02 MARCH 2015

THE DEATH PANEL:  THE BACK STORY

 

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“In hospitals, we see them everywhere.   Senior doctors in white coats–males and females–with trainees in tow. We see them marching up and down the shiny tiled halls of our medical facilities.  They barely have time to talk to you as they rush in and out of hospital rooms with plastic clipboards and pens in hand.   Are these people potentially “medical terminators” waiting to pass judgment on our loved one’s life expectancy?   Once before, I’ve  had them threaten  me to take away my mom.   Are they part of some  secret “death panel”?

It’s common knowledge now that terminally ill people can live for an indeterminate amount of time.  And for the most part, family members are choosing to care for their end of life seniors at home.  Many are not relinquishing this family obligation at the doorsteps of hospice or nursing homes.  More important, they are not allowing an assembled panel of doctors to bully them into “pulling the plug” on their seniors.  And why should they?  Families now have choices. They can assemble a team of family members and medical professionals to assist them in providing quality health care.  This support enables them to sustain the lives of gravely ill seniors for many years.  How can anyone deny them that continuation of family closeness and unity?

This is indeed a win-win situation. Families have their loved ones with them at home. And the government is not “footing” the entire medical support for dying patients.  However, family members must be aware that every time their seniors take a visit to the hospital, a death panel could be crouched behind the scenes poised with gang-type coercion to convince them to sever in home caregiving for their loved ones. So, don’t be caught off guard in your moment of sorrow, fear and fatigue.  Be prepared when they come calling.

That evening at the hospital, mom had been given her round of intravenous antibiotics.  It had been four days now.  And at 10:00 am, I had caught wind of good news about her being discharged soon.  Still, I couldn’t be certain. Things are never certain at hospitals.  It would all depend on her.  Well, I had been ready to go home.  I’m sure she was too.  So that was good news for me to hear of the possibility of her being discharged that day.  I felt that I could finally exhale.  My low grade anxieties and apprehension would be a thing of the past. Mom would be going home.

I had been quietly, but impatiently, sitting in that much uncomfortable hospital chair next to mom’s bed. I was watching a cooking channel on TV.  Come to think of it.  I was rather hungry.  I had spent the night at the hospital. I had not yet eaten.  My sister would be there soon to relieve me.  Meanwhile, I had been relegated to official clock watcher. Suddenly a nurse spritely walked into the room with a big smile on her face.  She asked me had I slept well last night. I told her yes—even though I really hadn’t.  Those green hospital chairs are brutal on your back.  If anything they needed to give me a couple of those $15.00 Tylenols for free.  I certainly would have greatly appreciated that.

Soon after I had taken a big yawn, she told me that my mom’s doctor had wanted to talk to me later. I really didn’t feel like talking to anyone. My mind had been back at home with mom resting comfortably in her own bed. Besides, she had been in there because of a UTI that had been allowed to go untreated for too long due to a flawed testing procedures and processes by medical agencies. After the nurse finished checking mom’s vitals, she left.

Shortly after, a group of doctors and trainees entered the room–six of them. The female doctor told me to follow them into a conference room. Little hairs started standing up on the nape of my neck. I felt something else had been behind their ready smiles and cordial countenances. So I turned off the cooking channel and followed them. Little did I know that it would be I who would be served up for the main course that morning.

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No sooner after I sat down, their demeanor changed.  A difference between day and night. It was almost as if I were facing a firing squad. There they were.  The six of them seated in front of me armed with their loaded ink pens and smoldering thoughts.  My body, waiting for the first impact, became tense.  Whatever the punishment, please let it be swift, I said to my myself.  Would I, at least, be offered my last meal?   I still had not eaten.

“—Mr. Williams, what do you want with a brain dead old woman? There is no more that you can do for her.” one of the six doctors swiftly fired off at me without any warning. Her direct and unvarnished starting question had been a tall glass of iced water dashed into my face. There was absolutely no tact whatsoever in her delivery.  I had realized then that these doctors were a team of bullies. They wanted me to give up on my mom. They wanted me to allow them to remove her feeding tube like Marie Schiavo. They wanted me to give her to hospice.  Once there, they would quietly allow her to fade into the sunset from starvation.  And they were trying to accomplish this by intimidation and verbal coercion—not by legal mandate.  They strove to convince me into being a willing accomplice into doing something I had been uncomfortable in doing.  If I were not awake then,  certainly I was now.  I had to be firm.

