An edited version of the following originally appeared on the website Everyday Health.

 

Like so many other medical professionals, I felt voiceless in the face of a gargantuan healthcare non-system built to do things to people, rather than for people. But after a decade of hospital practice, my “cry for help” looked slightly different than the typical midlife crisis: it involved the creation of a somewhat ridiculous blue-scrubbed rapping doctor alter ego. “ZDoggMD” could drop mad truth via YouTube in a way that “Dr. Damania” never could. I had finally found my voice.

But with “Ain’t the Way to Die”, about the suffering caused by our failure to think and talk about our end-of-life wishes early on, I was moved to see that thousands of others were able to find their voices, too. The response, an outpouring of painful and poignant reflections across social media, spoke to the nature and scope of what physicians have long known is our not-so-secret national shame. As one commenter on our blog observed:

“America is the best place to live, and the worst place to die.”

The emotional stories left in response to our video evoke reality better than the video itself ever could. There were the families lamenting the immense burden and guilt of having to make decisions for loved ones who never expressed their wishes in advance:

“He was ready to leave, we were not ready to let him go. Our selfishness, our sorrow, our love didn’t want to let go. He should have left sooner, but we could not release his hand to send him on.”

Then there were fellow healthcare workers sharing all-too-familiar experiences. They told of “hating themselves” after being forced to administer such tortures as rib-shattering CPR and mechanical ventilation on elderly patients whose families refused to let go, not understanding the horrors that our “do everything” approach can inflict:

“She came to me without any sedation, eyes bulging, screaming without a sound through the breathing tube, grabbing at whatever she could. I had to tie her hands to the bed and sedate her heavily so she wouldn’t have to remember anything. Then I pushed my way out of the room and broke down in tears in the middle of the ICU.”

But the stories of “good deaths,” of times when dying was treated as a crucial element of living, a source of peace and closure for patients and loved ones—these truly light a path to a better way:

“As a nurse-midwife, I have had the privilege of holding many babies as they take their first breath and greet the world; being able to hold my mother as she took her last breath, in such a peaceful way, was no less of an amazing privilege.”

The common theme of such stories of hope and peace in the dying process was clear: it all begins with a conversation. It might be with a loved one, a friend, or a trusted medical team member. Or it might be a conversation we have with ourselves: what matters to me at the end of my life? What compromises and interventions am I willing to accept, where do I want to spend my final days, who will I entrust to make decisions for me when I can’t?

To consider these questions during calm times, and communicate through open, ongoing discussions with those who matter to us, is a gift. Not just to ourselves, but to those closest to us who would otherwise suffer guilt and agonize in indecision:

“Our son was about to go through full body radiation on top of overwhelming chemotherapy — a last ditch effort to cure his relapsed AML. We had a serious conversation that day, in the office of the radiation oncologist, who had bravely brought up all the grave concerns that come with this kind of treatment. Solemnly, maturely and with remarkable self possession, my son spoke plainly on a subject nobody his age should even be aware is an issue. He told us he did not want to be kept alive on a ventilator if there was little hope for meaningful recovery. Meaningful recovery for him meant the ability to go to school, to have a girlfriend, to look to the future with hope of an independent life. A mere four months later, we had to make the decision no parent should have to make and silenced the machines keeping the shell of our son alive. Knowing his wishes some days is the greatest source of comfort I have. So many people deny that death comes and do not want to have to make these decisions, but doing so may be the final gift of peace for your family. If a 13-year-old can face this and discuss it, so can you. Do it now.”

How? We need to talk about dying. The Conversation Project offers one approach to starting that crucial first dialog with your loved ones. When you are clear on your decisions, fill out an advanced directive to document your wishes and your choice of a trusted person to make decisions for you when you can’t.

Find your voice and make it heard, now.


