Sorry to Kick a Very Bruised, Very Abused Horse

[boarderboy]

but this is probably the most important health care issue that we'll, hopefully, begin to take very seriously in the U.S.

http://www.nytimes.com/2010/04/07/business/economy/07leonhardt.html

I hope, when it's time, I'll have the courage, the character, and the faculties, to refuse intensive, hideously expensive, and, at best, marginally effective end-of-life treatment.

Peace

BB

[Petrol]

yep, we could cut 'health-care' spending dramatically by rationing care and shipping folks off to hospice. could probably do even better if we empower panels to consider the continued value of 'health-care' recipients lives, say every 5 yrs, to see if they are a net gain or loss to society, productivily speaking

[Petrol]

btw I have to ask, why wonder if you'll have the courage character and faculties to live what you wish imposed on others, and start a new thread for this?

[Alaskan Rover]

End of life? Yeah, that's a tough one, all right. What one says now, in health, can often change when one faces his final moments...staring at that final black void.

My dad was dying of esophageal cancer, and had to undergo many radiation treatments...but I think he knew that the disease had already progressed past that stage. I think perhaps he was doing those last few fights against that cancer more for us, his family, than for himself. I thought then, quietly and to myself, that he had already made his own peace with death and the end of his life.

During those radiation treatments, they were required to ask him if in the event something goes wrong, did he wish to be resuscitated? Standard procedure, I guess. But I remember what he answered to them one time, as I sat beside him. He said: "Well....maybe JUST a little." I'll always remember that....I guess for me, it sort of defined the dusty passages that one goes through when one finally becomes acquainted with the gaping maw of death. Things change in those moments...dramatically.

In the end, he died in his own home, in my old home....and somehow there was more grace, dignity and peace in that, then could EVER be found in the intensive care ward.

[snowboardworm]

good post AK Rover. sincere and from the heart.

keep it toned down. unless you want to keep me, and others, entertained with your verbosity.

[BlueB]

My childhood's best friend's little brother, who also was the best friend of my sister, passed away, at age 36, 2 weeks ago... The kid was like a younger brother to me, we all went to the same school, played together after school, spent summers together at their seaside condo...

Dusan grew up to be a wonderfull man and MD, specialist Rheumatologist. He battled the cancer and knew that he was loosing the battle. He tried to keep the familly as little informed as possible. When it finally spread everywhere, he refused any treatment and refused hospitlisation. They told me that he suffered greatly over the last few months, but he found his peace now.

RIP.

[jonbass]

My childhood's best friend's little brother, who also was the best friend of my sister, passed away, at age 36, 2 weeks ago... The kid was like a younger brother to me, we all went to the same school, played together after school, spent summers together at their seaside condo...

Dusan grew up to be a wonderfull man and MD, specialist Rheumatologist. He battled the cancer and knew that he was loosing the battle. He tried to keep the familly as little informed as possible. When it finally spread everywhere, he refused any treatment and refused hospitlisation. They told me that he suffered greatly over the last few months, but he found his peace now.

RIP.

I am sorry to hear that BlueB. I hope that you will cherish the value of the times you had with him. My prayers are with you and their family.

[Aisling]

my heart goes out to those who told stories of lost loved ones, as some may know i was at my nana's side in february when she passed.

however, slightly askew to the topic... taking a little turn off the road to generalization of the topic... i don't see anything wrong with saying NO to a lot of things. how about government says no to big company bailouts and lets the chips fall where they may? how about we say no to buying houses we can't afford? say no to using credit cards when we don't have the cash to back them up? there's a reason i haven't bought a new board for a long time... i don't have the extra "fun stuff" money. gotta take care of the regular life stuff. anyway my point is gov't and people should think about personal responsibility.

and now back to your regularly scheduled programming

[skatha]

If people want to seriously have a debate about health care issues in this country, I will happily take any questions. I graduated medical school in 1990 and I am a board certified internist. I have had hundreds of end-of-life care discussions with patients and futile care discussions with patients' families. I have seen people die of inability to afford medical care-these people can't get appointments with other docs. It's not an issue of "I'd rather buy a fancy car than to get a pap smear or a colonoscopy". I have seen people undergo torture at the hands of specialists because we reimburse docs by procedure-I'm talking about demented patients getting chemotherapy for advanced breast cancer or dialysis. We will use 90% of our Medicare benefits/dollars in the last 2 weeks of our lives. That is a statistic unchanged for the last 10 years.

I have been trying to change how we let our family members die in this country-with hospice at home instead of in an ICU with limited family visitation. I have watched the discussion co-opted by claims of "death panels". The discussion we need to have in this country is "best care" or "good enough care". Without the hysteria....

This panel will address issues of limited benefit for cost. Like the issue of vertebroplasty-a procedure for osteoporotic patients with a spinal compression fracture. It costs $3000 per procedure, thousands have been performed in the last 10 years and-guess what-it doesn't help. Without a panel to determine medical usefulness, we would have seen lobbyists from the radiologists and the AMA continuing the reimbursement for the procedure. Hopefully, now, that won't happen.

[boarderboy]

The last scene.

If I could go in quiet, sweet contemplation with a gentle snow falling, I think I'd leave this place a happy man.

I've had the (premature) near-death experience with tubes and needles and chaos. Didn't like it, and don't want to go there again.

Peace

BB

[skatha]

The last scene.

If I could go in quiet, sweet contemplation with a gentle snow falling, I think I'd leave this place a happy man.

I've had the (premature) near-death experience with tubes and needles and chaos. Didn't like it, and don't want to go there again.

Peace

BB

Or on a beach with a Corona in hand.....

I watched my team care for a man with end stage myelodysplasia when I was a 3rd year medical student. The guy had one good day and lapsed into a coma before his family was told he was dying. I researched myelodysplasia and asked my faculty the next day that, since we know people with myelodysplasia live for about 2 years after they are diagnosed, why didn't we tell his family he was going to die BEFORE he went into a coma so he could say goodbye? I vowed that I would never shrink from that hard discussion with a family just so I could be comfortable after that. We need to multiply that by the 700,000 practicing MD/DOs in this country

[BlueB]

Wow, Narayama! What an artistic and meaningful movie! Completelly forgot about it...

In some very remote mountainous areas of my country of birth, they had the tradition of Lapot, (edit) legend has it uptil maybe 4 decades ago (/edit) ... When an old man gets way to old to be any good to anybody, including himself, his son would take him to the peak of the mountain, place a bread on his head and wack with a huge mullet. The last exchange of the words would be something like this:

"Forgive me Father, it's not me who'll kill you, it's this bread. My son will do the same for me.

"You've been forgiven..."