the 10 or so patients we had. We had a lull in CoVid cases so all of our patients were either CoVid negative or Covid suspect with a low level of suspicious. One still needed to dress up in medical battle gear but the sense of foreboding is a bit less when the suspect is low risk. I do try to be fastidious about the technique of approaching these patients. Gown. Mask. Overmask. Face Shield. Gloves. Double Gloves. I t is routine but there is usually some glitch. My glasses fall of or the mask string breaks or I pull too hard and the neck of the gown opens up. It is usually more annoying than it is serious but one cannot be cavalier when gearing for battle.

Today was kind of a coast day. The patient's got slowly better with little assistance from us. The notes got written and the needed conversations were held. I got a nice thank you from an older woman who is slowly improving from her breast cancer and the pneumonia the cancerous spread to the lungs had caused. She is still very sick for the long run but in the short run she is much more comfortable and she should go home in a day or two.

So a mundane day. These are rare these days and though I have only golfed rarely, I enjoyed telling my patients that I was late getting to see them because I was out on the golf course. Most of them were actually happy for me, though I did correct the misdirection I gave them. Those course corrections went a lot more smoothly than my ride to work corrections did.

Hope all of you had a nice day on the course, whatever course you are taking these days

[+ Charlie]

The highway construction workers here in CA all seem to be out doing projects, because the traffic on the freeways is so light that it is a good time to do it. Snowbird neighbors of mine here in Palm Springs decided to return to their home in Seattle a couple of weeks ago, and they said the emptiness on Interstate 5 through CA and OR was eerie--they saw more construction workers than travelers.

[instudiocity]

The highway construction workers here in CA all seem to be out doing projects, because the traffic on the freeways is so light that it is a good time to do it. Snowbird neighbors of mine here in Palm Springs decided to return to their home in Seattle a couple of weeks ago, and they said the emptiness on Interstate 5 through CA and OR was eerie--they saw more construction workers than travelers.

And twice the usual number of 100 mph+ speeders, apparently.

[+ honcho]

The highway construction workers here in CA all seem to be out doing projects, because the traffic on the freeways is so light that it is a good time to do it. Snowbird neighbors of mine here in Palm Springs decided to return to their home in Seattle a couple of weeks ago, and they said the emptiness on Interstate 5 through CA and OR was eerie--they saw more construction workers than travelers.

 

The California highway construction and maintnence agency (CALTRANS) decided to move up a replacement of bridges in the interchnage between US101 and I280 in San Francisco, knowing that traffic was going to be light. It had originally been scheduled

for July, but working night and day, they did the underpining work in a couple of weeks, and then did replaceced the decks in about a week with further surface work ending this coming saturday.

[+ purplekow]

I am ready for a break from patient care. Since mid January I have been doing clinical round. I see patients every day. I admit patients every other day. I am on call every other evening. And over the four months I have had one 6 day break. When I finish this week, I have two weeks where I will be doing some of the other aspects of my job. Mine is an academic position and in July we start with a new group of interns with the other years moving up to more repsonsible positions. With the CoVid drain on the hospital, most of the educational component has been restructured or abandoned. Lectures have been moved to on line conferences. Small group mento sessions have centered on CoVid and keeping the residents up to date on the ever changing policies and plans.

July first will bring a new group in, maybe.

Many of our incoming interns are foreign nationals. Many of them have a J1 visa, which is basically a work visa. CoVid spurred changes in immigration as well as government work changes has made getting these visas much more problematic. So far, only 3 of the 13 interns have managed to get their papers in order. The residents who are staying on also need to update their paperwork and several of them have been caught up in red tape. It is conceivable that we will be down as many as 10 or 36 doctors in the program. Add to that the inexperience and CoVid may be even more problematic to handle come the summer.

My responsibilities will change from clinical to educational and administrative. Usually I find this aspect of the job tedious at best and torturous at its worse. Now, I am looking forward to the work because it gives me a physical and emotional break from the patient care. It also allows me to try to structure a program that will insure that those patient get an excellent standard of care, even with manpower shortages and inexperienced doctors. It seems this part of the job may be more important than ever.

Meanwhile, I am still working with patients and I have managed to send a few people home, CoVid and regular patients both.