 

Postscript

Right around the time I released Ain’t the Way to Die, I received the following email sent to the friends and family of a close friend and his wife, who had been battling metastatic cancer at too young an age. Just days after sending this, she passed away at home. He’s given me permission to change the names and share this. It beautifully illustrates the painful complexities that accompany caring for a loved one who is dying:

Family and friends,

In October of 2013 my wife Jane underwent endoscopic surgery to drain 1.5 liters of fluid built up between her lung and chest wall cavity. During this procedure her chest wall lining was biopsied to determine the nature of what appeared to be microscopic tumors. The tumors were not benign and the big ‘C’ entered our lives.

What followed was too numerous to count CAT scans, MRIs, x-rays, blood tests, and side effects. After 10 months on hormone receptor pills, months of vigorous chemotherapy treatments and localized radiation modern medicine is unable to successfully eliminate the spread of the disease.

What lies ahead for us and all of you is the process of making Jane as comfortable as possible for her final transition from this life to the next. We have asked all the questions, looked at all our options and are working though the inevitability of her time left with all of us.

Be patient. This is new for us, while we pride ourselves on being ‘above the fray’ there will be decisions, actions and communications that do not meet your expectations. This is not intentional. It just is.

What we ask from all of you:

Jane has good days and not so good days. She has asked me to be the primary point of communication with everyone to manage her time and energy. Please do not call/text Jane directly, and please do not just stop by. I realize this will be close to an impossible ‘ask,’ but she needs everyone to respect her wishes as it is her life, her decision and we all have to respect her decisions.

Time. It is impossible to predict a ‘when’ or ‘how long.’ Suffice to say it is not as long as we hoped for, given the prognosis. Please don’t ask her, she does not know, no one does, and the end is not our focus, her life is.

She is in a lot of pain. The pain medication does not forestall the progress/pain of the disease which means physical contact of any kind causes excruciating pain. Translate that to: not touching her and definitely no hugs.

This next one is a tough one: Keep in mind there is one of her and many of you. Her physical being cannot absorb and recover from strong emotional events. It’s okay to be sad, grieve and feel the loss. She can’t help you through it, like she did for so many in the past, as that is too stiff a headwind for her. Be present, be positive, be her Mother, sister, brother, niece, nephew and friend.

Jane has asked that this be a private family and friends process. She specifically asked this not be a social media event, fodder for blogs, fundraisers, discussion forums, posts on your Facebook page, she is a private person and asks that you respect this.

We need positive vibes. We do know each person will process this unimaginable event in their own way, however please respect her time and energy as she is the best and deserves to be remember and treated as such. This is not a time of grief and agony for us. We are blessed in so many ways. All the parts of life we shared with many of you and have felt, seen, smelled, hiked, biked, ate, drank add up to an insanely wonderful time together. It is sad, loss is not easy, please remember to remember the best moments in her life that you shared. You know the good times, the really good times.

Strive for normal. The most mentally and emotionally draining interactions are when someone treats Jane as ill or infirm. She’s still got it, so tread lightly on trying to help with your own comparisons, verbalizing similar experiences, and asking her if she needs ‘help.’ She’s tough, she’s got this.

No pictures. She does not want her final time with us documented. Keep the pictures you have as she is physically not the person many of you know, or have seen in the past.

Faith. Jane and I have ours and each of you have your own. We know people are praying for us. We have friends of all faiths and religions and appreciate everyone who calls on their faith to support us, understand, comprehend, cope and process this. If you see her, Jane asks that she not be reminded of your depth of belief, the sincerity of your prayers, only that you are present as family or as her friend.

I wrap up by thanking all of you, my life would be diminished if I did not have the brains, and if she hadn’t lost hers long enough, for me to talk her into marrying me.

Best,

John

“If I just lay here. Would you lie with me and Just forget the world.”

Sent from a mobile device w auto korrect


 

Get ZDoggMD to come speak and perform this song live.

 

43 Responses to “The Conversation”

  1. Kay Walker

    John is a wise man. We can all hope for many more. Thanks John.

