Random Thoughts of a Disordered Mind

Slow Medicine

2 Comments

The mother of one of my staff is dying of cancer and we find ourselves having small conversations in different combinations of people, talking about that situation but also more generally about death and dying, thinking of ourselves, family and friends. And then I read an extraordinary article in the New York Times: For the Elderly, Being Heard About Life’s End.

It’s about Slow Medicine, a phrase I wasn’t familiar with. But the concept of it is important in our increasingly aging world with newer and better abilities to sustain life, sometimes at all costs. It also reminded me of a conversation I had with my parents months ago about what they wanted for medical care for something huge like cancer.

My mom is 77 and Dad is 80; although they are young at heart, their bodies are aging and things are starting to not work as well. Let’s face it, that’s going to happen to all of us. Joints deteriorate, organs fail, systems get clogged or sick with diseased cells that multiply into a myriad of possibilities including but not limited to cancer. Minds can become foggy with Alzheimer’s. The ability to care for ourselves isn’t always there.

Just because it’s medically possible to intervene and fix things doesn’t mean that it’s always a good idea for someone who is older. I’m not talking about euthanasia or treating people harshly or with indifference. But older bodies are often not as good candidates for successful surgeries as younger, healthier ones even as current medical practice seems to push us to try everything no matter what the cost. And the cost is not just on the body and spirit, it’s also financial. Medication and surgery, physical therapy and treatments cost big bucks.

Slow Medicine is about having choices including the choice not to pursue treatment. If the decision is not to treat cancer, then why have a biopsy to verify that you have it, if doing so puts other things at risk? My parents have made a decision to pursue some things but not others. They are older than I am (well, duh, they are my parents) and the choices they are making for themselves at their ages are not necessarily the ones that I would make for myself now. But later? Yes. I want that right to make those decisions in an informed way, sharing them with my health care proxy and my doctor, looking to the quality and dignity of life that may remain.

There was much discussion when Terri Schiavo was the subject of a tug of war over her care at a point in her life when she wasn’t able to voice her own wishes. The time to think about these issues is now, while we’re healthy and aware and in full command of our faculties. Unfortunately, it usually gets discussed too late. Tara Parker-Pope at the Times also blogged about Last Wishes. Gotta love the Times; there is so much meat, so much to think about.

Even things we would rather went away.

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2 thoughts on “Slow Medicine

  1. My mother’s husband is at this stage also (I am 47, she is 67 and he is 87).

    Pneumonia this winter was treated.

    But, he is no longer having his prostate checked – because even if it is bad – it is not going to be what “takes” him in the end. so, just as you said – what is the point in checking, knowing and then worrying about it.

    He has episodes of what my mother calls the “dwindles” – where there might be something wrong, but it is probably just parts getting tired and unless he is in distress or real pain – they just ignore it . (He either he gets used to it, or sometimes, it just goes away.)

  2. Both my parents have decided “no more colonoscopies” even though there is colon cancer on both sides of the family. The tests are hard on them and really, even if they found something worrisome, the parents don’t want to have surgery for it. I completely understand.

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