Fear of Letting Go

Reading, “Letting Go” by Atul Gawande has only confirmed my thoughts on medicine at the end of life. Medicine at the end of life should be there in order to provide comfort and relieve pain. I do not believe in dragging out a life that is ready to end. However, it is very easy to see how this becomes the route for many, even for those who did not wish for it, such as Sara in this short story. Fear of dying is real for many, even worse for those who face it within their presence. One may think they are ready to confront death head on when it is their time, to only change their mind at that moment.

When medicine cannot save a life we tend to disregard this information. We tend to think medicine will always save a life. If it is not the current medication or treatment, it will be another. We grasp onto this thread of hope because we are all afraid of losing the ones we love or the unknown of what happens after death. After much reflection, I have come to realize it is usually the family members who will be left behind that push new treatments when others do not work. The family must be ready to confront the disease and death of their loved one as much as the patient. Allowing curative care to be stopped may be seen as admitting defeat, as if you are allowing your loved one to die. However, that is not the case. It is merely the acceptance of another type of care, in which the ending moments of life can be lived out as one had always hoped.

Before class discussion and reading this article, hospice scared me. Now, that I am more knowledgeable I find myself an advocate. For me, the answer to this question is simple. When medicine can no longer save my life I want it to make my death bearable.  I want it to help maintain homeostasis for a small amount of time so I can say my goodbyes and part with the world on my terms. For terminally ill patients the disease controls their lives. Having a bit of the control back, given by the benefits of medicine to stop the suffering, would be an amazing gift at that point. The title of the article says it all. Being able to let go: the fear, the battle, and the pain, that is what medicine should help you do at the end of life.

My Sister’s Keeper

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5 thoughts on “Fear of Letting Go

  1. I think that you hit on a good point-that people might think that they are admitting defeat when they choose to stop curative treatment. Often, people will feel guilty for letting that person go and blame themselves or regret not doing certain things with that person. This just means that we must appreciate what time we do have in life, especially with the ones we love. Personally, I have witnessed a situation like this when my great grandpa was in the hospital. During that time, I missed about a month of school to go to West Virginia with my grandma and the rest of my family. This was an extremely hard time for my grandma because she had left her very strict parents at a young age to start a new life on her own. Now that she was in the hospital and EOL decisions were being made, it was extremely difficult for her to accept what was going to happen, especially since she could not make up that time that she lost. After witnessing that, I also agree that everyone fears death, even the family, and we become so afraid that it is hard not to grasp onto the thread of hope or feel guilty and regretful.

  2. I agree with your ideas of what medicine should do at the end of life. Trying futile after futile treatment, grasping at the “thread(s) of hope” can do more harm than good to the patient and their family. If a person and the family know that, in reality, there is no hope for a cure of getting better, they must accept and come to grips with the fact that their family member’s time has come. Medicine should be used in easing that person’s pain and suffering to allow them to live out their final moments in peace and ensure quality of life. The patient is already going through the inevitability of death; they should not have to deal with the physical pain on top of the emotional.

  3. I totally agree with what you have stated. Majority of the time its the patients family that want them to try new treatments, not being considerate to how they feel about it, whether or not the patient wants to continue with this medical roller caster ,where one week the medication is working and you’ve gain hope, then the next your doing much worse that how you were prior to the new treatment, and all of that is simply because of selfishness, people tend to be afraid of being left alone after a loved one passes, and afraid of change and there for we force what ever can to try and and keep that loved one around regardless of the physical, emotional or mental effect it may have on the patient. If the medication cannot help cure the patient, then a positive alternative is to use the medication to make the process of death easier on the patient.

  4. I agree with the ideas you have presented here. I think people have an unrealistic view of how far medicine can go. We sometimes tend to think that medicine can solve every issue right away. Like you mentioned, we lean towards the notion that medicine will always save a life. In the back of our minds I think we know that it can’t save every life and I think accepting this is the hard part. It does sometimes feel like we are admitting defeat, but if we realize that death is a natural part of life, it makes palliative and hospice care easy to accept. This type of care is essential to making sure someone is comfortable in their last days.The idea of hospice also scared me at first, but after I realize that these people dedicate their lives to making sure we feel comfortable at the end. Great post!

  5. Your idea of medicine at the end of life is aligned with my own, that it should be used to comfort and relieve the patient until the moment they die. I also like how you addressed not only how the patient may feel and act but also family members and how essential hospice care is at end of life. One factor I feel may be missing from your post it the medical staff. At the end of life, doctor’s can be reluctant to stop treatment and may be constantly suggesting new medications and additional tests. It is part of their duty to the patient to be up front and honest with the patient and their reluctance to stop treatment can breed false hope and increase the patient’s suffering.

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