Last week I had five patients on ventilators in the ICU under the care of the intensivists. Now there are three, The 37 year old was officially transferred today and while physically he is doing about as well as can be expected, he has suffered some setbacks. Attempts to feed him failed. Usually failure of this type is related to difficulty swallowing water an endotracheal tube has been in place for a long time, injuring the structures that allow for swallowing. The patient underwent a swallow test (get your mind out of the gutter) and he passed. However, once he was fed, his gut did not handle the food. He has been receiving nutrition by vein and now, his system is not up to handling the intake. He will have to be slowly readjusted to eating. He has been up to the hair but he remains weak and unable to stand. His mental functioning which seemed to be at the level expected when the tub was first removed, has not improved that much. There are several possible reasons for that and right now it is unclear if or when he will start to be more of the person he was before all this. So, after a hard fought victory, the battle to return this man to himself goes on.

Unfortunately, the battle for another one of my patients does not go on. The landscaper who came in looking like the picture of health with a mild flu and quickly went downhill has died. After 28 days of intensive care, there were no more tricks in our armamentarium. His blood pressure stopped responding to strong medications given to allow his limited oxygen to get to the organs. His lungs transferred less and less oxygen. His kidneys failed. Ultimately, there was no more to be done except the phone call to his anxious family. His. wife, 3000 miles away screamed out when I told her. I am still not sure if I heard the scream through the phone or across the continent. It was a deeply pained scream that oscillated and reverberated and ultimately faded off into the universe to haunt other planets and other solar systems. Most times when I have told families of the passing of a loved one, there is a gasp and then a muffled cry and then a turn away to sob as privately as possible. Usually they have stopped hearing anything said after the opening "I am sorry to tell you..." So while it may seem dispassionate or cold to basically say "I am sorry your relative has died. My condolences on your loss" and then nothing more. Experience has told me that any explanations will go unremembered. Any information will not be retained. The pain overtakes every aspect of the brain and the kind thing to do is to allow the survivors time to regroup. Usually I tell them I will be back and then go off. Frequently when I return they are surprised to see me as they did not recall that I had told them I was coming back.

Then there are the cases where the pain is so intense or the shock is so severe that a scream is emitted that seems to take every molecule in the persons body and transfigure it into sound and then reach a pitch so intense that it causes anyone in the area to have a skipping of their heart beat and a temporary sensation of their own lives in empathy. The scream that the gardener's wife let out was a difficult to hear and absorb as it must have been for her to hear the news of his passing.

Tomorrow, I will be seeing the patients who were admitted during the evening and night and I will hope that I never have to hear that scream from one of their loved ones.

[+ honcho]

I am ready for a break from patient care. Since mid January I have been doing clinical round. I see patients every day. I admit patients every other day. I am on call every other evening. And over the four months I have had one 6 day break. When I finish this week, I have two weeks where I will be doing some of the other aspects of my job. Mine is an academic position and in July we start with a new group of interns with the other years moving up to more repsonsible positions ....

 

(concerning the lost of a patient ...)]His. wife, 3000 miles away screamed out when I told her. I am still not sure if I heard the scream through the phone or across the continent. It was a deeply pained scream that oscillated and reverberated and ultimately faded off into the universe to haunt other planets and other solar systems... there are the cases where the pain is so intense or the shock is so severe that a scream is emitted that seems to take every molecule in the persons body and transfigure it into sound and then reach a pitch so intense that it causes anyone in the area to have a skipping of their heart beat and a temporary sensation of their own lives in empathy. The scream that the gardener's wife let out was a difficult to hear and absorb as it must have been for her to hear the news of his passing.

 

Tomorrow, I will be seeing the patients who were admitted during the evening and night and I will hope that I never have to hear that scream from one of their loved ones.

 

It just isn't possible to merely respond to an account like this with a simple emoticon, and it even seems overly facile to say "I deeply thank you for your most needed and difficult services", but it's true and I wish I could do more.

 

Keith.

[CuriousByNature]

I am ready for a break from patient care. Since mid January I have been doing clinical round. I see patients every day. I admit patients every other day. I am on call every other evening. And over the four months I have had one 6 day break. When I finish this week, I have two weeks where I will be doing some of the other aspects of my job. Mine is an academic position and in July we start with a new group of interns with the other years moving up to more repsonsible positions. With the CoVid drain on the hospital, most of the educational component has been restructured or abandoned. Lectures have been moved to on line conferences. Small group mento sessions have centered on CoVid and keeping the residents up to date on the ever changing policies and plans.

July first will bring a new group in, maybe.

Many of our incoming interns are foreign nationals. Many of them have a J1 visa, which is basically a work visa. CoVid spurred changes in immigration as well as government work changes has made getting these visas much more problematic. So far, only 3 of the 13 interns have managed to get their papers in order. The residents who are staying on also need to update their paperwork and several of them have been caught up in red tape. It is conceivable that we will be down as many as 10 or 36 doctors in the program. Add to that the inexperience and CoVid may be even more problematic to handle come the summer.

