When it rains, it pours ...

Another piece of good news from our current administration.

From The New York Times:

"WASHINGTON — The Obama administration moved on Friday to undo a last-minute Bush administration rule granting broad protections to health workers who refuse to take part in abortions or provide other health care that goes against their consciences."

The article references issues related to women's rights and reproductive choice, but as I blogged earlier this week, Barbara Coombs Lee has been very vocal in getting the word out that this law would also affect people's access to death with dignity.

And just like that, I'm a Robert Gates fan ...

For me, proof that even in the most stressful times, life is still full of happy surprises.

Defense Secretary Robert Gates has reversed the policy that forbid press coverage of flag-draped caskets carrying the remains of fallen U.S. soldiers coming into Dover Air Force Base in Delaware.

The decision will now be left up to individual families whether to allow media access to each homecoming.

If draping a flag over the casket is not meant to be a visual symbol, then why do it? And if it is a visual symbol, why are we afraid for people to see it? And if the family of the fallen wants to share it with the world, why shouldn't they be able to as part of their efforts to fully honor their family member?

The policy was first put in place in 1991 by George H.W. Bush, and this time around has been in effect since 2001. (I believe President Clinton put a hold on the regulation when he was in office, but I'll have to double check on that.)

Anyway, as they say on one of my favorite blogs, Shakespeare's Sister, taking one little teaspoon out of the sea of injustice.

Photo from ABC News.

Practical Advice on Handling Death

As I've said many times before, Diane Rehm is my favorite, favorite radio host.

On Monday of this week, she interviewed NY Times columnist Jane Brody who has a new book called Jane Brody's Guide to the Great Beyond: A Practical Primer to Help You and Your Loved Ones Prepare Medically, Legally, and Emotionally for the End of Life.

Self-aggrandizing, super-wordy titled aside, it sounds like a very practical, down-to-earth write-up of some of the small details many of us are not prepared to deal with. She focuses on both what the dying person and the loved ones of the dying person should do. Things like a living will, of course, but also assigning a health-care proxy, someone to advocate for you and your wishes.

She also advocates bringing death back into the regular conversation of life and not separating it out into something that strictly happens in a hospital, removed from everything else. And you all know I'm in favor of that.

Here's a link to the interview. Here's a link to the book.

Death Penalty Being Done in By Economy?

An interesting article from The New York Times today about the costs of the death penalty.

It seems abolishing the death penalty is becoming increasingly popular during these hard economic times as a cost-cutting measure.

We will have to watch to see if any of these arguments come up during the two executions Washington state has scheduled for March of this year.

Death with Dignity Specifics Adopted

Washington state has adopted the specific guidelines that it will use to implement its new death with dignity law. The Seattle PI has this article about the guidelines.

Unfortunately, the article is not super informative and is actually pretty vague and confusing. (I think it tries to cover too much in one piece instead of just focusing on the most recent developments.) But I'm going to link to it anyway since it's one of the first mainstream pieces written about death with dignity in our area in a while.

I'm hoping, as the deadline approaches, some better, more specific information will come out.

Suze Orman Will & Trust Kit—Free

Right now, Suze Orman is providing free access to her online will and trust kit.

Go to this link and type in the password PeopleFirst.

I haven't used the service myself, so I dont' know how user-friendly it is. But I caught the last few minutes of her show the other night during which she was discussing this offer, and I thought I should pass it along.

I assume the offer is good least until her next episode airs (Saturday night). But if you're interested in checking it out, I'd make a quick move.

And if you do use the service, I'd be curious to know how it goes.

The Conscience Rule

Barbara Coombs Lee of Compassion & Choices has recently been blogging at Huffington Post about the "conscience" rule.

This law went into effect on January 19 it allows medical workers to refuse to participate in care that goes against their moral beliefs. Obviously, one of the areas this can and will affect is death with dignity. And we already know some facilities in Washington state have decided not to participate in the newly passed law.

Particularly troublesome for me would be any physicians who would refuse treatment but also would not tell patients that the option is available for them. The post by Barbara Coombs Lee says most physicians who object to a treatment would let a patient know about a treatment but some would not—no figures are given though.

Whatever side you come down on, it is an important issue that is getting lost in the midst of economic worries. Check out the blog or Google the topic—but Google "conscience rule HHS," or you won't get decent results.