    Reply
  2. Samuel Sampson

    Thank you ZDoggMD. It takes a lot of guts to go this direction. In fact it may go further than you thought when you posted it, and it may not be as contained a conversation as you might have imagined it would be. But our society needs to talk about this and we need someone who’s been there to start it off. Your, Atul’s, and other’s voices are the leading edge of a conversation that needs to be both honest and compassionate.\n\nFor most of us, if we think of death at all, we think of it as a physical failure. But it is an integral part of being human. I know this, you know this. We as a public need to also learn this, so that we can make the choices to begin to deal with our fellow human beings on their last journey humanely.

    Reply
  3. Andrea Rambo

    My mother was diagnosed with gastric cancer in 2012. She went through all the chemo and radiation for a year. She was still mobile, active, lucid, and relatively pain free until November 2013. I got the call I was dreading from my dad. “You need to come.” I came. Mom was in the ICU, on BiPAP (breathing mask), but was still lucid. She had discussed her situation with Dad, my brother, and myself when she was first diagnosed. No breathing tube, no feeding tube, and definitely NO CPR. I am a respiratory therapist with several years of ICU experience and I knew exactly what that would mean. Mom had worked as a veterinary assistant for many years before her diagnosis and she told me “we treat our animals better than that, I don’t want a futile effort to save my body. Living on a machine is not life. It’s keeping a corpse.”\n\nWe all agreed. Mom said that “I can’t do this anymore.” It hurt to hear my strong, brave, Navy veteran, always there mother say this, but we did it. We took Mom home. She died November 16, 2013 after 3 days at home. She was lucid until about 3 hours before she passed. No pain, no tubes, no drama.\n\nI keep telling myself that’s the way to go. I have drawn up end of life care, powers of attorney, and living will documents. I am in good health, but you never know. I don’t want to die like some of my patients, with tubes sticking out of every orifice, puffy from fluids and steroids and unable to communicate well, if at all.\n\nThank you, ZDogg, for pushing this topic out there and maybe it will make some people realize that death is not a bad thing, but the dying process can be brutal, and it doesn’t have to be.

    Reply
    • ZDoggMD

      Thanks Andrea, for telling your mom’s story…

      Reply
    • Sherri Jo Caudill

      It’s not just about the DNR. Its about having a POA that will abide by your wishes …even if it’s not your closest relative (usually better if its not) or conducive with their beliefs. I have seen pts families rescend their DNR after they no longer have capacity. I have seen MDs that don’t agree with palliative care do invasive procedures that are not conducive with the pts DNR. I have watched pts be resusistated and sustained repeatedly for almost a year because the family wanted to collect the disability check, and I’ve seen families hold on because no one was willing to say “there is no hope”….these are real problems that need to be addressed on all sides….

      Reply
  4. Seth Cohen

    I am a big proponent of advance directives. I tell my patients that they need to put things in writing otherwise you run the risk of hurting family members already in a difficult situation. I tell them, “You can’t choose how you come in to this world, but you can choose how you go out.” My father didn’t have anything written down. He wasn’t able to be extubated and was was unresponsive when the sedatives were attempted to be weaned and we were unable to perform the proper tests to identify brain activity. He had smoked all his life and had emphysema. His brother knew he did’t want CPR, I knew he didn’t want a tracheostomy. When the ICU physician brought up a tracheostomy, I knew he didn’t want it. My uncle wanted to try it because there was a chance he could recover. I had worked for several years on a vent floor and knew his chances of removing the trach were poor at best. The physician said he knew of a great facility that helped people have trachs removed but in my heart of hearts, I knew it would happen. I agreed to the procedure, as I was in charge of his medical care, as certain as I could be, that this would only delay the inevitable. I agreed to it for my uncle. If he lost his brother not knowing, he would have a hole in his heart and how he would cope, or not be able to cope, would effect our relationship. The grieving process begins well before the loss of a loved one. I knew this, my uncle I believe, did not. This procedure was done more for my uncle than my father. The worst thing is I remember telling my wife I hoped my father didn’t wake up. When he didn’t, we finally turned off the vent. My father passed 15 minutes after I stepped out with my brother with my wife and uncle at his bedside. Your video really touched me. Thank you.

