Healthcare Decisions Day and a Heroine

I am an admitted control freak. Not my best quality, but an undeniable one to be sure.

So when I have to admit that “things” have a way of working out, I am humbled to say the least.

I had a wonderful time away this weekend- relaxation and good times. Driving home and getting my ‘game face’ back on for the week, I thought about the days ahead.

Monday, April 16th is National Healthcare Decisions Day and I had already decided that the occasion merited a blog. Having seen horrible scenarios play out in ERs and ICUs, I am very passionate about everyone making it a priority to complete Advanced Directives to make their end of life wishes known. 

On my drive home, I thought about ways to emphasize the point about wishes. I thought about my childhood and my compulsion to make a Christmas list. The arrival of the fat Sears catalog was a monumental day for me as a child. I spent hours combing the pages, folding down corners and writing down the many toys I hoped to see under my Christmas tree.

An Easy Bake Oven. A Lite Brite “ultra” set. A Cabbage Patch Kid. A Swatch Watch. A Sony Walkman. Please and pretty please.

I made this list because I lived by two absolute certainties: I was loved and believed to be “good” AND Christmas was definitely coming. Everyone seemed to agree this was a helpful, and became ritualistic practice. When Christmas morning came and wishes were fulfilled, not only was I delighted, but the gift givers enjoyed satisfaction for their efforts. Win. Win. 

Today, I am (chin to chest) forty-seven years old. I still make a Christmas list and a birthday list. I don’t think I am greedy or entitled. I simply continue to believe that I am loved, those holidays are most certainly coming and it is helpful to let my loved ones know what would please me.

So here comes the annual “National Healthcare Decisions Day”. Let’s break it down, friends. You are loved- by friends and family. Hopefully a long way away, you will deal with an end of life scenario. This may be a sudden, catastrophic event or it may be a result of a longer, insidious illness. The brutal truth is, none of us are getting out of here alive. That reality of mortality feels out of control and makes it very easy to deny and ignore. 

Denying and ignoring is a mistake. A grievous mistake. A mistake that could leave your suffering body in an ICU indefinitely exposed to indignities and pain. A mistake that could change your legacy from one you’ve spent a lifetime building to one that haunts your loved ones with memories of tubes, monitors, alarms, and nothing that even resembles peace. A mistake that could permanently divide the people you love most while you are paralyzed to repair that rift. A grievous mistake, indeed. 

National Healthcare Decisions Day is really a marvelous day. It is a day sanctioned for preventing these grievous mistakes and promoting a different outcome. It is a day where all adults, young and old, get to make a list as precious as the one they used to make for Christmas, that details their wants and wishes. It encourages completion of a document that acknowledges the loved of its author and the inevitability of the time it will be needed. 

An Advanced Directive is the modern version, the updated and more practical version, of a living will. It is a simple document that doesn’t require an attorney but provides a checklist about some of the most important choices that need to be made in an imminently terminal condition. It only speaks for its author when he or she cant speak for themselves but it is a near “get out of jail (ICU hell) free” pass. Aggressive treatment and life prolonging measures are always the default for all people, despite diagnosis or age, in the absence of the blessing of an advanced directive.

So as I drove home today, thinking about National Healthcare Decisions Day, I prepared this plea.  And then an Advanced Directive in the mainstream media came before me and I could have cried with its demonstration of bravery. Things had a way of working themselves out, despite my control tendencies. 

WASHINGTON (Reuters) - Barbara Bush, the wife of former U.S. President George H.W. Bush, is in “failing health” and has decided to no longer seek medical treatment, the office of the ex-president said in a statement from Houston on Sunday.

The former first lady, who is also the mother of former President George W. Bush, “will instead focus on comfort care,” the statement said. She is 92 years old.

The brief statement did not indicate the nature of Bush’s illness but said that she had had a series of recent hospitalizations.

I drove home trying to think about how to write smartly about Healthcare Decisions but lo and behold a heroine stepped forward to lead by example. 

Mrs. Bush has always been a favorite of mine. I actually had the privilege of seeing her speak at a graduation when she shared the wisdom to which I have held tightly. Before I was a nurse who even considered end of life care, I heard this accomplished woman say with conviction, “At the end of your life, you will never regret having passed one more test, not winning one more verdict or not closing one more deal. You will regret time not spent with a husband, a friend, a child, a parent.”

20 years of hospice later, I cannot begin to tell you the wisdom in these words. Absolutely spot on.

So when Mrs. Bush announced today, on the eve of National Healthcare Decisions Day, her wishes for comfort measures, and in so doing releasing her family from guilt and responsibility for what they should “maybe”, I can only be in awe of her.

 Asking for a peaceful and uninterrupted end of life process isn’t as fun as asking for an easy bake oven on Christmas morning. It is scary and lacking with guarantees. It is however brave, loving, and motivated by the same premise of “I am loved and this day will come.” 

Friends, treat yourselves, gift your loved ones, follow in the example of a true American hero. State your wishes and bless your loved ones with the responsibility of honoring your wishes as opposed to guessing in crisis. 

Merry Healthcare Decisions Day!