Another great link from Christian Sinclair. I love this video for its simple honesty. It reminds me of this article from Scientific American that talked about consciousness after death.

Many of us ponder death in a way that assumes we will have thoughts and sensations after it happens, but when it comes, both the article and the video say, we will simply stop, and we will not have consciousness to be aware that we have stopped. Therefore, there is no reason to fear our end.

In his post on the video, Sinclair compares its tone to that of a children's book. I could not have said it better myself. There is a simple, instructive narrative. A heartwarming feel, despite the hard subject. The narrator sounds like he wants to take care of us. To walk us gently through this harsh truth.

Give it a watch. I'm curious to know what other people think. Also, nothing really happens until the 40-second mark, so if you're a techy-generation, impatient sort, you'll want to zoom ahead.

Death Cake

Man, oh man. What a way to say Happy Birthday! Christian Sinclair sent this link to me—he's been sending all kinds of great links lately. Thank you, Christian!

From the very funny blog cakewrecks.blogspot.com.

Death as a Metaphor for a Cluttered Life

Anti-Clutter Expert Peter Walsh is interviewed in the March O magazine (p 50). To point out the dramatic effect clutter and mess can have on us all, he draws our attention to the language used by his clients:

"My clients say things like 'I was buried under all that stuff,' 'I was drowning,' "I feel like I'm suffocating.' We use those metaphors because clutter robs us of life. It robs us socially, when we're too embarrassed to have people over. It robs us spiritually, because we can't be at peace in a cluttered home. And it robs us psychologically, by stealing our ability to feel motivated in our space." 

Considering how difficult it can be for us to talk about death in actuality, I think it's interesting how easy it is for us to rely upon it as a metaphor. 

What do you say when you don't know what to say?

A family I know and have been close to for years recently lost their grandfather. And there is a bit of tension in the family because a far-away grandchild (not someone I know personally, but a grandchild in another unit of the family) did not call or reach out to the family in any way after the death. Her reason: she didn't know what to say.

Now, you don't have to read much of my blog to guess what I think of that.

But I do have compassion for her position. I've been near to people in grief and not had a clue what to say to them. My operating theory has generally been to just call or stop by and stumble my way through the conversation. I guess, I figure saying something awkward is better than not saying anything at all.

I realize this is far from ideal, however. Does anyone else have better advice for what to say when someone is feeling loss and you have no idea how to express your sympathy?

Pet Euthanasia

Dethmama has a sick doggie, and will be euthanizing her later in the week. (My thoughts are with you, Dethmama). Her beautiful post about the emotional experience is here.

It prompted me to do a little research, and I found this link with suggestions for some things people should be aware of/prepared for before making an appointment for a euthanasia. For example, make sure to tell the receptionist at the vet's office that you want to see the vet when he/she is not in a hurry.

Also, Dethmama has scheduled an in-home euthanasia, so her dog can spend its last moments in the comfort of its own environment. I didn't know that was an option, but looking around online, it appears that many vets offers that service. Something to keep in mine, since many of us will sadly be faced with this decision one day.

Vial of Life

I ran across this item at Bartell Drugs. They were selling them at the counter for a $1 donation.

The product is called Vial of Life. It's basically a large prescription pill bottle, and it comes with a magnet and some paperwork. You put the magnet on your fridge, fill out the paperwork in the bottle, and place the bottle in your fridge.

The magnet lets any emergency medical workers who might be called to your residence know that you have a Vial of Life in your fridge.

The paperwork includes information on medications, whether you have an advance directive, contact information for family members, any do not resuscitate orders you may have, even medical records if you want.

There is also an online version that involves affixing paperwork to the front of your refrigerator in a plastic bag.

The program is aimed at seniors, but it could be useful for anyone who has health problems. I love the idea of encouraging people to store their pertinent medical information in an easily accessible spot, especially in a way that emergency workers can find if they have to treat you while you are unconscious.

Cybertime—Repost

Reposting my post on Cybertime from earlier in the year that Dr. Sinclair called a "must read," in his Palliative Grand Rounds so that anyone looking for it doesn't have to search through the archives ...

