Last Aid and the Splendid Splinter

Note before the Note: My colleagues at Georgia Trend might remember this stuff, and they won’t be too surprised to see a liquored-up version of it here (especially after some of the other stuff I’ve posted). So, we just got our copy of Newsweek in the mail and the headline was “The Case for Killing Granny,” with a subhead, “Curbing Excessive End-Of-Life Care Is Good for America.” Seeing the magazine reminded me of a story I wrote on this topic a few years back (March 2007 edition). Well, I reread that old article and it still seemed relevant, and sort of timely – so here’s a heavily revised and shortened version:

The Note
The gift of life comes with one guarantee: It will end. Somewhere in the fine print of our genetic code is an expiration date. We pass away, become no more, snuff it, assume room temperature, give up the ghost, cease to be, bite the dust, kick the bucket, buy the farm, turn out the lights, draw a terminal breath and shuffle off this mortal coil to join the choir invisible.

We die, and our inclination to discuss it euphemistically or in the abstract has less to do with Monty Python than with the subject matter itself – it’s bloody grim. We’re afraid to talk about it, even though we really, really should, because we’re reaching the finish line in greater numbers.

Every few seconds another person turns 50. More than two thirds of the people in history who have reached 65 are alive today. We’re living longer, healthier lives, but almost everyone who reaches old age will experience severe illness at the end of life, spending two or more final years disabled enough to require assistance with even the most routine activities of daily existence (“Could you raise the toilet seat, please? You’ve got two hands, don’t you? Well, use ‘em! I can’t do everything myself. Matter of fact, I can’t do much of anything myself, so … whoops! Sorry, you weren’t ready.” And so on.).

Most of us imagine or hope we’ll just drift off in our sleep at home, surrounded by loved ones. The reality is, about three fourths of us check out in a hospital or nursing home. About half of us die in pain that could be treated and prevented, and the seriously ill come to fear losing their dignity more than losing their lives. And not everyone wants to go the Hunter S. Thompson route.

Fact is we just don’t die particularly well in this country. A little talk and proactive planning can go a long way. Silence and typically American repression can be really costly, and the national health care system will be pushed to unprecedented limits as more people require end-of-life care. The challenge is compounded in a U.S. healthcare system that is concentrated overwhelmingly on acute care, but often lacks the capacity to care effectively for the chronically ill at the end of the road.

We might start by increasing the use of advance directives, a sort of living will that charts your path toward the inevitable by addressing personal, medical and spiritual needs and desires, helping to remove emotional burdens when tough choices are impending, and helping to prevent families from financial ruin. Health-care expenses are the leading cause of bankruptcy in the U.S., even among people who have insurance. If everyone had an advance directive, it would save about $2 billion a year in personal health-care expenses.

While the weirdo faction wants to use last-aid as a divisive smokescreen in the national debate over healthcare (“Oh no, death panels!”), I say we need to meet the challenge head on. Speaking of heads … Baseball great Ted Williams wasn’t clear enough about his wishes, and he slipped into a coma. Then his kids fought over whether or not to have the Splendid Splinter cryogenically frozen. They compromised and only froze his head. 

So, this is my new argument for a national healthcare plan – lets develop a workable plan that takes not only access to care and quality of life into account, but also last-aid, or we’re all liable to wind up like Ted Williams, a bunch of frozen heads in a freezer. 

Tune in next week when we discuss how to convert vast tracts of Antarctic land into the world’s largest depository for human heads.

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