In Life’s Last Moments, Open a Window – NY Times

This weekend, the New York Times published an opinion piece by Rachel Clark, the author of “Your Life in My Hands: A Junior Doctor’s Story”. She is also a physician with the National Health Service of Great Britain. It reminded me of my late wife’s last days. In the book I wrote about Karen’s life and death, “The Good Bits” is the final scene with her:

I had a thought. I moved to the double doors and unbolted them. “Let’s wheel her bed into the fresh air where she can hear the birds singing. Get her under the huge fir. She loved to read under it.”

“That’s a great idea,” Debbie replied.

Isaac helped lift the bed over the threshold. We turned it so that Karen’s head faced the edge of the deck railing. Just beyond the railing spread the boughs of an eighty-foot Douglas fir, almost touching the roof line of the porch. The day was sunny and hot and even though it was still early. The scent of fir was intense.

From here, Karen could smell the sea, the fir tree and hear the birds. Let her think of the thousands of nights under the stars, if she was still thinking. She loved to sleep outside, without a tent. I remembered a night camping on the eastern slope of the North Cascades and her description of the mountains of Afghanistan. “It was the most beautiful place I’ve ever camped,” she had said. We had slept that night in the Cascades in each other’s arms, under those stars.

Dr. Clark, also describes a similar scene.

Another patient, whom I admitted in July with about a week to live, was mostly concerned that I keep the windows open, so that he could “keep on feeling the breeze on my face and listening to that blackbird outside.” I rushed to make sure of it.

It is important that as we work to help loved ones through their final days, that we stay open to some simple, basic ideas. Having the ability to die under the stars, or under a favorite tree is simple, yet so very hard to think about in the moment. Be willing to take small steps for comfort.

Here is the link to Dr. Clark’s article.


Let’s talk about death. Before it’s too late, a doctor writes – Seattle Times

Well worth a read. This article touches on something that most medical professionals know, but most patients don’t.  My father was dying in a hospital of advanced COPD, and the doctors there seemed unwilling to tell him he was near the end. It took me stepping in and saying, “You mean that he will either die soon of heart or kidney failure?” The answer from the doc, in front of my dad, was, “Probably.”  I turned to my dad and said,” So dad, where do you want to die, here or at home?”  He made the choice to go home and he died there a couple of days later surrounded by loved ones and in peace.

This article is a very good teaching lesson about the dirty little secret of medicine in America. And we are trapped in a system that makes a lot of money on end of life procedures and often is the last place you’ll get good information to make a decision about whether you really want it or not.

Despite growing recognition that more care isn’t necessarily better care, particularly at the end of life, many Americans still receive an enormous dose of medicine in their final days. On average, patients make 29 visits to the doctor’s office in their last six months.