John Lennon and Life

John Lennon sang “Life is what happens while you’re busy making other plans.”  He wrote the words for ‘Beautiful Boy’, a song he dedicated to his son Sean.

I know another John. Last week, one of his lunch meetings was cancelled. Because he keeps his bicycle and helmet in the office, John is  always ready for breaks like this. The sun had finally peeked through the clouds. A leisurely ride and he’d be back in time for his 2 o’clock meeting.

Two miles away, Robert’s wife was insisting on driving him to his doctor’s appointment.  Irritated at how she and the kids were ganging up on him about giving up the car keys, Robert, 85 years old, wouldn’t listen to her.

“Stop badgering me. I’m just going two miles,” he said, slamming the front door as he left. Climbing into the Lincoln, he slowly backed out of the driveway.

Ten minutes later, along the tree-lined road that cast shimmering and confusing shadows, John was killed when Robert’s car hit him. John’s cell phone was ringing. His daughter was reminding him that they had a date to go shopping for camping gear that evening.

John’s family has no life insurance because John had delayed paying the premium. His wife, as busy with her company as he was with his, didn’t check if he’d paid it. Both their wills needed to be updated; neither could find the time to consult their attorney.

Robert’s family is in shock. Angry, frightened and remorseful, they’re consulting with their attorney about the legal actions they will face as a result of not being insistent enough with Robert.

We can’t see our own life unfolding. But our families will live with the consequences of how well we handle our responsibilities. Are your insurance premiums paid? Are you being too soft on someone who shouldn’t be driving anymore?

Or, as John Lennon puts it, are you busy making other plans?

 

 

 

Stanford Doctor Stresses Need for Advanced Directive

What is an advanced directive?

An advanced directive is a legally sufficient document that gives health care providers and family members information and guidance regarding care of a patient who does not have the capacity to make decisions for him/herself. The patient can fill out this five-part document on his or her own and is not required to see an attorney. Once the document is completed, a patient can either take it to a notary public or have it signed by two witnesses.

Who should have one?

Advanced directives are for all of us. The document speaks for the patient when they can’t speak for themselves. Even though a younger person may not think it is important to have an advanced directive, one of the most common reasons young people visit emergency rooms is trauma, and in such cases individuals can lose the ability to speak for themselves. Furthermore, a single person living alone may have no one to speak for him/her regarding resuscitative measures.

Most people don’t want to contemplate being in that position. How do you convince them that they should consider an advanced directive?

As a physician, I have seen numerous family members come in distraught because their loved one was not in a position to make decisions on his/her own and hadn’t made their wishes known. An advanced directive really helps family members make sure they are taking care of their loved ones.

How is an advanced directive different from a do not resuscitate order?

A do not resuscitate (or DNR) order specifically states that under certain circumstances the patient does not want to have various resuscitating treatments, such as cardio-pulmonary chest compressions or being placed on a ventilator. An advanced directive may contain these same instructions, but may also add specific additional instructions such as: “I do want pain control” or “I do want to be resuscitated, intubated and I do want to have nutrition.”

The advanced directive also goes further, detailing what is to happen if the patient expires — including whether the patient wants to donate organs or have their body go to research.

How would someone get started?

While state law requires certain provisions to appear in your health care directive, there is no single form in use to document your wishes. For information, see http://oag.ca.gov/consumers/general/adv_hc_dir.  An advanced directive form can be downloaded here: California Probate Code Sample Form, pdf.

Notify your doctor, family and close friends about your end-of-life preferences. Keep a copy of your signed and completed advance health care directive safe and accessible. This will help ensure that your wishes will be known at the critical time and carried out. Give a copy of your form to:

  • The person you appoint as your agent and any alternate designated agents
  • Your physician
  • Your health care providers
  • The health care institution that is providing your care
  • Family members
  • Other responsible person who is likely to be called if there is a medical emergency

A person who has executed an advance health care directive may register information regarding the directive with the Secretary of State. This information is made available upon request to the registrant’s health care provider, public guardian, or legal representative. See http://www.sos.ca.gov/ahcdr/forms.htm.

Can you break out the five parts?

The first part names who you want to make the treatment decisions. The second part is the individual instructions you want carried out. The third part asks about organ donation. The fourth and fifth parts are for designating your primary care provider and including your signature, respectively.

Any final thoughts?

I have seen families whose loved one has not taken the opportunity to fill out an advanced directive where one was needed, and the decisions the family members had to make basically tore the family apart. Families are often thrust into situations they don’t expect. An advanced directive avoids much of the strife of very difficult family decisions. As a patient, I would not want my loved ones fighting amongst themselves about how to care for me. With an advanced directive, the medical issues are very clearly outlined.

From an article published in the Be Well @ Stanford News with Dr. Dana Welle, DO, JD, FACOG, FACS, physician risk consultant at Stanford Hospital and Clinics. https://bewell.stanford.edu/advanced-directive-dana-welles

The Ripple Effect


I was walking my dog a few days ago when I saw a tall blonde woman walking towards me with small slow steps. Holding a cane in one hand, and the leash of her large dog in the other, she seemed to be a paradox – a image of fashion, beauty, youth and vigor, yet she was taking small steps with a cane. 

“He’s friendly”, she called out reassuringly. I loosened the hold on my dog’s leash. The dogs began their get acquainted ritual and we chatted a bit. Her name is Lois. I learned that she was recovering from a broken back injury, sustained when she fell down a flight of hardwood stairs. I asked how it happened. “There was some mud on my husband’s shoe after he walked the dog. It blended into the dark wood. He didn’t see it, I didn’t see it, and I slipped,” she explained.

“It’s no one’s fault. It just happened. I feel so lucky that it wasn’t worse,” Lois continued with a wide smile. “I used to run with the dog, but he’s learned to walk slowly with me. After two years of surgeries and rehab, I’m walking again. How great is that?”

We exchanged names and I said I’d look forward to seeing her again on the walking path. I haven’t seen her again, but I hope I do. I want to thank her for reminding me of something I know, but to which I pay too little attention. 

It’s not what happens to us, but what we tell ourselves about what happens to us, that makes all the difference. I’ll try to remember that the next time I get irritated about something that wouldn’t even register on Lois’ scale.