    Reply
  5. Victoria George

    I am a former Oncology nurse, have married and then buried 2 husbands, and now have a Parkinson’s related condition myself and I can tell you this: No one gets outta here alive so enjoy your life and when its your time- talk about it!

    Reply
  6. Laurie-Jean

    Jane’s, advise on no pictures really resonated with me. When my father was nearing the end of his battle with pancreatic cancer I insisted on having photos of the two of us. He tried to convince me that no, I really would not want these images once he had passed. He said they would not be enduring and bring comfort to my grief. However, I persisted and had a couple of images taken. No question, he was right. Those pictures are NOT my father! John, thank you so much for sharing!!

    Reply
    • Mary

      That may be true with adults but with babies that parents have never had a chance to get pictures taken this may be the only pictures a parent ever has.

      Reply
  7. Mary

    About 15 years ago I decided that I wanted to start traveling as a nurse. At that time, I sat down with both of my parents and had ‘The Talk’ with them. Most people equate ‘The Talk’ as a necessary educational session about the birds and bees between child and parent……..well, this one is just as important and can be just as surreal. ‘The Talk’ was a discussion about what each of us wanted to be medically done in the event that we could not speak for ourselves. I knew, as the middle and most responsible child, that the burden of making medical decisions would be mine. My parents had even named me as executor of their wills because they knew that I understood the responsibility and would strive to ensure that their wishes were respected. For some reason, they did not see fit then (or since) to draft an advanced directive. I think it may have something to do with the religious beliefs of the extended family, which indicate that everything possible should be done no matter what the quality of life. The funny thing about ‘The Talk’ was that it was not only for me to understand their wishes, it was also for them to know mine. As a traveler, I was out to experience what the world had to offer. I went coast to coast, north to south and did a lot of fun, adventurous things. My dad would scold me fairly often saying, “Why can’t you do something safe, like knitting?”. I was and am well aware that accidents happen all the time. I did not want them to have to decide what I would want. After every few assignments, we would revisit ‘The Talk’- something that is just as important. It surprised me to find that my parents wishes changed as they got older. Even though I have somewhat settled down and haven’t traveled in about 6 years, we still discuss our wishes every so often.

    Reply
  8. Jay__Money

    The way it is . . . Healthcare like cops…we go and do what others dare not do and make life and death decisions others could not / would not do!

    Reply
  9. Jay__Money

    The way it is . . . Healthcare like cops…we go and do what others dare not do and make life and death decisions others could not / would not do!

    Reply
  10. Kim Martin

    Thank you Zdogg. Some years ago my mother, who had Lupus, was in the hospital yet again. She most definately did not want any cpr or other life extending measures and had made it clear to us and her doctor. She was done fighting the good fight. Well, she went into cardiac arrest and guess what.. her doctor ran a code on her. Twice. The code was not successful and she passed away. I asked her Doc why on earth he ran a code on her when she was a no code. His response? “Well, she was so young (she was 50 ) that I knew she would want us to try”. NO SHE DIDN’T! The anger I feel toward that doc is still with me today.

    Reply
    • ZDoggMD

      That is awful. Did she have it spelled out in her chart, etc? If so, that’s malpractice and assault. If not, then we need to be more proactive as physicians in making sure we document what our patients wishes are. Thanks for sharing this story!

      Reply
      • Kim Martin

        Thanks Zdogg. I was young and a brand new nurse at the time so I was still a little intimidated by the doctor ( not like now ) so I wasn’t aggressive in pushing the issue. By the way.. I LOVE your videos! I showed them at work last night in the ER and we were laughing hysterically!

