revisiting the classics

I found myself with a bit of spare time today and began to read, once again, a book that changed my life in many ways. "Dying Well" by Ira Byock was the cornerstone of my turn away from clinical medicine with more attention to the details of life quality and opportunities for families to heal before it's too late. The hospice philosophy is not new, by any means. Our hero Ms. EK Ross had a nice little hospice for HIV patients in Virginia during her heyday. I've silently plotted for about five years now to make some sort of humane difference with the patients that I serve, even if it's just a hug ( IF they don't stink too bad or bite me!) It's hard to do that when you run instruments all day behind closed doors. The family dynamics involved with a death are intense at best and a dang free for all in the worst case scenario of many families.

Back when I was on call a lot, I got summoned to the emergency room around 4AM to draw a blood alcohol. No big deal....until I cracked open the door and spotted this obviously very passed out guy with mismatched socks poking out over his feet. When I got closer and saw that he wasn't breathing, I ran out to the nurse's station and was told he'd been laying in a ditch all night after a wreck and was just found. YIKES!!! In case you didn't realize it, you can't draw blood from dead people's veins because well...there's just no flow there. Whatever ER doc was on that night asked told me to get it from his heart. Uh. I don't think so dude. Do it yourself because you make the big bucks , not me. They've also tried to make me stick feet before when all the arm veins are gone, but that's not in my job description either. It's freakin' amazing what a doctor will do when he or she doesn't get it like they want it, in a timely manner and all correct and with respect and such. My mother's new cardiologist is an exception to that rule, by the way.

Anywho....back to the hospice thing. When BG was a senior in HS she needed help with her term paper and I was pretty well educated on that subject so we tackled it together and did quite well. My Christmas present from mama and daddy that year was a book written by a DC physician about ethics and procedures for humane and loving end of life care. Palliative, to speak that lingo. It was about this time that I met Einstein's mama Lori through our blogs. She wrote often about her experiences as a hospice volunteer, doing aftercare with families. What most folks don't realize is that with the normal aging and disease processes there is plenty of time for most of us to accept that it's almost over and take care of business. Modern medicine lies to us about mortality, teaching us that if you take this drug or have that test there's a chance you'll live forever. For intelligent realists, this window is an opportunity to get used to the idea slowly and grieve along the way. When death comes suddenly and unexpectedly, tha grief comes after the funeral and when the shock wears off. Either way, it's a bitch.

I've done it both ways, and I'm sure you have too. One is no easier than the other because a loss is a loss and it hurts like hell to lose someone you love. I prefer to think of it the way my grandmother put it to me. "Janie" she said. "We're all just loaned to each other here on earth by God."

^j^