My mom just opened up a Gmail account that she rarely uses. Actually, rarely is an understatement. She set it up, but really hasn't opened it up since then. So, it has sat idle for a couple of years. But fed up with hotmail spam, she finally decided to switch to the account.

When she logged in, she found 177 emails from my grandfather, her father, who died 14 months ago.

Email provides us with some odd timing situations ... and they can be especially odd when the sender has passed on. Susan Barnes writes about the nature of time as it relates to email: "Email messages are sent and received in asynchronous time." Barnes continues, "Cybertime blurs the distinctions between past, present, and future because when reading email we have the sense of simultaneously conversing with the author in cyberspace."

The author sends the email in the present, and it sits in our inbox for a given amount of time ... could be seconds, could be years. However, whenever it is that we get around to reading it, we perceive that moment to be the present for the email.

In cases where the author has since passed on in real-time, the reader is left in a strange, emotional limbo in which the author still exists in cybertime.

Most of my grandfather's emails were silly forwards about safety at the gas pump, not forgetting 9-11, etc., so it probably wasn't as jarring as receiving 177 new, personally crafted emails ... but still, it had to be a disquieting experience for my mother.

Palliative Care Grand Rounds, Vol 1, Issue 1

The inaugural issue of the Palliative Care Grand Rounds blog is up at Pallimed: A Hospice & Palliative Medicine Blog. 

Set to be published on the first Wednesday of every month, these posts will rotate through different palliative-care-focused blogs and will highlight the best content on hospice care, palliative care, death, dying, and end-of-life issues that is currently out in the blogosphere. 

This month's entry is written by the always thoughtful Dr. Christian Sinclair, and it is a must read!

And you thought it was bad when it rang in the middle of the night

A local Seattle television station, King 5, has this news report about the growing trend of being buried with a cellphone.

According to the story, it is the second most popular request, after the request to be buried with a pet's ashes (which is currently illegal in this state.)

My first thought was that the trend was a throwback to the days when people were buried with a string that connected to a bell above ground that they could ring in case they had accidentally been buried alive. If you have your cell phone, theoretically, you could call someone if you somehow got buried by mistake.

But it does go further for some people.

The funeral director interviewed for this piece says the trend makes sense to him. The reporter finishes the thought, saying "it keeps the lines of communication open." Can I just say, no it doesn't. I'm pretty sure making a phone call to a cellphone buried six feet underground, in the possession of a dead person, is closed communication. No conscious person is receiving that message.

I can't embed the video, but here's a link.

http://www.king5.com/video/featured-index.html?nvid=328650&shu=1

In the great extreme, a woman in Manhattan has kept her husband's cellphone contract current two years after his death, and has carved his phone number on his headstone so other people can call him. Does she realize the digital technology will not reanimate his body and will not allow passers by the talk to his dead, no-longer conscious form? In that case, it seems an extreme version of not being able to let go.



On a side note, the funeral director interviewed for the King 5 piece says the thing he is most often asked to put in caskets is a can of beer: "One for the road." Really?

"That's what a hospital is for."

"Nobody should have to go to work thinking, 'Oh this is the place that I might die today.' That's what a hospital is for."

-Michael Scott on last night's special episode of The Office.

The following chaos ensues after Stanley has a heart attack:



You can watch the full episode online, here.

Death with Dignity Deadline Approaches in Washington

According to The Seattle Times, medical organizations throughout Washington state are struggling with whether to participate in Washington's new Death with Dignity Act.

And whether they decide to participate, they are frantically working to prepare for the March 5 deadline to be ready for implementation. Caregivers must be able to handle questions on the law, be set to refer patients, give out prescriptions if they and their organization are choosing to do so, know their policy on mental-health evaluations, etc.

Oregon, the only other state to legalize death with dignity, ended up with approximately three years to implement their law due to all of the legal challenges brought against it, as this New England Journal of Medicine article pointed out. Since their state's law was taken to the U.S. Supreme Court, we're unlikely to end up in a similar situation.

Let's hope for some patience and cool heads during this transition. It's a tight, tight deadline for Washington state. Only four months to put into place a very complicated and very controversial law.

A Super Bowl Story

From The Today Show:

The story of Super Bowl Star, Arizona Cardinals' Larry Fitzgerald, is a story of not saying I'm sorry until it was too late.

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