Thursday, September 3, 2009

Intensive Care

I've been going to visit a woman in intensive care. She sleeps a lot, so I read scripture, pray, sometimes sing a hymn. I figure she can hear me. I don't know how she's doing.

My father-in-law spent a week in intensive care before he died. We thought he was going to get better, but he didn't.

Intensive care can be a scary place: all the machines and tubes and noises, people scurrying around. Sometimes you're just there for a day; sometimes intensive care goes on for a long time, and you don't really know what will be the outcome. And sometimes you know, but you don't want to face it.

"It's really a spiritual crisis, isn't it?" she said to me at the end of our conversation.

We were talking about health care: she's a nurse, and she was talking about some of the end-of-life issues she deals with when she cares for older patients. Sometimes a patient will confide in her that they really don't want to go through a difficult surgery, but that their children are pressuring them; sometimes a doctor will wonder about doing an invasive surgery for someone in their eighties. Will their bodies be able to handle it? they wonder. But if the person's mind is active, shouldn't they do the surgery anyway, on the outside chance of a good outcome? Then there is the emerging language about "death panels", and "health care rationing", all because of language in the health care bill about "end of life discussions." (The language has now been removed.)

"It's really a spiritual crisis, isn't it?" she said at the end of our conversation.

What she meant was this: as a nation, we cannot speak well about death, about the fact that we are all going to die someday. Of course, this is universally true; there's that old gospel song with the title "Everybody wants to go to heaven (but nobody wants to die)". But I think that this has become especially true in the United States in this time. Both modern medicine and technology conspire to make us think that we can do anything we want, live as long as we want, fix every problem -- even death. But someday, we are all going to die; even when we save a life, it is only temporary. We are not immortal. But we have a hard time looking at death, talking about death, acknowledging death.

It's a spiritual crisis, as my nurse friend says. It's a spiritual crisis that we do everything to cover up the truth of the fact that our bodies tire out, wear out, give out. It's a spiritual crisis because our behavior has become driven by our fear rather than our hope.

Intensive care. Some people get intensive care, and others do not. Some people are afraid that they will be thrown away when they are old, and others are being thrown away right now, because of fear. And it's a spiritual crisis, a crisis where our fear of death speaks louder than our hope for life -- both this life and the life to come.

You shall love the Lord your God with all your heart, with all your soul, with all you strength, with all your mind. And the second is like it: You shall love your neighbor as yourself.

Your neighbor as yourself. What does that mean? It means that I want my neighbor to have the same things I have: a meaningful life, an opportunity to work, good health, friends and family. It means that I want my neighbor to know abundance, and to have hope in dying.

It's a spiritual crisis, isn't it?


PS (PSanafter-thought) said...

Nice essay, in that it covers many sides of this issue. Maybe we have to get past thinking about the physical stuff to finally get to the spiritual stuff. And all the pressure to do this or that and all the tubes just get in the way.

Grrrrrr on the public debate about discussing the end of life things with the doctor. Two years ago, husband and I did a new will and the power of attorney papers, and the papers about what we want and don't want. I can tell you bluntly that the paper (standard form from the state lawyers group) that the lawyer gave us was pretty bad. It was written by lawyers, not medical people. A person does need these things explained to them. We did go over this with a doctor and changed things to our own wording and choices.

The problem is that most of us never see death, except in the movies. And a movie death is a person getting shot, then their eyes roll back, then they die. But real life and real death isn't like that. There are stages and lingerings, going in and out of consciousness.

One of the greatest gifts given to my mother-in-law when Father-in-law died was the hospice nurse talking to her about what death would be like. She had realistic expectations.

My son was in intensive care for 21 days when he was 1 1/2. I had never lived in that type of uncertainty before. The medical people liked working with him because, although they couldn't guarantee that he would recover, they did know that if he recovered from the infection, he would be normal. Most of the other pediatric patients had conditions that would prevent a normal life, no matter how much better they eventually got. That month was quite an education.

Fran said...

It is a spiritual crisis and a big one.

Wow Diane, you really nailed it with this post.

We think we can control it all - both from the perspective of those who speed their own death to those who think it will be sped up. Lord have mercy on us all.

As you know Diane, I have done funeral ministry and I love it. And I also watched my mother die, a moment that, sad as it was, was a gift.

We are so lost as a nation.

DogBlogger said...


Mompriest said...

In the community I serve these are daily, hourly, topics of conversation and situations we face - parshioners and clergy alike.

I just told my daughter - when I get too old, just give me a canoe and a paddle and I'll head off up the river saying, "I love you, it's been a good long life" the American Indians have done....I don't want the surgeries or the meds or the nursing homes....nor the strain on my kids.

I know. naive....over-simplification....but that's me.

Presbyterian Gal said...

Yes it is.

Well said.

Barbara B. said...


Ruth Hull Chatlien said...

So cogent, so insightful. Thank you.