        Reply
  11. me

    As an ICU RN for neonatal, peds and adults (burn and MICU), beginning in the 80’s, and well, I could share stories that are not fit for layman consumption. Back then, we medical folks had all the new technology, FABULOUS & AWESOME technology, which naturally every resident, fellow and attending wanted to use. Asking parents to make a decision to put your newborn on ECMO (heart-lung machine) but that he/she would probably be blind at BEST if they survived was brutal. And that was an EASY conversation.\n\nWhat I would like most on this post to say is that family, TALK to the nurses at the bedside. They often can explain options and reality with more candor than physicians. You have a different relationship with them; you are together for 12 hours a day. If you ask your doc and nurse to PLEASE don’t let them suffer, we can take care of the rest, and try our very best to give you a “good death”.

    Reply
  12. Vicki

    My mom was diagnosed with stage 4 breastfeeding cancer at 59. I was a hospice nurse at the time. An interesting thing, to do “your job” with your mom. We talked about everything. Everyday she asked me what was next, what it would look like to die. She was private and modest. She was mortified at the idea of needing help to bath or go to the bathroom, or god forbid, be in diapers. She made promise to knock her out at that time”. When the time came, she had brain mets, not really aware. She did have a cognizant moment at the end,during a diaper episode. She panicked, screamed at me for not doing what she wanted. That was anted as her last words to me. She was never alert after that and passed less than 2 months from her 60th.

    Reply
  13. Christine Gavett

    I just found out about you and your work through this video. Keep it real, my dear!\nMy mother has been living with me for 7+ years, and is starting to fail a bit. Having been a eucharistic minister in the RCC and a hospice volunteer, she’s held the hands of several people as they died. She and I have had many long conversations about her last wishes, and I’ve had to try to explain to my siblings. So her last MI has left her with less than 30% cardiac output and smoldering CHF, along with her 30+ years as a diabetic. Surprisingly, she’s still spunky and loving, in pretty good health otherwise (still has all of her extremities and vision, even with glaucoma). Being a former nurse and a present optometrist, I keep her on her “schedule”, along with my brother and her daily caregiver. \nBut with this last heart episode, the cardiologist was very frank in revealing he would not perform any more surgeries (she’s had stents placed twice, and her pacemaker has already been replaced once). She adamantly refuses extending her life – in other words, no tubes, and no CPR. (C’mon, she’s 91, ferkrissakes).\n\nMy brother’s response was, “No CPR? But why not?”\nI said, “She has almost no heart left. And that’s not what she wants. If she’s gone, she wants to stay gone. She wants to be with Dad, and she wants to see Jesus. It’s easy to do everything. That’s the easy decision. The hard part is not doing anything.”\nI learned that when I changed jobs (way back in the 80’s) while I was still an LPN. I went from CCU to a nursing home – for nuns. My little nunny-bunnies, I called them. When I was being familiarized with the nursing station, I casually asked, “Where’s the crash cart?” \nThe response was, “We don’t have one.”\nI was shocked, shocked, I tell you! “What do you do when someone codes?” I asked, incredulous. \n\n”We pray”, was the answer.\nAnd so, over the space of several years, I learned how to NOT do everything. To hold some little woman’s hand, and listen to her soul sisters pray. It’s hard, but it’s the right thing to do.\nThank you so much for this video, and everything you do. Even though your parents didn’t want you to be a doctor, I’m betting they’re very pleased with how you’ve turned out!

    Reply
  14. Eva Thompson

    Thanks for this video and stressing the importance of “having the conversation.” My parents were clear about their wishes, and now I’m trying to be clear about mine. I have metastatic colon cancer; am living well still but am about to fill out P.O.L.S.T. forms. These orders come through your doctor, stay with your medical records, and are therefore followed better than Living Wills are. Most importantly, I tell my family constantly that when things progress, I want comfort care only: no breathing tubes, no artificial feeding. I stress at every appt. with my oncologist that I want “quality over quantity.” I’m pretty confident that I’ve made myself clear.

    Reply
    • Hpmdoc

      Eva, thank you for sharing. I wish everyone thought of “quality over quantity.” I often see precious time and opportunities lost in the shuffle of more treatment which may not have been indicated but offered because the patient and/or physician are not ready to let go.

