by Monica Williams-Murphy, MD
NOW THIS IS DEFINITELY A WEIRD TOPIC but here goes:
I have cared for people who have died in almost every way imaginable. I have seen people die from decapitation, a hole shot through the heart, and those who have ”simply” fallen over dead from a sudden heart attack. Those are quick but possibly painful ways to “go.” In contrast, I have cared for those who have slowly died over the course of years: Alzheimers, where the brain is dying long before the body catches up; Emphysema, where the lungs slowly lose their wind, to name a few of the chronic disease-pathways to death.
But by far, my favorite way to die, is by a sudden massive brainstem hemmorrage. I am envious of people who get to end life this way. However, the likelihood is that you and I will die some other way, likely of one of those chronic-illness pathways or natural decline. So, here is why I am fond of the sudden brainstem hemmorrhage. It is based on my experience with two men in their late 70s who were in previously good health.
Patient A, was a man who was known as the “life of the party,” always quick to put a smile of the face of strangers and loved ones alike. This gentleman spent the last day of his life doing what he always did. Apparently, he was sitting on a rocking chair on the front porch of a friend’s home, cracking jokes. In the middle of hysterical laughter, he fell over unresponsive and never woke up again. He was flow by helicopter to my care and I pretty much knew what had happened to him when I walked into the room: his blood pressure was through the roof, his pupils were tiny and pinpoint and he was basically brain-dead.
As I apologized to the family for this terrible occurence but simultaneously sought to assure them that this gentleman had not suffered, a daughter interrupted me and said, “Doctor, this is the way he wanted to go. He would have wanted to be with his friends, telling jokes. And, if he could talk to us right now, he would say, “Good days people, we’ve had good days.” I found myself thinking, “Wow, what a way to go. I’m jealous.”
Patient B was a man who had “lived life on his own terms,” according to his family. He had been visiting all day with his son and they were talking about their next gambling trip. The patient remarked, “I’ve got a headache and I never have headaches.” Those were the last words he ever said.
But, I had learned from patient A and in explaining patient B’s prognosis to his family, I said, “When I am 78, if I can spend my days doing what I love and then “go” like this, I will consider it a blessing. You are awake, you are yourself and then you are gone. We all die and I call this kind of death a blessing.”
You should have seen the looks of shock and surprise, but then an “Ah-ha” moment occured in the room and they got it. Everyone began to nod their heads, “Me too,” a few of them said.
Now, I want to confess why this is my preferred way to die: these sudden brain stem hemorrhages often plunge you directly into a coma and just like you, I want to avoid suffering. Sure, all of us would like special time for sharing the ”I love you’s” and “Goodbyes” before keeling over like my patients, but overall I will bet that everyone reading this would like to be in great shape when they “go” regardless of ”how” they leave.
No one wants to spend years lying in a bed hovering around death but not quite there yet (one foot in the grave and another on a banana peel to quote a folk-wisdom-filled relative of mine).
Even more explicitly stated: No one I know wants to suffer and then linger in suffering before the end of life. Ergo, we must be super-careful regarding the choices we make for ourselves and those whom we love when that time arrives.
So, here is a thought provoking multiple choice question: What is your favorite way to die? Would you rather it be said of you:
A. She died while planting red tulip bulbs
B. She died in her rocking chair holding “Cookie” her pet cat, or
C. She died in the intensive care unit at 2 am after a long fight with cancer
or D. (Insert your own ideal dying here)
I know the answer to my test. What is the answer to yours?
The answer to your test should be used as the key when making medical choices at the end of a long life or at the end of a terminal illness.
(See, I told you this was a weird one, but this kind of in-your-face article was written to shake up your thinking. However, I will remind you that I do not support Physician Assisted Suicide or Euthanasia. Yet, I do believe we should be very careful to prevent unneccessary suffering at the natural end of life.)
About Dr. Monica Williams-Murphy
Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. She is the co-author, with her husband, Kris Murphy, of the book, IT’S OK TO DIE.
Her website/blog IT’S OK TO DIE: WHEN YOU ARE PREPARED has some very useful, downloadable “preparation checklists” including: Planning Your Death, Death of a Loved One, Someone has Died, and Bucket List; plus many useful articles.
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