Make Wise decisions for Inevitable Journey

Mom on her eightieth birthday.

​This piece was published in the Pasadena Star News on November 21, 2004.

I was shocked when my husband told me that my mother’s physician returned my phone call. As soon as I got on the line, the doctor told me I was close-minded. Surgeons can be arrogant, but this one was over the top. His name closely approximated that phrase so I bestowed it on him:  Dr. Over-the-Top.
 
In the last ten years I consulted many doctors while my sister and I cared for our elderly parents. Some were good, some were bad and some will remain forever etched in my gratitude gallery for saying the right thing at the right time.  
 
My father was diagnosed with colon cancer in the summer of 1998 and beat it, but contracted non-Hodgkin’s lymphoma of the cervical spine late in the summer of 2000. One month after entering the Medicare Hospice program, he died at home in his sleep.
 
In the last two years of my Dad’s life, my sister and I consulted with several physicians:  a neurologist, cardiologist, oncologist, internist and ophthalmologist. We learned how to talk to them and speak their language.  
 
Those physicians helped us gently guide our dear father to a peaceful end. They listened when we said we wanted to stop the radiation that we knew would not save his life, but would prolong his suffering. The doctors helped us let him go.
 
Much too soon we were on that weary path again, after our mother got weaker and sicker and moved from a from walker to wheelchair. Our hard won knowledge of how to care for a soul in need of rest was not lost when our mother began her journey home.  
 
Enter Dr. Over-the-Top, telling me I was close-minded because I questioned the need for more tests to prepare my mother for a surgery that had some serious risks. After her fourth hospitalization in three months, on the week-end, the brash young Dr. Over-the-Top entered our lives with all the bravado a recent medical degree can bestow on a vascular surgeon. 
 
He took one look at Mom and decided she needed a really nasty test that required the insertion of a tube into her groin so dye could be infused into her carotid arteries. The test was to determine what we already knew: both arteries were blocked. 
 
Two bouts with pneumonia be damned, the diagnosis of dementia be damned, the loss 
of stamina be damned, the grief of losing her mate of 56 years be damned – this woman 
needed surgery. 
 
Dr. Over-the-Top scheduled the test for Monday morning, unbeknownst to my sister, in 
spite of her twice daily visits to the hospital. It wasn’t until I called my Mom to say goodnight that she told me she was going to have the procedure “first thing in the morning.” 
 
I called the floor nurse, who said she’d page the doctor. I thought that would be the end of it. When my husband handed me the phone I engaged in a conversation with the most ignorant, highly educated man I’ve ever encountered. My experience with good doctors helped me battle this viper.
 
He, after all, had spent an hour with my mother. He thought he knew his patient better than the daughters who had stood with her during the last harrowing days of her husband’s life, helped her bury him and then moved her to a new retirement community. His one-hour assessment made his judgment superior to ours and rendered our opinion “close minded.”
 
When we ended our conversation, both of us were mad for different reasons. My vigilant sister arrived at the hospital early the next morning and found that Mom’s cardiologist, a physician with education andwisdom, had explained the risks of the test and the surgery. He discerned her true wishes – to return to her retirement community in time to have dinner with her lady friends in the dining room.
 
My mother died peacefully in her sleep three years later. She was in hospice care for more than two years and lived comfortably with palliative care. Neither my sister nor I believe the surgery Dr. Over-the-Top recommended would have added any additional time or quality to our mother’s life.  
 
When we reflect on our parents’ lives, we know they spent their last days far from 
possibly unnecessary but certainly agonizing medical tests and procedures and went on 
their inevitable journey with their daughters by their side.