My responsibilities will change from clinical to educational and administrative. Usually I find this aspect of the job tedious at best and torturous at its worse. Now, I am looking forward to the work because it gives me a physical and emotional break from the patient care. It also allows me to try to structure a program that will insure that those patient get an excellent standard of care, even with manpower shortages and inexperienced doctors. It seems this part of the job may be more important than ever.

Meanwhile, I am still working with patients and I have managed to send a few people home, CoVid and regular patients both.

Last week I had five patients on ventilators in the ICU under the care of the intensivists. Now there are three, The 37 year old was officially transferred today and while physically he is doing about as well as can be expected, he has suffered some setbacks. Attempts to feed him failed. Usually failure of this type is related to difficulty swallowing water an endotracheal tube has been in place for a long time, injuring the structures that allow for swallowing. The patient underwent a swallow test (get your mind out of the gutter) and he passed. However, once he was fed, his gut did not handle the food. He has been receiving nutrition by vein and now, his system is not up to handling the intake. He will have to be slowly readjusted to eating. He has been up to the hair but he remains weak and unable to stand. His mental functioning which seemed to be at the level expected when the tub was first removed, has not improved that much. There are several possible reasons for that and right now it is unclear if or when he will start to be more of the person he was before all this. So, after a hard fought victory, the battle to return this man to himself goes on.

Unfortunately, the battle for another one of my patients does not go on. The landscaper who came in looking like the picture of health with a mild flu and quickly went downhill has died. After 28 days of intensive care, there were no more tricks in our armamentarium. His blood pressure stopped responding to strong medications given to allow his limited oxygen to get to the organs. His lungs transferred less and less oxygen. His kidneys failed. Ultimately, there was no more to be done except the phone call to his anxious family. His. wife, 3000 miles away screamed out when I told her. I am still not sure if I heard the scream through the phone or across the continent. It was a deeply pained scream that oscillated and reverberated and ultimately faded off into the universe to haunt other planets and other solar systems. Most times when I have told families of the passing of a loved one, there is a gasp and then a muffled cry and then a turn away to sob as privately as possible. Usually they have stopped hearing anything said after the opening "I am sorry to tell you..." So while it may seem dispassionate or cold to basically say "I am sorry your relative has died. My condolences on your loss" and then nothing more. Experience has told me that any explanations will go unremembered. Any information will not be retained. The pain overtakes every aspect of the brain and the kind thing to do is to allow the survivors time to regroup. Usually I tell them I will be back and then go off. Frequently when I return they are surprised to see me as they did not recall that I had told them I was coming back.

Then there are the cases where the pain is so intense or the shock is so severe that a scream is emitted that seems to take every molecule in the persons body and transfigure it into sound and then reach a pitch so intense that it causes anyone in the area to have a skipping of their heart beat and a temporary sensation of their own lives in empathy. The scream that the gardener's wife let out was a difficult to hear and absorb as it must have been for her to hear the news of his passing.

Tomorrow, I will be seeing the patients who were admitted during the evening and night and I will hope that I never have to hear that scream from one of their loved ones.

I'm really sorry to hear that the landscaper did not make it - it is never easy breaking news like that in person, let alone by phone. Thank you, as always, for keeping us posted.

[+ purplekow]

Thanks to all of you for your support and kind comments. On a day such as today, it is particularly difficult to keep a positive outlook Believe it or not, I think that despite all this tragedy and illness, I have kept a positive outlook. I am not sure that comes through in the accounts, but when I consider how we were doing at the beginning of this and how we are doing now, my spirits are lifted and I do have hope; Though today was probably one of the more difficult days to work and to have hope and then one small thing changed that.

Starting at the beginning of the week, I had transferred five patients to the ICU who were still being treated in that unit. Today, a little more than three days later, there is one left. Three have succumbed to their illness. I have related the story of the healthy middle aged gardener and his struggle for 30 days on a ventilator and who slowly slipped away. Another patient was a man in his 60s with Parkinson's disease who had been in the ICU for less than a week and who seemed to be doing well, until he was not. The end came quickly for him, quickly enough that his passing was surprising even to the ICU nurses who are heroically attending to each of their patient's every need. The third one to pass was and elderly man who had spent nearly a month in the ICU. His passing, while tragic for his family and friends, was expected. He had Covid and was 94 years old. Religious beliefs prevented anything less than a full out onslaught of medical treatment and invasive procedures. In the end, 94 years was his allotted time and his death was treated with care for the patient's family but otherwise perfunctorily by the staff who have seen many 94 year olds pass from a variety of illnesses in their experience. This may sound callous, but the efforts with this man were extraordinary and the outcome was as expected, except in the length of time the combined medical caregivers gave to what was seen as a largely futile effort,

The patient who remains in the ICU is the man in the black bikini underwear. Well who was in the black bikini underwear, I am not sure where they are now. He is hold on and there is hope for his improvement. Still, setbacks are a sad reality and in this setting almost an eventuality. So he will be attended to carefully. I hope he joins my team back on the regular CoVid unit.