      Reply
  15. Dee Bee

    Are we still in a prehistoric age? There should be NO pain, EVER. There are drugs out there to alleviate everything…the problem is that nobody wants to administer enough to keep the patient from pain…WRONG WRONG WRONG WRONG…incredibly wrong on a human level…

    Reply
    • Shari Latif

      Nope, because with life, comes some pain. By embracing your idea of “perfection” we medical persons have created a generation of folks addicted to narcotics.Embrace your withdrawal from pain, because it is coming to an end.

      Reply
  16. transitionguide

    Wow! I am so stoked that young people get this! I guess because I worked with hospice for so many years, mostly with older dying folks, I’ve been directing my message that we really need to take death out of the closet and start talking with our families about what we want our own death to be like, what treatments we will accept or not, whether we might consider the Death With Dignity option, while we are healthy and it’s not even an issue… to the older generation (my own generation actually)– thinking they should be the ones to bring it up to their children. But I’m finding the older generation is afraid to talk about anything to do with “death,” as if that would bring it on. So maybe it’s the children who need to be bringing it up to their parents so it’s all out in the open and everybody knows how it will go if it comes up. If/When a health crisis arises, deeper conversations will be easier to have. More specific questions will need answers. Even roles can be quickly assumed when previously considered… who is going to arrange care for mom when she can’t take care of herself anymore? Who will handle the insurance, the banking, her finances? Who will raise our children if we are both killed in an accident? Personally, I think everyone should fill out an Advance Healthcare Directive when they get their first Drivers License (as 16-20 year olds have the highest accidental death rates). We have to decide then if we want to be an organ donor, why not if we want or don’t want CPR? We each have a right to decide our own definition of “quality” of life concerning our own body. Sorry to self-promote but after years of doing this work, I put together a workbook to help people deal with end of life issues as a family, all the documents one needs are described with links to resources and helpful book recommendations, discussions about death and dying to open the conversation, figure out your values and beliefs and how they apply to your last wishes… and I’m very passionate about getting this information out there to help families deal with the grief of losing their loved ones and the trauma of going through the whole dying process. Sometimes it is very peaceful and loving, but, man, I know families traumatized for years after a nightmare series of visits to ICU with the patient being hooked up to all the wires and tubes and machines, getting worse and worse, while the family argues about whether to pull the plug and what she would have wanted and did they do the right thing. It doesn’t have to be that way. Death is part of life, the next step. I think of it as a graduation into higher forms of learning. With acceptance of the end of our physical life, the letting go of our physical attachments and identities, it can be a time of reflection, to reconcile our lives, do forgiveness and gratitude work, do our life review before we die, find the peace we may not have had during our busy lives, and start to explore our sojourns into the spiritual world that awaits us Beyond the Veil: Our Journey Home (the name of my book 😉 Bless you for this music, I can see it will open many to a new way of looking at life and death. Can I get your permission to put your video on my website? Namaste!

    Reply
  17. Diqui LaPenta

    Such a powerful and important message. Some may want every intervention, but many do not. The only way to prevent prolonged suffering is to have an advanced directive. I haven’t yet had to make sure that one is carried out, but my parents have their directives. Odd, how we allow our pets a pain free exit from life, but we refuse to let people do it.

    Reply
  18. Joan Smith

    This made me cry, I am a retired nurse worked in critical care, so very sad and unfortunate the things I have seen. Loved ones on ventilators and other types of life support. The staff well aware they are in the process of dying. I am all for dying with dignity. The ICU is NOT the place to achieve that dignity. My family knows my wishes, I have an Advanced directive. Just because the technology exists does not mean we should all take advantage of it. These issues are the reason I left nursing, I could not stand to see the physical and emotional suffering\n

    Reply
  19. mommynator

    My 78-year old ALS patient died yesterday. At home. He was trached and vented. He had good care from three nurses (myself included) who kept him stable for about 10 years from his decision to be vented. We nurses had many conversations with his wife and him about what they wanted at the end. His passing was peaceful. His wife got up to make tea for herself and for him (through his g-tube). She looked at him before she left the room, he looked at her, and when she returned, he was gone. All us nurses feel a great loss, as home care sometimes feels like one is caring for family. But I personally am glad he was home with his beloved wife instead of being inflicted with all the other things that could have been done to keep him “alive”.

