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20May

What Matters?! About Death and Dying

by Paul Sherman

This past Christmas my 85 year old dad suffered a bout of pneumonia and congestive heart failure. After a weeklong hospital stay we moved him to a recuperative facility to try to get him back on his feet. After multiple attempts at physical therapy, ten days later he requested that additional treatment be withheld. His body, having been ravaged with Parkinson’s disease, could no longer fight. Without further intervention we knew that it would only be a matter of time before the pneumonia and congestive heart failure would return and ultimately cause his death. Despite these consequences that was the choice he made.

The doctors initially told us that it would only be a matter of days, certainly no more than a week or two before he would pass. While I was extremely sad that he was going to die, that fact in and of itself did not cause me needless suffering. I fully accepted the thing I couldn’t change…that at 85 years old his body had given out and he had chosen to forgo additional medical treatment. That was his perogative. So, we did the only thing we could. We asked that he be “kept comfortable.” As we had with our mother 13 years earlier, my three siblings and I put our regular lives on hold and began the death vigil.

Before continuing to share my dad’s final chapter with you, I want to take a slight detour and tell you about an experience that I'd had seven years prior- the death of my beloved dog, Winston. On a sunny July day at the age of 14, Winston suffered a stroke that left him completely incapacitated. The vetinarians informed us that there was no possibility of recovery. David and I knew what we had to do. We called our friend, Winston’s “Uncle Tom,” and he joined us at the animal hospital.

There we were, the three of us gathered in the hospital room. It was time. I held Winston lovingly in my arms, tears streaming down my face, and thanked him for the joy he had brought to my life. David and Tom each took their turn saying goodbye. With Winston still in my arms, the doctor then injected him with a solution. A minute later he went limp in my arms and was peacefully asleep. It was one of the most painful yet beautiful moments of my life. The vet lovingly scooped Winston out of my arms and escorted us out of the room. She took a right out of the room, we a left. The three of us held hands crying as we watched her walk down the hall with the body of our beloved dog. He was no longer suffering needlessly. Out of pure compassion, we had helped to make that happen. They called it euthanasia. I called it love.

Now, back to dad. Having removed him from all of his medications we fully expected his body to rapidly decline. Days turned into a week. A week became two weeks. Two became three. Then we were at a month. You get the picture. During that time my father lay in his bed, drifting in and out of consciousness. The nurse’s aids (God bless them), fed him, changed him, and shifted his position every few hours so that he would not develop bed sores. The clinicians regularly administered roxanol, a form of liquid morphine, to control his pain. This situation was horrible to watch. I kept returning to the serenity prayer…"accept the things I cannot change…accept the things I cannot change." It brought me the familiar comfort I was used to. Then, one day, something happened that rendered the serenity prayer useless.

It was a cold early February night and I had stopped off to see dad. You never really knew what you would find…sometimes lucid…sometimes totally out of it. This night he was awake. Our conversation (if you could call it that) mostly consisted of me telling him about the events of my day and those of my siblings and their kids, his beloved grandchildren. In the middle of our visit, dad began complaining of pain. I immediately alerted the nurses and they arrived with a dose of roxanol. We waited for the medicine to kick in. 5 minutes, 10 minutes, 15 minutes. “Paul,” my dad moaned through his haze, “Help me. Help me. I can’t stand it. You’ve got to get me some more.” I ran to get the nurse. “My dad’s still really uncomfortable,” I told her. “You need to give him another dose.” “I’m sorry, Mr. Sherman, I can’t do that. Our medical protocol requires that we wait another 30 minutes.” “What?” I yelled, “Are you afraid you are going to kill him? The man is on his deathbed!” “I’m sorry, Mr. Sherman. We have to wait the 30 minutes.” The whole thing was surreal, reminding me of that scene in Terms of Endearment when Shirley MacClaine is screaming, "My daughter is in pain, give her the shot God damn it!" To my horror, this wasn't a movie. It was my real life.

I returned to my dad’s room infuriated and incredulous. By the grace of God, he had finally dosed off. Yes, as promised, the medicine had finally kicked in.   As I sat there recovering from this incident, it hit me. Why? Why, 6 weeks after his having said that he wanted to throw in the towel should he be living like this? It was bad enough that this once dignified man (he was a judge for almost 30 years) was laying in his own urine and fesces. Add to this the pain factor and the whole thing was absolutely ludicrous. While the pain became manageable from this point forward (he was now on enough morphine to take down an elephant), there he lay completely sedated waiting to die a slow death. I imagined if my father were watching all of this on a video how disgusted he would be. Not to mention that Medicare was paying for all of this! Wouldn't that money be put to better use feeding a hungry family than prolonging a suffering man's life?

In the ensuing days I became more and more angry, an emotion I'm not accustomed feeling. It completely baffled me that 7 years earlier I had been able to help my dog to pass peacefully, yet I was powerless in this situation with my own father! We treat our pets more humanely than our loved ones. To quote Mr. Spock from Star Trek, "highly illogical". I just couldn't get my arms around it.

When I expressed my outrage to friends and family they were highly empathetic. Though highly respectful of me, there were some who did not share my opinion. "Let Nature take its course." "Who are we to play God?" That argument just didn’t work for me. If God/Nature didn’t intend for us to be able to take this compassionate action, why were we given the capacity to do so? And, wait a minute. Hadn't I already “played God,” twelve years earlier when I donated a kidney to my father and significantly prolonged his life? I had alleviated his suffering then, why couldn't I do it now in a different form?

During the ensuing weeks I did my best to contain my anger in order to be fully present for my dad and family. This wasn't easy as I witnessed him waste away day by day. What made the situation even more difficult was watching the toll this was all taking on my siblings. Unlike me they had children who needing tending to. Running back and forth to the nursing home wreaked havoc on their already complicated lives. The only positive thing at this point was that the clinicians were able to continue to keep his pain under control. Then, thankfully, on February 26, my father, Judge Arthur Sherman, passed away with my siblings at his bedside. What we thought would be just a few days ultimately lasted 6 weeks.

It's now been almost two months since my dad's passing. Since then my anger has subsided and I've been able to experience a healthy grieving process. The serenity prayer tells me to accept the things I cannot change. I believe I should have been able to end my dad's suffering by helping him to die. The law told me I couldn't even if I had the courage to do so (which I did). Rather than continuing to be angry I have decided to channel my energy into changing this societal norm.

In my home state of Massachusetts, physician-assisted suicide is illegal. I believe this is wrong. Those who are terminally ill and are suffering should be able end their lives under the supervision of medical and mental health professionals. This action is legal in Vermont, Montana, New Mexico, Oregon and Washington. Why shouldn't the other states do the same?  You can learn more about this highly sensitive topic at www.CompassionandChoices.org I urge you to speak with your elected officials and advocate for the legalization of physician assisted suicide. We do it for our pets. We should be able to show the same compassion for our loved ones. No human being should have to suffer the way that my father did during his final weeks of life. That's What Matters?!

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