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17 Jan
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RadioLab: Source of great conversations

I wasn’t searching for a way to talk about death and the end of life discussions that families must have about it. I was just transporting my son from our home in Paola, KS to his gymnastics class in Lenexa. It’s a thirty minute drive – give or take. Perfect for a good conversation or a couple songs – perfect for a RadioLab Short.

My son is seven and we both like listening to these programs on our drives. I know he’s a little young for much of the material, but it always makes him ask such good questions. It challenges him in his thinking and he gets to see a parent consider and turn over new ideas too.

I wasn’t paying strict attention. I was driving. I was zoning. I was in the audiobook / NPR / Podcast Groove. My eyes on the road, my mind on a walk with the program. We were driving North at about 70 mph and absorbing the program as it pulled us in, bit by bit.

Gallo-figure-2

Doctors who would accept given care options if they were in a state of advanced illness

The Bitter End – a short about how doctors and lay people see end of life care through very, VERY different eyes. To be honest, there was nothing very surprising in the discussion on the radio. Despite the fact that I am not a clinician, my viewpoint of end-of-life care was precisely in line with that of most medical professionals that were surveyed in this report.1 But, that’s a completely reasonable consequence of the proximity of my work to the medical field, having many close friends who are physicians -even my wife in a clinician.

The reality is, people who work in and around hospitals and people who’s impression of hospital care is shaped as much or more by real hospitals than those in TV land, have clear, unromantic ideas about what end of life is like. Also, we have seen more and talked about more situations of ‘heroic’ interventions and know what those outcomes look like.

For instance, my aunt had a heroic intervention by a neurosurgeon following her seizure and fall on the stairs that resulted in a severe head injury, best left to its natural conclusion. Instead, I listened to the doc pat himself on the back for his ability to save her life and turn a sudden trauma with a virtual DOA arrival at the hospital into a yearlong struggle with finding her care as she remained in an unresponsive coma. Oh, and I almost forgot, that meant that we had to actively make the decision to withdraw her feeding tube and fluids so she could die slowly over a number of days in the only legal outlet from this terminal condition. So,… thanks, Mr. Surgeon. Good work.

As I said, I was sort of in the zone and not thinking until we came to a stop at a red light and I suddenly remembered my seven-year-old passenger and thought about what we were listening to.

I don’t believe that there is anything wrong with talking about death – even with children. Death comes to us all in time and we all lose parents and friends and other family. Nevertheless, I thought I might want to take a quick exit before the story went too far. But to turn it off, I had to ask if he had been listening (yes) and would he like to talk about what we heard? (also, yes)

I was relieved when he told me that if I was in the hospital and going to die that he would tell the doctors to give me a ‘sleep shot.’ Then he thought about it … and thought about it some more… And then the waterworks started and he was wailing about how I couldn’t even die, nor his mother, nor his grandmother (Oma) – who would mend his blankie?! No. None of us could ever die. And he would tell the doctors to do anything and everything they could to keep us alive for one more day, one more hour, or minute, or second. And when we died, he wanted to die as well.

fortune-cookie

Are you feeling lucky?

I let him cry a bit and brought him back from the brink with some cuddling in the parking lot of the Chinese restaurant we were headed for. Then we had a nice talk about cognitive dissonance before we drowned our sorrows in wonton soup.

Reference

1. http://www.jhu.edu/jhumag/0601web/study.html

End of Life Care: A RadioLab discussion

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2 Comments

Posted by on January 17, 2013 in Uncategorized

 

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2 responses to “End of Life Care: A RadioLab discussion

  1. Prateek Garodia

    January 17, 2013 at 11:45 pm

    It is very hard to talk about death with kids especially when this conversation was not intended. My wife & I had taken my daughter to see the Taj Mahal. I believe she was 5 or 6 at that time. While we were admiring its beauty, she was asking about who built it and why. Like good parents we explained the whole history. As she digested all the information, my daughter realized that this wonder of the world was a memorial of a queen by a king. Memorial meant people die. Dying meant not being around people and going to to some other place that we did not know of. As this realization sunk in, she started crying and just like in your case, she also started saying that mom should not die and be with her the whole time. It took us a while to console her and get back into touristy mood but I believe that was her first realization about death. Since then she has matured a bit, probably because she actually has witnessed death in the family. She still needed a lot of talking to but it wasn’t a surprised bawling as it was at Taj Mahal.

    I agree with you that it is a good idea to talk to the kids about it, if it ever comes up but I do believe some form of softness is required. It is very hard for them to digest the permanency of it all in its raw form.

     
  2. downhousesoftware

    January 18, 2013 at 12:01 am

    My first thought was…. ‘Oh no! This isn’t age appropriate!’
    Then, I corrected myself: There is nothing age inappropriate about death. It’s a fact of life and it comes to everyone at some point. Even little children are exposed to it all the time. Aside from family members, my son has lost many pet mice, chickens (to coyotes), etc. And he mourns each one with such vigor!
    I suppose it is the pure heart of the child that makes him give himself up and express every kernel of his despair. I suppose we bury these same feelings down deeper as we age and forget how painful it can be before you’ve learned to protect against these emotions.

    Thanks for reading this, Prateek. I would love to see the Taj Mahal one day as well.

     

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