Bob's cancer was diagnosed as untreatable.
Bob was able to die at home surrounded by friends and family, with his wits and wit intact to the end of his life - he preserved his dignity and autonomy. There was an uncanny precision and timing to the unfolding of events, especially in his last two weeks.
But he came very close to encountering some of the medical intervention described in this article below. He had been promised he wouldn't be hospitalized but a call to a hospice about possible oxygen somehow brought a couple of EMT's to the trailer. I suppose fortunately, they arrived after he had passed.
Steve Powell emailed me about this article by Dr. Atul Gawande in the August 2, 2010, issue of the New Yorker. It's long and describes a lot medical procedures, but I have copied the essence below.
Letting Go
What should medicine do when it can’t save your life?
For now it's available at this link.
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all
From the article:
"In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.”
People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives."
-Al Cantrell