The fifth patient was the 37 year old man who was transferred out of the intensive care after a month on the respirator. The one who had been cleaned and shaved and propped up for his photo meeting with his wife and who was able to tell her that he was okay. Today I spoke with him. He was more alert and awake than he has been and he was started on liquids by mouth once again. His voice is still a whisper, probably related to trauma from the endotracheal tube being in his throat for almost 30 days. I reminded him who I am, and asked if he remembered me from when he first came into the hospital. He said he did not. In fact, when asked if he remembered anything from the time in the hospital, he said no. The medically induced coma had been kind to this man. Sometimes patients in that state still dream or have nightmares or are awake enough to be aware that they are there but they are unable to move or do anything at al except think and lie there. It is reminiscent of a book I read in high school "Johnny Got His Gun." about a soldier who finds himself in that space between life and death.

I told the patient not too worry about the missing time and why he had no memory of it. I told him I had been monitoring his progress all during his hospital stay. I asked about pain. He had none. I asked about other symptoms of shortness of breath and nausea. He denied those as well but the numbers told a slightly different story. I always try to believe the patient rather than the numbers. Numbers do not account for personal strength, desire to improve, ambition and willingness to succeed no matter the odds. How could you accept the numbers when this man had all of those things in abundance, So after examining him, I prepared to leave, knowing I would have to watch the numbers, but that there was an indefinable quality to this man which had gotten him to this point. On the way out, I said: "Adios, y portanse bien." It is a phrase I usually use with Spanish speaking patients and roughly translates as: Go with God and Behave yourself. I sometimes forget that this is not something everyone would understand and I will say it to patients who do not speak Spanish. The patient then said, straining his voice to be heard: Now I remember you. I smiled and said: "who could forget a doctor this good looking". And then much to my delight,, he shook his head and laughed. I do not know if it is the first time he has laughed but it was the first time I had heard it and it feed my soul. I firmly believe that this man is here, not because of every single medication we gave him, or every second of care or the technology that kept his lungs moving even when they should have stopped. All of those things are never enough. I believe he survived when others had not was in his ability to laugh at a bad joke and in doing so, lift the sagging spirits of a fatiguing physician. I look forward to seeing him tomorrow. I have lots of bad jokes and for right now, he is a captive audience.

[+ Charlie]

This is not meant in any way to denigrate the efforts that the medical staff made to keep that 94 year old man alive. For all I know, he may have desperately wanted to live. I just hope that the "religious beliefs" that prevented anything less than those efforts were his and not just his family's or those of some other authority. I'm sure he could not have known what those last 30 days would be like, any more than I would if I had not been following your posts so closely. I have had a long and probably better life than I did anything to deserve. Knowing what I know now, if I get this disease and my condition becomes critical enough to need to be put on the ventilator, I hope I will be able to refuse it, even if it is not needed by someone else, and can ask to be allowed to depart naturally. I would rather that the heroic efforts be devoted to patients like the 37 year old, who may still have some satisfying life left to enjoy.

(I admit that I am somewhat motivated by my own mother, who lived to 102, but who confided to me that she was psychologically ready to go at 94, and really wished that it had happened then.)

[CuriousByNature]

This is not meant in any way to denigrate the efforts that the medical staff made to keep that 94 year old man alive. For all I know, he may have desperately wanted to live. I just hope that the "religious beliefs" that prevented anything less than those efforts were his and not just his family's or those of some other authority. I'm sure he could not have known what those last 30 days would be like, any more than I would if I had not been following your posts so closely. I have had a long and probably better life than I did anything to deserve. Knowing what I know now, if I get this disease and my condition becomes critical enough to need to be put on the ventilator, I hope I will be able to refuse it, even if it is not needed by someone else, and can ask to be allowed to depart naturally. I would rather that the heroic efforts be devoted to patients like the 37 year old, who may still have some satisfying life left to enjoy.

