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Michael Attas: Lent
season offers reminders of our shared mortality
Waco Tribune-Herald (TX) - Tuesday, March 6, 2012
Author: MICHAEL ATTAS
This
past week three different sources told me what was essentially the same story
seen through totally different lenses.
On Ash Wednesday, my pastor began his sermon by looking around to those
gathered for the beginning of Lent and spoke loudly and forcefully words
intended to shock us out of our complacency.
“You are dying” he said. “You are dying. And the only difference is that some
of you know it and have been given a specific diagnosis and a general time
line, and others of you don’t.
“But rest assured. It is happening.”
We silently came forward later in the service to have the ashes placed on our
foreheads, hearing the solemn words that bring it all home: Remember that you
are dust and to dust you shall return.
Leaving in silence and darkness, one cannot help but get a good reality check
about our shared fate.
Two days later, I received a tender, quiet email from a colleague at Baylor
University who recently was diagnosed as having terminal pancreatic cancer.
He may have six months to live, but he wanted to thank me for a workshop I led
at his church many years ago on the major difference between healing and
curing.
Healing is possible
Healing, I reminded them, is possible even as we walk through the valley of the
shadow of death. It is possible when curing is painfully absent.
And in his words, I saw courage in the face of darkness, love in the place of
despair and acceptance of the words I heard my pastor say only two nights
before.
Yes, we are dying. My friend has chosen only basic palliative care and will
actually go quite gently into the good night. He will not rage at the injustice
of it, and I am sure that he will die with the peace and dignity with which he
has lived.
Yes, I am dying, he said to me. Yes, we all are.
The third of the “messages” was an article that a dozen or more friends
forwarded to me at about this same time. It was published in the Wall Street
Journal and was headlined “Why Doctors Die Differently.”
The thrust of the article was the rather amazing and very true statement that
doctors — who surely have access to all of the latest clinical and research
trials and cutting-edge technology — often forgo those when faced with terminal
illness and choose to die simple deaths surrounded by loved ones. Just let it
be what it will be.
The article confirmed what I have observed in 40 years of medicine. The most
aggressive and unending treatment options are often chosen by those who have
been the most disenfranchised by medicine for most of their lives.
The higher the education and socioeconomic standard of the patient, the more
they want to simply die with minimal heroic measures.
And the people who have been pushed to the margins most of their lives often
want “everything done,” even when the medical team knows it is wasted effort.
Health care cost
So where does that lead us? An alarming set of data confirms that 25 percent of
our national health care expenditures comes in the last 30 days of life, when
we know the outcome is futile.
As a nation, we are squandering precious resources refusing to accept the fact
that my pastor and friend both freely acknowledge.
We are dying. We are dust. And to dust we shall return.
It is a collective Lent reminder of our shared mortality.
Yet we continue to insist that all diseases can be conquered, death can be
squelched, and if we only pour enough resources into health care we can avoid
our certain fate.
Our minds tell us otherwise, of course, and deep down we must certainly know
better.
What can be done? For starters, I believe we must have a calm, respectful,
loving and rational national conversation about end-of-life expenditures and
issues.
It must be done without one side accusing the other of “death panels.”
It must be done without inflammatory rhetoric and threats of catastrophe or
socialism.
We cannot continue to avoid realities in this part of health care. We have
abundant resources and are simply not using them wisely.
Yes, we must be cautious about turning these decisions over to congressional
committees and legislation.
But yes, we also must be cautious about turning them over to corporate board
rooms and stockholders.
And, yes, we must be careful about turning a blind eye and saying “let’s just
leave it to the marketplace and the sanctity of the physician-patient
relationship.”
Facing facts
Trust me, we have neither the collective wisdom nor access to all of the facts
we need to make a wise decision about many of these things. Together, we must
face the fact that we are in a Lent of our national life about health care
issues and expenditures.
We must face these together — and wisely — or surely we will all fail together
in our efforts to provide compassionate care for our society.
It is Lent, and to dust we return.
Dr. Michael Attas is a Waco-based physician, a medical humanities professor and
an Episcopal priest. His column appears on a biweekly basis. Send email to
Michael_Attas@baylor.edu.
Section: accesswaco
Record Number: 17966898
(c) 2012 Robinson Media Co. LLC - Waco Tribune-Herald
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