    Reply
  20. Stephanie

    As a former critical care nurse I have seen too many painful, torturous deaths. I currently work as a hospice and palliative care nurse and it has truly been a privilege to help provide comfort to the dying so they die a peaceful death. Unfortunately, around 30% of the patients we admit into our hospice die within 7 days and it’s very hard on the families because they feel this option was not discussed with them until the last minute. This conversation is so important and we too often see it not happening and people are not allowed to die they way they wish. Thank you for the video, it brought me to tears.

    Reply
    • ZDoggMD

      Thanks for reminding us that we need to have this conversation early and often.

      Reply
    • Teresa Brown

      That was one of my biggest frustrations when working as a hospice nurse. It’s really hard to do good symptom management, plus educate and support the family when you only get the referral when the patient is actively dying. Of course, we do the best we can do, but I used to think how much better things would have been for some of our patients had we been able to get in there’ll before the patient is taking his/her last breaths.

      Reply
  21. Teresa Brown

    John Lennon said “Life is what happens to you while you’re busy making other plans.” Well, death can happen to you while you’re busy making other plans. Make sure the people you love know what your wishes are regarding end-of-life care.

    Reply
  22. Tamarah Chancellor

    HI ZDogg….\nI worked in a prison for men with chronic health conditions. I was STUNNED to find out that, because they are convicted criminals, offenders are NOT ALLOWED to have a DNR or Advance Directives in our state. The first reason is because offenders are considered wards of the state, ergo, state is responsible for welfare of wards. And, because every death is treated as a potential homicide, even people who are elderly or had cancer get CPR until a doctor arrives. In one case, that was 45 minutes. In another prison, someone with Stage 4 cancer, emaciated, frail, weary from pain received CPR. \n\nThis is a population that needs to have a voice in their deaths, too. When the most vulnerable among us is dehumanized, the humanity of all of us is diminished.

    Reply
    • Shari Latif

      So very sad-and have seen this as a hospital administrator

      Reply
  23. NoTime4Bullies

    Just for you, I put my comments through Da Ali G translator: Dis video wuz me introducshun to da ZDoggMD phenomenon. Maximum respect. Please keep da messages comin. Truth!

