Friday, March 03, 2006

Dying in America

I was talking with a friend from Russia about how her grandparents died. She said they just died. One of her grandfathers died in his sleep, another had cancer of some kind that made it impossible to eat.

They took him to the hospital. The hospital said they could do nothing. So, they brought him home, and he died a “relatively” slow death. It took about 3 weeks and was uncomfortable. On the upside, all the family was there and he was well cared for.

My grandma on my mom’s side also cannot eat. It’s not cancer. I want to call it old age (she’s 93), but maybe that’s unfair. I know not too long ago her stomach was sucked into her esophagus. She had surgery to fix this, but I don’t think she has been able to swallow since. Grandma is Italian, all my life she has been feeding me.

When the doctors explained the problem to my mom, she talked to my grandma and said something like, “Momma, there’s something wrong with your throat so you can’t swallow anymore. Either the doctors put a tube directly into your stomach and feed you with a machine, or you starve to death over the next few days.” My grandma said, “I guess I’ll take the machine”.

She is in a convalescent hospital now. She sleeps most of the time. The machine is always there, pumping “Fiber Blend” into her stomach every 15 seconds.

My grandpa is with her. It is nice they are together.

When people talk about dying in their sleep, my understanding is this is usually from heart failure. My grandpa had a small heart attack in his late 60’s, and another in his late 70’s. A computerized sales call hitting his bedside at 3am caused the second attack.

In his early 80’s, the doctors put him on medication to thin his blood, or slow down his heart, or something like that to help prevent more attacks. The effect was to put him to sleep for the great majority of the next couple of years.

One day a substitute doctor saw my granddad and was appalled at all his medications. He promptly cancelled most of them. Overnight grandpa woke up and rejoined the family.

Several years went by, and one night when he was 88 or so grandma got worried when he did not come back to the easy chair after getting up to go to the bathroom. Grandma wandered through the house looking for him. She found him in a stupor, sitting on the bedroom floor.

She called 911. The ambulance came and took them to the hospital. The doctor talked to my mom around 3am. He told her that grandpa had suffered a heart “event”, his brain was starved for oxygen for some amount of time, it was unclear how much damage had been done, his heart beat was erratic, and if they didn’t put in a pacemaker he would probably die that night.

My mom had them put in the pacemaker.

He is a favorite at the convalescent hospital. Physically he is relatively mobile, and he is gracious and charming. He did lose something that night. One time I came to visit wearing a red Che Guevara sweatshirt with a star on the front. My hair was very short after shaving my dreadlocks off a month before. Grandpa called me admiral, shook my hand and let me know how much he appreciated my visiting him while I was on leave, and asked me where I was stationed now – about 20 times.

Grandma and Grandpa were working class folks. People complain about the Teamsters, but the union was nothing but good for my grandparents. They weren’t rich but they received good pensions working in the canning and bottling mills of Canada Dry and Schlitz. They spent their money frugally, saving a little each month. Altogether, they managed to save around $150,000 by the time things got bad and they had to move into the convalescent home.

Each month costs them around $11,000. They have been there close to a year, and will exhaust their life savings probably by June. I don’t know what this looks like. Grandpa can go to the VA hospital. Grandma?

My grandma on my father’s side was bedridden ten years, the last three in a skilled nursing facility before passing away. She was hooked to oxygen for much of her last years, and slept most of the time. I remember talking with my mom about this when her mom and dad started having a hard time. Both of them had signed documents that said “Do Not Resuscitate” and “No Life Support”.

At the time these phrases seemed clear, but as we go thru this process I realize that the actual problems people face as they die are generally more gradual and complex. And at 3am when decisions need to be made no one is checking through documents. They are asking the nearest loved one questions like, “Should we save your father’s life?”

1 comment:

swamps said...

Nice, Freeman.

sometimes these "life saving" procedures really do save people's lives. and for many others it just seems to prolong ... prolong... some aspect of life. i don't even know what you want to call it.

i'm really glad oregon has the death with dignity act.

i think it's an act of sanity.

and now... with these wounded soldiers of the iraq war, there are many who have been severly wounded, that in previous wars, would have died due to complications. but medical technology has gotten so good that the soldier patient can be kept alive. though, they are abit brain damaged or they're complete vegetables...

death. no one talks about it enough.