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DNR---Leave Me Dead
By
ANN PATTERSON |
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My mother lived alone. One warm summer morning, she went at her church at 10:00 for Bible study. The church seldom planned Saturday meetings but having one that day proved to be a miracle for her.
She arrived on time, stumbled as she went to her favorite pew, and just as she started to sit down, she reached her hand to her head, moaned and fell.
A friend rushed to her while the pastor hurried to the office and called 911. In minutes the emergency vehicle and emergency medical technicians arrived, stabilized her condition and rushed her to the hospital.
She had suffered a severe stroke.
As soon as she could, she asked the hospital to verify that her Do Not Resuscitate (DNR) document was available to her physician and the Critical Care Unit staff.
Since that day, I have questioned our cultural values as they relate to the Do Not Resuscitate order.
The DNR form is signed by thousands of people in America every day to ask that no measures be taken to resuscitate them if their heart stops beating. They want nature to take its course.
Now, more than at any other time in human history, medical technology actually makes it possible to bring the dead back to life. My mother knew this. After having the debilitating stroke, she wanted a natural death as directed by her body rather than by the medical staff. She did not want a machine to restart her heart if she died.
Perhaps signing the DNR forms can be interpreted as one way to seek passive suicide. If mechanical and technological devices restart a heart, do they intrude on the timing of natural death? Is there any difference between DNR, so often requested by elderly patients like my mother, and the Death with Dignity law in the state of Oregon law?
In contrast, if a physician does not use all possible measures to restore or maintain life, is he following the Hippocratic Oath of his profession?
She was not asking to die. Rather, she knew that the stroke had made great changes in her body, emotions and mind and that she would never recover her energetic life. The contrast in her, before and after the stroke, was significant.
Mom, a petite woman, has silver-white hair that crowns the loveliness of her lovely face with its golden-rose complexion. Her light brown eyes always reflect the special love that lives in her heart.
Before the stroke, her engaging smile was grand and expressive and her eyes glistened when friends visited or when she winked a grandchild. Her only wrinkles were the laughter and smile lines visible at the corners of her eyes and just above her thin lips.
Before the stroke, Mom embraced the belief and the hope that she would live long and enjoy old age, like her mother and grandmother. Thoughts of suicide were impossible for her. Her joyful heart and Christian faith could not allow death by her own hand.
Before the stroke, Mom’s exuberance and her physical capabilities led her to push herself to the limit. At 84, she was still working full-time at her favorite drugstore after retiring from JC Penney department store 19 years earlier. Unlike most people who rest on their weekly day off from work, Mom did not. She would clean the house, and even windows and carpets. Following that, she would tackle the lawn and landscaping before she went to the hair salon for her weekly appointment. She chose Sunday as her day of rest.
That Saturday morning the stroke struck her like a booming bolt of thunder. It was only because she was among friends who acted quickly that led to emergency assistance that saved her life.
Until that dreadful moment, her life was good, even wonderful. In that moment, her energy melted, her laughter died, and her body and her spirit dramatically changed. The life she had known was suddenly stolen.
Two special days vividly illustrate the contrast that the stroke made in Mom’s appearance, her life, and especially her way of participating with family and friends. Eventually the stroke and medications deadened her emotions---she couldn’t cry, laugh or even become angry. She was left with only an occasional simple smile on her expressionless face.
Those two days were her 75th birthday and her 85th birthday. With joy, I remember her strength and liveliness at her 75th birthday party; and, with sadness I remember how weak she was the day she turned 85.
More than 175 friends and family attended the 75th birthday party hosted by her children and grandchildren.
At the party Mom felt great and had no obvious health problems or disabilities. She walked briskly, smiled broadly, and spoke fluently with excitement in her voice. Her smiles were interwoven with laughter and delight. Her back was straight, and her body relaxed.
She shared precious moments with everyone. She moved with energy and balance in a pastel dress of her favorite aqua color.