(I admit that I am somewhat motivated by my own mother, who lived to 102, but who confided to me that she was psychologically ready to go at 94, and really wished that it had happened then.)

I'm somewhat surprised when I hear about people of faith using extraordinary and invasive means to remain alive for the longest possible time. Particularly when most people of faith believe there is something more beyond this life. I've seen both sides - those who do everything possible to remain living, despite the pain and weakness of a terminal illness, and those who only request comfort care and accept that their existence in this realm is drawing to a close. Of course it is never a simple choice, as other people will no doubt be affected by the decision, one way or another. Im not sure how I would respond if the time comes for me to make that decision, but one elderly woman of profound faith once told me that death is nothing to fear because it is the one thing we know that each of us will one day experience. No exceptions. I thought there was some wisdom in those words, regardless of a person's religious belief or unbelief.

[+ purplekow]

This is not meant in any way to denigrate the efforts that the medical staff made to keep that 94 year old man alive. For all I know, he may have desperately wanted to live. I just hope that the "religious beliefs" that prevented anything less than those efforts were his and not just his family's or those of some other authority. I'm sure he could not have known what those last 30 days would be like, any more than I would if I had not been following your posts so closely. I have had a long and probably better life than I did anything to deserve. Knowing what I know now, if I get this disease and my condition becomes critical enough to need to be put on the ventilator, I hope I will be able to refuse it, even if it is not needed by someone else, and can ask to be allowed to depart naturally. I would rather that the heroic efforts be devoted to patients like the 37 year old, who may still have some satisfying life left to enjoy.

(I admit that I am somewhat motivated by my own mother, who lived to 102, but who confided to me that she was psychologically ready to go at 94, and really wished that it had happened then.)

This is a critical decision in people's lives but it a difficult one to face and as a result people put off even considering what it is that they want. In NJ at least, there is a POLST form, Physician Orders for Life Saving Treatment, that delineates what the person wants and who should be making the decisions. This form only comes into play at the time the death has occurred or is imminent and plans for invasive life extending treatments are being made. This is a brief, codified form of a living will. Living wills may include things which are not covered by this document. For example, if someone has opted not to have life extending treatment and they are being attended to in a way to allow comfort to be the goal, a living will might include such things as the kind of music the person would like to be playing in the room, or the specific visitors one would want to see. The POLST only deals with medical issues. The main questions ask things such as do you want to have mechanical ventilation, do you want a feeding tube placed, do you want CPR to be done, who is the person you want to be making your medical decisions should you become incapacitated, The form we use is one side of one page. I have seen living wills which have 15 to 20 pages of instructions.

[+ Charlie]

This is a critical decision in people's lives but it a difficult one to face and as a result people put off even considering what it is that they want. In NJ at least, there is a POLST form, Physician Orders for Life Saving Treatment, that delineates what the person wants and who should be making the decisions. This form only comes into play at the time the death has occurred or is imminent and plans for invasive life extending treatments are being made. This is a brief, codified form of a living will. Living wills may include things which are not covered by this document. For example, if someone has opted not to have life extending treatment and they are being attended to in a way to allow comfort to be the goal, a living will might include such things as the kind of music the person would like to be playing in the room, or the specific visitors one would want to see. The POLST only deals with medical issues. The main questions ask things such as do you want to have mechanical ventilation, do you want a feeding tube placed, do you want CPR to be done, who is the person you want to be making your medical decisions should you become incapacitated, The form we use is one side of one page. I have seen living wills which have 15 to 20 pages of instructions.

Thanks for this reminder, PK. I do have a living will, but I should have it updated, because the person who is authorized to make the decisions is probably no longer competent to do so, and I will have to decide who is. Unfortunately, I also know that the legal documents are not always followed. I held the medical POA for a friend, who didn't trust his family to follow his desires, but I was never notified when he was hospitalized, and I didn't learn of his illness until he was already dead.

[+ bigjoey]

Thanks for this reminder, PK. I do have a living will, but I should have it updated, because the person who is authorized to make the decisions is probably no longer competent to do so, and I will have to decide who is. Unfortunately, I also know that the legal documents are not always followed. I held the medical POA for a friend, who didn't trust his family to follow his desires, but I was never notified when he was hospitalized, and I didn't learn of his illness until he was already dead.

 

Not notifying the person who makes the decision is a problem that frequently happens if the document is not known. One of the biggest mistakes is people put the document with their will in a safety deposit box. The person in an emergency ends up in the hospital and no one knows about the directive until the safety deposit box is opened after they are dead.?

 

The moral is that someone who is actively involved in your life should know about the directive and where the document is located with access to it.