Taking Control of Death

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Science isn’t the only game in town. Literature can teach us things about the world that science can’t. It can give us vicarious experience and insight into other minds. Two recently published novels illuminate why perfectly rational people might reject the help of scientific medicine and prefer to die a little sooner but to die on their own terms.

In Finding Frances, by Janice M. Van Dyck, an elderly woman with COPD and heart disease has had a gradual decrease in her quality of life and has been ready to die for some time. She believes in God and an afterlife and is not afraid of dying. When she needs emergency surgery to remove a section of infarcted bowel, she wants to refuse it, but accepts mainly because she is told that otherwise she will be sent home where insurance won’t cover her care and her husband’s savings will be depleted (which isn’t really true). The first surgery leads to complications and she is offered a second operation with a 25% chance of success. She refuses despite the strong urgings of her health care providers and her entire family. She is given hospice care, stops eating, and eventually dies. The book chronicles the course of the death process in hospice, giving a feel for what the experience is like and how it impacts family members.

In The Leisure Seeker, by Michael Zadoorian, Ella and John, a couple in their 80s, set out on one last road trip in their RV, to follow the entire length of old Route 66 and revisit Disneyland. Their doctors and their children try desperately to dissuade them. He has Alzheimer’s and she has cancer and other health problems: between them they have one functional brain and one functional body. She has refused surgery and chemotherapy, uses a walker, and is dependent on pain pills. He has made her promise that she will never put him in a nursing home. After many mishaps, misunderstandings and misadventures, they manage to reach Disneyland. Then she finds a way to end both their lives at the same time so neither will be left alone. She is a feisty, colorful character and the book is hilarious despite its sad subject. Ella tells us what it feels like to become old and decrepit, to be handicapped and live in pain, and to live with a demented loved one who must constantly be watched and doesn’t always remember who you are. And how one can find joy in the small pleasures of life despite all those problems.

I don’t think I would make the same choices in their situation, but I can understand their choices and empathize with them. They didn’t give up hope or turn to false hopes, but they created their own realistic hope — the hope of a “good death.” They rejected dependence on medical care, took control of their lives, and met death on their own terms. I have to respect their autonomy and admire their courage.

As Ella says at the end of The Leisure Seeker after she plans her own and her husband’s death by carbon monoxide poisoning:

This is not always what love means, but this is what it means for us today. It is not your place to say.


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Silly Cay

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silly-cayProbably one of the most unique island names, Silly Cay is a pristine 11 acre island located the Turks and Caicos. The Island is currently being developed by Silly Creek Estate and Marina Club, and presents a unique opportunity to enjoy water frontage in more ways than one in the 3 phases of the project.

Lots are located on a 46 acre peninsula, the tip of the peninsula being cut off by a new canal to create an attached virtual island of close to 3 acres (Emerald Cay), plus the third phase, an island called Silly Cay, comprising an additional 11 acres. All located on the Provo’s southern shore, bordered on one side by the sea and on the other by the easternmost end of Silly Creek. A central roadway winding through the peninsula creates a natural property divide between ocean side and bay side plots, with the entire development boasting three miles of water frontage, permitting all lots to be waterfront.

The property was designed to permit owners to purchase cross lots, with the main residence built on the ocean side and a guest house or boat house, with private dock, occupying the bay side section.

For more information on how to take part in this project visit Private Islands Online

Our view: Education can encourage primary-care doctors – GoErie.com

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Plain Dealer (blog)
Our view: Education can encourage primary-care doctors
GoErie.com
The path to medical school starts at a young age, when you develop an interest in science and take the right kind of courses to prepare you for the rigors ...
Doctor shortage in Miss. about to worsenJackson Clarion Ledger
Will there be enough family care doctors to treat newly insured?: Health Care ...Plain Dealer (blog)
Guest editorial: New approaches will ease shortageThe Tennessean
Jacksonville Daily News -al.com (blog) -Sioux Falls Argus Leader
all 26 news articles »

Human Recklessness is Causing Incredible Environmental Disasters

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To those who think us puny humans can’t really affect the weather, the climate, the environment, the planet — see this sad, shocking video.

“NUKUS, Uzbekistan — The drying up of the Aral Sea is one of the planet’s most shocking disasters, U.N. Secretary-General Ban Ki-moon said Sunday, as he urged Central Asian leaders to step up efforts to solve the problem.

Once the world’s fourth-largest lake, the sea has shrunk by 90 percent since the rivers that feed it were largely diverted in a Soviet project to boost cotton production in the arid region.

The shrunken sea has ruined the once-robust fishing economy and left fishing trawlers stranded in sandy wastelands, leaning over as if they dropped from the air. The sea’s evaporation has left layers of highly salted sand, which winds can carry as far away as Scandinavia and Japan, and which plague local people with health troubles.”

Read more at Huffpo.