    Reply
  24. Venita

    I just saw your “reissued with lyrics” video and commented there. I commented there but I feel the need to expand on my comments here. I am a 63 YO, 10-year stage 3A breast cancer survivor who is living with cognitive impairment and chronic pain from the chemo and other cancer therapies. My husband Jim is a 75 YO 10 year end-stage liver failure survivor who spent over six months in hospitals and was sometimes placed on home-health care and then finally on home-based hospice, all during the time I was going through multiple surgeries, chemo, radiation, and hormone therapy. Other than the infrequent home-health care and then the very helpful hospice folks, I was Jim’s sole at-home caregiver, and often his caregiver both in the hospital and in a SNF facility because he required 24/7 care that those facilities could not provide .I spent many a night sleeping on the floor.\n\nAfter a couple months in the hospital, when Jim was being shuttled back and forth in our local acute-care hospital between ICU and the medical floor and his prognosis was grim, Jim and I had a frank talk. I asked him if he wanted to live. Jim’s advanced directive called for no life-saving measures and I was his healthcare power of attorney. The ICU Dr already had had me sign a DNR form. But Jim was fighting so hard I has to ask him that question. \n\nHe said yes, he wanted to live. This after he had spent weeks in the general ward with insane hallucinations and many days in the ICU bleeding from every pore on his body (even his fingernails) because as it turned out the Drs didn’t put together that they had him on a blood thinner because of a DVT from weeks of lying in a bed. His condition also was mismanaged by the home-health care nurse who didn’t recognize extreme low blood pressure as a sign of sepsis so she didn’t call the Dr and left me to call 911 an hour after she left, saying he was just fine, when Jim collapsed and was completely unresponsive. \n\nAfter the conversation Jim and I had, I had him transferred to another hospital — a long-term acute care hospital (Select Specialty Hospital in Wilmington DE). SSH had rejected Jim early in his hospitalization because he wasn’t sick enough. But now he was on death’s door, so they took him. And they made him better. The nursing and PT/OT care there was amazing. Now, ten years later, Jim eats an extremely healthy diet, limits his alcohol intake (and I bitch at him that alcohol should be ZERO), goes to the YMCA five times/week for 1.5 hours of cardio exercise, and is presently in FL for his 20th year watching the Philadelphia Phillies Spring Training. I am so proud of his recovery.\n\nI, on the other hand, am failing. I suffer severe chronic pain from chemo-induced peripheral neuropathy in my feet as well as the anxiety and depression associated with chronic pain. I am now basically housebound. I worked for three years with my cancer center’s pain management specialist on various therapies (too many to list), and I was referred back to my general practitioner (GP) for ongoing pain management on Oxycodone PRN, which I would take maybe three times/week. My GP prescribed for me for a couple years, but then the FDA and the state authorities stepped in and my GP told me that she would no longer prescribe opiods for any patients. We fired each other, and she told me that she would oppose any other Dr taking me on as a patient because I was “drug seeking.”, She followed up on that threat. I cannot find a local GP who will accept me as a patient. For three+ years, I have had no continuing medical care. If I become ill, I have to go to urgent care or an hospital ER. That is not a good place for the medical establishment to put an elderly breast cancer survivor who should have ongoing monitoring for osteoporosis, cardiac problems, a cancer recurrence, and other treatment-related conditions. Two months ago I went to the ER for severe abdominal pain and after spending nine hours there I was DXd with acute colitis and referred back to my GP (which they knew I didn’t have) for follow-up. Another continuing pain I have to endure. I am now attempting to live on a soft diet of yogurt and oatmeal. \n\nSo perhaps, ZDoggMD, you can take at look at the current issue with opiod access by those who are recreational addicts vs the millions of people in the US who suffer chronic pain. Especially the regulatory pressure placed on MDs. I feel this is a critical issue. I will not try to push you to one side or the other of the debate, but I would like to see your take on it should you look into it. I appreciate you considering that issue. Your voice, whatever side you take, will be huge.

    Reply
  25. Shari Latif

    I have worked LTACH and mostly acute care, This is awesome, and I cannot share with my colleagues enough. Your most important video ever. Thank you.

    Reply
  26. Laura Veremakis

    This is a late entry but I just found this:

    The first time I was married I was young – that also meant I
    was divorced young. I was the only one of my siblings with a child, I was the oldest, and I was getting married – again. Since I had a child I thought
    about the risks of the future and how to set up protections for my intentions. I was rushing through all the details of the wedding, the honeymoon, and the paperwork for “just in case” because my life was about to change. I told my sisters I was sending them documents, they had agreed verbally to the conditions, so I had everything drawn up. My new hubby is a brilliant man – but a softy and one who does recognize that possibility exists in medical care as well as risks. I didn’t want fuzz on these decisions, no drama, no unnecessary heartache, so he could not be the decision maker. This was in 1990’s. The wedding occurs and I mail everything and leave on my honeymoon. The drama that unfolded in my absence was simply unbelievable. My sisters, who had participated in discussions, women that knew how I felt about life and the way I wanted it to be concluded which was without fuss – no heroics – let me go dammit, had lost their minds. By the time I got back from my honeymoon the list of possible terminal illnesses they had attempted to research to see if I had the symptoms was enormous. I was flabbergasted
    – how could they hear the words, agree to the plans, know that they would get
    paperwork to protect those plans because I was getting married and not remember a darn thing we said ? This is why we must all put it in writing but most importantly – find a dispassionate party who understands your intentions to give the power to.

    Reply
  27. Saira Malik

    wow this really moved. I hope whatever the outcome, God is keeping you strong!

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *