By Justin Porter
The most important conversation we should be having in the face of the COVID 19 pandemic is one about our individual wishes if we become ill. From 17 years old to 97 years old, we need to be having this conversation with those around us and expressing our wishes. Make it clear to your loved ones what they should do in a scenario where you cannot make decisions for yourself. Picture yourself in a hospital room and unable to speak for yourself. What efforts should be made to keep you alive? Is it important to you that every last intervention be attempted before allowing you to die?
All this is not intended to scare you about the COVID pandemic. In fact, I’m quite optimistic about all this. We will get through this and learn a lot from it. My point is to implore you to have these conversations because it’s the responsible thing to do. Failing to have these conversations is akin to not washing your hands these days: at best you might be making a mess for the rest of us and at worst you might be causing harm. Worst-case scenarios portray more patients than hospital beds and ventilators. Being clear with our wishes is what’s best for you, your family, and the healthcare system at large.
Know your preferences
My wife knows my motto (obviously said with tongue in cheek): if in doubt, snuff me out. I am 35 years old and I know that it is not important to me to have every last resort exhausted before allowing me to die. I’d prefer to die with dignity and comfort rather than risk months of agony on a ventilator supine in a hospital bed. I’d rather die than be an undue burden to my family and the health care system. I’ve come to find that there are times in life when death is not the worst option. Picturing those scenarios can help you understand your own feelings and wishes.
Obviously I’ve thought about these questions a lot. My work as a paramedic at Aero Methow Rescue Service and as a registered nurse working in palliative care have given me the opportunity to see so many ways to live and die. It is possible and quite common to die with well-being. To do so, one must have the emotional work and difficult discussions done in advance.
Have a conversation
These conversations are admittedly not easy to have. I find that the best way to enter these conversations is to explore what’s important to your life or your loved one’s life. What elements make life rich? Simply start the conversation by asking, what’s a good day to you? When we explore what’s important to us from a positive perspective it opens us to see how the loss of those elements could make death a less-worse option.
For me it’s important to help other people, to have stimulating conversations and to be a loving father and husband. If I couldn’t engage in these things, I’d rather not live.
Write down your wishes
For young families, these conversations are even more challenging to have. If we die, who will take care of the kids? Better yet, who watches the kids while we just have this conversation! Don’t worry about doing the legal paperwork and finding a notary, just have the conversation, write your thoughts down and make them clear to those who would be at your bedside. Legal papers are helpful when there’s disagreement within a family about how to proceed or when no one is at your bedside.
If everyone knows your wishes, they are likely to be respected even without the paperwork. Whenever these conversations get really hard just remind yourself and your loved ones that this only applies when we can’t speak for ourselves, and no one expects you to be able to speak for yourself anytime soon. None of this is set in stone, you can continue to develop these ideas and articulate them as you explore this subject.
This pandemic makes it abundantly clear that we are all in this together. Not just as a valley of people, but more simply as human beings. The conditions in the seafood market where people initially became ill in Wuhan, China, matter to our lives here.
Likewise, these conversations have an impact on the lives of everyone around us. They help create a culture that cares for our sick in the most caring and enlightened way. These conversations also empower patients to drive their health care instead of reflexively plunging through interventions.
If you need help with these conversations, our team is here for you. People of any age or health status can email us for advanced care planning at okanogan.palliative.care@gmail.com.
Justin Porter is a registered nurse and paramedic at Aero Methow Rescue Service in Twisp.
