January 18, 2010
My wife's uncle recently passed away after struggling with multiple health problems. In addition to the pain associated with watching a loved one hurt, my wife; as I listened to the funeral, I was struck by how limited the medical field truly is. Despite our massive breadth of knowledge, our armament of drugs, and our ever increasing technology, there are many places in life where it falls utterly short. Her uncle suffered a mild heart attack some years back. About 18 months ago, he suffered another heart attack while also having a stroke. Somehow, he pulled through despite now missing part of his skull to alleviate the swelling in his brain. Then about 6 months ago, he had a lower leg amputated at the knee due to wounds that just wouldn't heal (stroke side and he was diabetic). He finally succumbed to an infection that went systemic. The funeral was in a small evangelical church, very informal. Several church members got up and recounted their relationship with him. Basically, it started at the time after his stroke when he was confined to either a hospital or rehab center. So here are people who did not know him, but knew his sister, and so reached out and visited him. They did something that medicine was unable to do. They tried to comfort him during his last year. The doctors threw everything medical they had at his condition but could only delay the inevitable. But I wonder, during that last year of his life, which mattered more? Did all of the hospitalization and medicine matter more than the human touch, even from the kindness of strangers? Then again, the hospital did keep him alive for another 18 months and did provide the opportunity for those individuals to comfort him. How many of us would turn that down? But even if in pain and suffering? And what about the family members? They're torn between wanting, hoping against the odds that their loved one will get better contrasted against the pain of watching them suffer and get progressively worse. I'm not sure of my own answer. It's not a clear black and white decision. No one knows ahead of time what degree of suffering is coming. Or, what level of joy is possible through extension of your relationship with loved ones. It just seems that our culture hasn't provided much in the way of dying well. I watched it with my grandfathers on both sides of the family, as well as when I volunteered with hospice. Pain is ever present and little is done about it. I don't know how much training is given to docs on assisting others with death but I'd wager it's very little. It's made me think that at some point of my training, I'll need to seek that training elsewhere. I shudder to put myself in the position of his attending, trying to balance hope with realism, allowing the family to grieve while feeling like they're not giving up. That's a tough path to nagivate.