She enthusiastically conversed with one person alone and, she had numerous group conversations. Her smiles, laughter, full participation, and interactions with people were like gifts from heaven for her.
Three years after the stroke, she attended a gathering of many generations of her family. The gathering was held the week of her 85th birthday. For her, it was an event of total contrast when compared to the day of her 75th birthday party.
More than 40 family members shared that day at the community center in the quaint small town of Paoli, Oklahoma, where she had spent her childhood. That day, Mom sat at the end of a table in the same chair most of the day.
She seemed to be out-of-touch, almost invisible. It's difficult for her to move around the room to speak and laugh with her large family.
Her face wore a wrinkle for every worry with which she had wrestled after the stroke. When she spoke, her mouth was distorted. Her smile was twisted. A silent sadness filled her face.
Her movements were no longer energetic and her back was no longer straight. She could not glide with grace throughout the room as she did at her 75th birthday party.
She could not join group conversations because the high-pitched sounds from her hearing aid interfered. Conversations with one person at a time were special for her that day but there were too few of them.
When she reached to hug her loved ones, her arms were weak. In turn, they carefully gave her a fragile hug, as it they might break her apart.
When I asked Mom why she had had signed the DNR order, she reminded me that her favorite aunt, Oma, had remained in a coma for 15 years after being resuscitated after a serious heart attack. Mom said that she did not want the same for herself.
Even more, she preferred that her family move on with their lives and memories, rather than to endure endless heart-pain during a long goodbye. She did not want to spend years in a bed at a nursing home.
In this age of amazing medical technology, natural death as experienced from the beginning of mankind can now be delayed. Is the signing of a DNR form evidence of a death wish? I don’t know. Does resuscitation steal a natural death? I don’t know.
I do know that in our world today, these and many other bioethical questions are being discussed along with values related to life, death, DNR, Death with Dignity, and suicide. Simple answers are no longer possible. Individual points of view differ wildly.
Former patients, whose lives have continued as a result of resuscitation, often have opposite opinions. Some of them have lived a full life with happiness, laughter and peace.
Others of them simply take one breath after another while they spend their final years in a nursing-home bed, have no interrelationships and lie in death’s shadow. They are not able to neither hear the questions nor speak their response.
Perhaps the most valid answers left with those whose passing resulted from the application of the DNR order. Their wish was granted; therefore their absence makes it impossible to give their responses.
My mother and other individuals who choose to sign a DNR request, or to allow every possible measure to be taken, have the right to fulfillment of their request.
My mother desires a natural death. That is her choice, not mine nor any other person or entity in our society.
By honoring her request, her physician, I believe, will truly be following the Hippocratic Oath.
Natural death, as known for centuries, can now be delayed by the flip of a switch on a defibrillator. Hospitals, ambulances, fire trucks and nursing homes, along with other medical facilities have defibrillators.
Technology has produced small defibrillators that are being placed in homes, churches, and numerous public places. This mass placement of technical equipment that can cause a dead heart to beat again, may, at the same time, betray the elderly and other patients even though they have signed Do Not Resuscitate orders.
Perhaps, DNR is a blessing, not a curse, and simply allows natural death, not suicide.
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Author's Bio
My career has been enjoyable and, as I said I wanted to do in life at 16, "I want to help people", I did that for the past 45 years. I have been a writer, teacher, counselor,administrator for nonprofit organizations that included: Idaho Nurses Association, Retired Seniors Volunteer Program (RSVP), Social Services for City of Davis in CA. I was Director of Volunteer Services for the Idaho State School and Hospital serving the Mentally Retarded, Community Resource Development Specialists for Idaho Dept of Health and Welfare and advocate for mentally ill, mentally retarded (now called developmental disabilities), and fund-raiser/grant writer for the above and numerous other organizations.
I was single, divorced mother of 3 children and raised 3 grandchildren and then came-out as lesbian, what I knew about myself at age 16 in 1954
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