Thanksgiving week is here

Last Thursday's waterfall

Do you think of your week as starting on Sunday or on Monday? I pondered that question as I thought of the title for this post. I myself think of Sundays as the day that can easily belong to either end of the seven-day cycle. This coming Thursday will be Thanksgiving in the United States, and people are on the move. I am always amazed when I read about the huge numbers of people who travel during the holidays: this year, almost 47 million Americans will drive, fly, or take trains to another part of the country.

For many years after my dad died, I would travel to Texas or Oklahoma to visit my mother for Thanksgiving. When she died in 1993, I would travel to be with other family members who live in the area. I always stay with my brother and his wife when I visit, but lately my choice of family to visit are my sister and her family who live in Florida, as you know. I purposely traveled before the holidays to avoid the crowds, and boy am I glad I went when I did. I'm sure airline travel will be much more stressful, not just with the crowds, but also because of current terrorist events such as Paris, the airline bombing, Beirut, and Mali. My dear friend Vagabonde has written a wonderful post that says it all so much better than I ever could. She is a Frenchwoman who came to this country many years ago with her American husband. I've followed her long enough that she feels like a true friend. She has taught me so much about the history of France and much, much more. In that post she introduced me to a Latin phrase that has been a motto of France since the 16th century: Fluctuat nec mergitur, which translates as "tossed but not sunk."

Last week I had my introductory interview to decide whether or not to pursue the training to help others fill out their Advance Care Directive forms for end-of-life choices. I've decided to go ahead and do it and have agreed to give a few hours every month to that effort, once I'm done with the training. As I've learned, it's time to begin thinking about these things now, today, no matter how old or vigorous you are. Check out this website and Begin the Conversation. Here's a wonderful quote from that website:

End of life care planning requires filling out appropriate advance care documents, but conversation about these documents is key. Those chosen to carry out your end of life care wishes must know what you want. Documenting your end of life care wishes and telling others is a gift.

I also attended a presentation that was held in a packed room about the realities of advanced medical interventions. Two critical care ICU nurses, Cathy and Koala, decided it was an important thing to let people know. A year ago they held what they thought would be a one-time presentation. But the demand was so huge that they have held 19 more this year, and will continue for as long as there is interest. Some people have attended their presentations more than once, and I will probably be one of them. It was enlightening to find out what exactly happens in the Intensive Care Unit if you are admitted there. Scary, too.

It brought back to me in vivid detail the difference between the deaths of my father and my mother. Daddy had a massive heart attack while walking into the hospital. He collapsed in the entrance after having been driven there by Mama. A few days later, all six of his adult children had traveled from wherever we lived to Fort Worth, Texas, where he lay in a hospital bed. As I remember, when I saw him he was propped up with pillows and not laying down, but I first noticed how the pupils of his eyes were just little pinpricks. That was caused by the morphine he was being given. Otherwise he seemed like himself, but he didn't mince words and let us know this was the end by using phrases like, "I'm glad you got here before I popped off." He knew. He lived three days after the attack.

But back then there were no advance directives, and he was placed on a respirator, even though there was little to no chance that he would survive. I still get chills when I remember that experience, and now I know why. If I could go back and do it all over again, I'd make sure Daddy knew he didn't need to do it. If I can save even one patient from useless end-of-life measures, it will be worth my time.

What Cathy and Koala showed us was what the equipment looks like, how it is used, and why, and what the chances are of someone actually recovering enough quality of life to even be sent home, whether or not they are able to return to a normal life. It's a very small percentage, and the older we get, the smaller it gets. I'm talking single digits here. We saw a film that showed a man who was actually having a heart attack, and how he was resuscitated with CPR and electric shocks. He recovered, because he had two professionals who knew what they were doing right there with him when it began. He was very lucky.

Mama, on the other hand, had a severe heart attack and was able to return home and go onto Hospice, where she had a doctor and a nurse who made daily visits. She was given palliative care, made comfortable and able to stay at home. My sister Markee is a registered nurse, and she was able to leave her job and come to stay with Mama for a few weeks. We were all able to visit her and be with her in a quality way before she finally died. She was never put on any machines. She went into a coma a week before she died. I was with her when she took her last breath, and it was a peaceful experience for all of us who were present.

Death is a part of life that we don't like to think about, but it comes to us all. And today we all have the opportunity to decide how much we want our medical professionals to do to us to give us a chance to keep on living. And what that living actually looks like from an ICU bed. I've got my advance directive forms on file at the hospital, my partner knows what I want and I know what he wants. My sister Norma Jean laughingly said, "you mean I get to pull the plug?" when I asked her to be my secondary person.

It's amazing how empowering it is to take a hard look at one's end-of-life choices and actually make them. I know this isn't a normal Thanksgiving post, but frankly, I cannot tell you how thankful I am that I and my loved ones have options. I won't be kept alive when all I want to do is slip away gently, like my mother did. It takes some courage to think about these things, but it's truly a gift to your loved ones.

So I give thanks this week for my current health and vitality, knowing that it won't always be this way, but until then, I'm going to enjoy myself. I'll happily prepare a Thanksgiving meal here at home and enjoy every morsel. And I am also wishing you, my dear readers, will enjoy your week until we meet again, and wishing that you stay healthy and happy, too.