“Uh…ma’am, I don’t believe that.  She is not a vegetable.  She’s not a puppy at the humane society waiting to be euthanized.  My mom shows us everyday that she still has valued brain activity.  She does that in subtle ways. One blink for yes. Two for no. She may not show that to you when she is in this hospital, but we see it at home.”,  I countered. …I paused as I struggled to fight back tears. Up until then, no one had ever been that calloused to me about my mom’s condition. I had been taught to have faith and believe that God performs miracles.  Besides, we were doing a great job of caring for her at home. She was not in that category where one week or even two years from now, she would die.  It saddened me to hear them tell me that my mom was “brain dead”.  It also made me somewhat angry.  I hoped that they would end this.

But, they persisted. One doctor would ask me a line of questions, and as soon as I answered those, another one would shoot off a volley of questioning.  Certainly, I would earn my battle pay before this day was done. “Mr. Williams, all she is going do is end up back in the hospital again.  She is not going to get any better”, the African American nurse barked as she intently peered at me over the rims of her glasses. I did everything I could to hold my composure. I long since learned that it would not be in my best interest to get too upset and start raising my voice in these hospitals. That would be playing into their hands.  So I calmly told them that as long as I am the primary caregiver and power of attorney, I will not allow my mom to be hijacked by Hospice or a nursing home to die.

For a while, the exchanges went back and forth. Thirty minutes had past.  It seemed longer.  I turned to the male doctor and told him, “Sir, I have read about how much abuse that go on in those nursing homes. And many bed bound patients who can not talk are absentmindedly neglected. Terminally ill seniors don’t live as long in those places. Besides, my mom told me that she did not want us to put her in a nursing home.  And as her son and primary caregiver, I’m going to honor her wishes.”

…There was a brief quiet in the room.  One of them loudly exhaled.  They began conferring among each other in hush tones. Then the lead doctor said, “Ok Mr. Williams, We understand. Your mother will be discharged to go home today. We will assign home health to come to your house for a few days to assist you in the “transitional period”, he said with a smile on his face.  “Would a week be ok?”  He offered.  “Sure-sure, that would be fine!”,  I managed.  We all stood.  We shook hands.  That’s was it.

As we all filed out of the room, they hastened down the hall in lock step in one way.   I jaunted back toward my mom’s room in the opposite direction.  I had been so elated that mom would be going home today.

Back in her room, sitting in that non-therapeutic green chair again,  I switched on the TV.  The cooking channel had still been on, but I had lost my appetite for watching.  So, I changed channels.  Still in the back of my mind I couldn’t help but ponder the fact that I had stared the hospital ‘s secret “Death Panel” squarely in the face and didn’t blank.  Sadly, it would not be the last time I would have to confront this issue—but in a different form.  Only the faces would change.  And certainly it would not be for to protect the innocent.  I shuttered.

“In America, much controversy has been stirred up concerning possible “Death Panels” at hospitals. In 2009, Sarah Palin falsely accused Obama for proposing legislation for “Death Panels” at hospitals. Instead he was only trying to have the federal government foot the bill for the discussions hospital would need to have with family members about end-of-life issues.”

Now of course, hospitals do not have a separate department designated as such.  That would be too obvious.  So  most likely you will not find grim lettering painted on a door labeled “Death Panels”.  However, make no mistake, that panel is there. It is potentially there anytime a group of doctors team together to discuss your senior’s last knock on death’s door.  When you think about it, there has to be some form of medical officials who are responsible for assessing terminally ill patients in order to determine who “Live And Let Die”.   And if you, the primary caregiver, know in your heart that your loved one still has quality life worth fighting for, have faith.  Do not allow some doctors to bully you into giving up on your senior.  Preparing an Advanced Directive can help prevent this.  Meanwhile, stay alert.  No one knows when it will be their time to face the “Death Panel”.

—Ok, cue the music, “When you were young and your heart was an open book…”

 

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