Sunday, 22 May 2016

HEALED, IF NOT CURED - WHAT A GOOD DEATH LOOKS LIKE

This morning I was scrolling through facebook when a friend's post caught my eye. Eric Fischer is a disability Dad whose son is palliative and very complex. I always read Eric's sensitive and searingly personal writing - you may remember that I reviewed his book of poetry here.

Today Eric shared a TED talk, "Healed if Not Cured" by his son's own palliative care physician, Dr. Ron Sabar. Dr. Sabar's talk originates in Isreal, so the subtitles are in Hebrew. But the talk itself is in English and I urge you to listen. Dr. Sabar shares his insights into what constitutes a good death and his conclusions might surprise you.



The good doctor points a finger at medical practitioners whose own fear of death prevents them from healing and instead impels them to continue seeking cure even when that is futile. Dr. Sabar is not afraid of death. To his patients at their end of life, he says "Go home. Enjoy the love of your family. Enjoy your last days. We will be there with you to ensure that you are comfortable."

But I was most interested in the questions that Dr. Sabar asks his patients when they transition from seeking a cure to seeking a good death. He asks three questions: 1) Tell me what you know about your condition 2) Tell me what you're most afraid of and 3) Tell what would make you happy now.



The doctor described a patient he treated who was diagnosed with end stage colon cancer.  In a darkened hospital room, she lay with her family nearby. She said to the doctor, "Please help me die. I used to dance. I used to be an academic. Now everything is over and I just want to die." Dr. Saba asked her the three questions.  "Tell me about your condition." As expected, this young scholar knew everything about her disease. "Tell me what you're most afraid of." She didn't want to suffer anymore. "Tell me what would make you happy now." "To finish my PhD", she said.  It turned out that this young woman was only weeks away from finishing her dissertation. Years of research would not form any kind of legacy without completion of her degree.  So, the doctor said "Go home and finish your degree. Together, we will do everything we can to give you three good hours a day for a couple of weeks - enough time to finish your work."  This, they did and a few weeks later, the young woman received a letter from the university informing her that her research had been accepted and she was now a Doctor of Philosophy. A couple of days later, she died peacefully.

Not all palliative patients will have unfinished projects.  Perhaps they would answer question #3 with a wish to visit a family cottage one last time. Or to see an estranged brother in order to settle longstanding differences. These three 'Tell Me' questions are worth asking to any chronically ill or dependent loved one. Anytime. They're especially worth asking at times of transition such as to another level of care or to a new diagnosis. I'm going to visit my Mom today and I'll ask her these questions. On the way home from Mom's I'll stop in at Nick's and I'll ask him too. It's good to check in with people we love and I'm grateful that now I've got the right questions to elicit the important answers.


Post a Comment