The problem with each environmental disaster that humans create is that it creates a domino effect and affects so much more than the initial reaction.  Lack of water where once local fishermen depended on the food and the work also leads to heart and health troubles far away.  Coal plants the burn coal in the midwest pollute air on the east coast and cause asthma and heart problems in the east, where they don’t even burn the coal that comes from there.  What will happen to the Great Barrier Reef now that yet another ship has run aground on the shoal on the southern tip of the reef,  with a hole in its hull?  The Shen Neng 1, was carrying about 65,000 tons of coal and about 950 tons of oil were on board.  Now it’s leaking into the ocean.  It’s a small amount, but any oil leaking into marine reserves is completely unacceptable.

Unfortunately greedy people, grasping on to their addictions to fossil fuels and with complete disregard for the environment, are causing these immense environmental disasters, and there is a big price to pay now and in the future.

Breastfeeding saves life, money: study – Xinhua

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National Post
Breastfeeding saves life, money: study
Xinhua
... linked to breastfeeding are vastly underappreciated, said lead author Dr. Melissa Bartick, an internist and instructor at Harvard Medical School. ...
Breastfeeding saves lives and moneyExaminer.com
Report: More Babies' Lives Saved with BreastfeedingWBAY
Breastfeeding may save US $13 billion a yearWHAS 11.com (subscription)
AOL News -eFitnessNow -Gather.com
all 639 news articles »

Another loss can follow for couples who lose a pregnancy – Los Angeles Times (blog)

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AnnArbor.com

New Facebook Group for Pre-Med and Medical Students Considering Pathology

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N110628148961395_2800 Dr. Kim Solez at the University of Alberta has created a Facebook group after it occurred to her that we as a pathology community may be missing out on the best and brightest young people who might not otherwise enter pathology because there is almost nothing about the discipline on Facebook and YouTube, the entities they commonly use to find out about something. 

I think this type of promotion to medical students will be critical to attract candidates for all medical specialties.  I am optimistic the pathology community can achieve this but remain skepitcal given lack of pathology in medical schools as it has been traditionally taught and lack of exposure to pathologists to help promote our specialty.  The likes of increased use of Web media and networking tools such as USCAP TV will help to showcase pathology in a positive light rather than negative media and impressions.

 

Please contact Dr. Solez with your suggestions/ideas about what other resources and links would you should be added or any other suggestions on how the site might be improved including  images and video. 

Name: Pathology Careers

Description: A group designed to provide information to premed and medical students considering careers in pathology and laboratory medicine.
Privacy Type: Open: All content is public.
Location: Edmonton, AB

Windy weekend

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Puffins up close on the Farnes
Razorbills mating
Monday 5th April comments:
It’s been a mixed weekend – a typical bank holiday weekend for the Farnes – we’ve had some good weather and we’ve had some poor weather – in fact we were closed today! The breeding birds have performed well during the open days, with vast numbers of Guillemots, Puffins and Shags on display. However the strong winds of today pushed them back off to sea, so the erratic behaviour continues.

Breeding birds: Shags on eggs, Guillemots, Razorbills and Puffins all seen copulating, Black-headed Gulls inspecting the main nesting colony, Kittiwakes on cliff ledges, Mallards five females on nests on Inner Farne.

Recent Highlights
Saturday 3rd Highlights: Red-throated Diver 4N, Sparrowhawk female, Black Redstart 6, Blackcap male, Willow Warbler, Chiffchaff 2 and Lesser Redpoll.

Sunday 4th Highlights: Black-throated Diver summer-plumage adult north, Red-throated Diver 2N, Canada Goose 2N, Swallow 2N (first of the spring), Black Redstart 3 including one singing and Chiffchaff.

Monday 5th Highlights: Mediterranean Gull first-winter, Sandwich Tern 37 in evening roost, Sparrowhawk female, Black Redstart 2 and Chiffchaff.

la tortuga viajera

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La tortuga viajera is Erin Ridley’s contribution to discovering Spain and it’s surroundings. An American, now married to a Spaniard and residing in Madrid, she shares her experiences, culinary recommendations (including cooking at home), and all things Spanish. Erin believes she’s living an enchanted life – one she shares via her blog.

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Jessica Corry, Republican Mom for Marijuana Legalization

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Marijuana Reform Advocate Jessica Corry appeared on Fox News on Sunday, expressing her support for efforts in California for legalization.

From Mediaite:

“GOP Mom” happens to be Jessica Corry, “a Republican activist, and mother of two young girls. She is also a marijuana advocate who says Republicans should get behind the movement.”

During the interview Corry espoused an essentially Tea Party message:

"This is more than about Pot. This is about a future where we don't rely on the government to enforce our moral behavior. And as we've jut heard the national debt is a greater threat to our country than Afghanistan. And when every American born today is issued a bill for $45,000 as their share for the debt, nothing should be no line item left off the table."

The initiative will be on the ballot in November.