Archive for August, 2009

One of the most sobering words in our language is “death,” especially when talking about our own. That’s precisely when most of us don’t want to talk about it. But for this discussion, we must.

A lot of misinformation and outright lies have been tossed about in our current health care imbroglio as it deals with end-of-life issues. The only reference to this subject in proposed legislation deals with doctors being paid by Medicare for certain appointments to talk with patients about living wills, durable powers of attorney and other medical details associated with our last days. Nothing else.

While the “Wasilla Wailer” blew it all out of proportion with her “death panels” lunacy, she did perform a public service of sorts by highlighting the end-of-life discussion. Not as she sees it but as it should be seen.

Federal law already requires certain patients of hospitals and other forms of institutional care execute a “living will” upon entry. Simple in form, that document is our most trusted way to let families and health care professionals know exactly what sorts of medical treatment we want … or don’t want … when we are no longer rational or otherwise able to communicate.

You can specify using all the medical technology available to keep yourself “alive” no matter what your condition. You can select fluids and other comfort measures to be administered until your death. You can tell ‘em to just “pull the plug” if that’s your desire. You can also appoint someone to see that your wishes are carried out. No exception. But the decisions are made when you are legally capable.

The durable power of attorney for health care is just as important. It gives the named person authority to make decisions regarding your life so other “interested parties” can’t alter your instructions.

Had Terry Schiavo had those documents in her health records several years ago, she would have passed away quietly and with dignity, rather than becoming a rally cry for anti-abortion extremists and a self-inflected embarrassment for certain members of Congress.

I’ve been named the executor in living wills and holder of durable powers of attorney for health care several times. It is an awesome responsibility but one I accepted gladly. To know that someone trusts you so completely that you are given such power in their lives is as much a gesture of love and respect as it is a trust.

I have stood at more than one bedside, holding the hand of a dying loved one, ready to do not what I wanted but what they requested. It was both terrifying and reassuring at the same time. As I helped carry out their wishes, I wondered what would have happened if they had not had the foresight to make their own decisions.

There’s nothing scary about either that time in our lives or dealing with the simple preparations to see that we are treated as we desire. Those that have tried to make it so are wrong. Dead wrong.

While these instruments are now required by law in only limited circumstances, each of us should execute and file these forms with our wills and other personal documents. Our physicians and attorneys should have copies in their files as well. You can download them right off the Internet.

It’s not enough to just tell someone what we want. It must be in writing! Working in Hospice care, I saw many instances of an estranged child or former spouse showing up at the beside or at the funeral home. Even a previously unknown blood relative. Conflicting claims were made based on supposed previous “conversations” with the dead or dying. Families already in grief were thrown into confusing and costly legal battles with people they never knew existed. And it was always … always … needless.

There’s an additional step I would consider though it isn’t required by law. Either have a conversation with your closest family members about what you want medically in your last days as you fill out these forms, or fill them out and give each a copy. Avoid any possible misunderstanding of exactly what you want. And expect.

Regular wills are important and should be kept up-to-date. (Reminder to wife: we need to do that.) But those documents deal primarily with things: not with your life as you want it lived. Or ended.

Frankly, in the scheme of things, I don’t give a damn who gets the car or the artwork or even what few dollars are left. What I DO care about is that I’m not left weakly hanging onto life with plastic tubing, interminable liquid feeding and fouling the bed every few hours. When the time comes, really comes, I want to let go with as much dignity as I can muster.

There is one family in a small town in France that has lived in the same house for 11 generations! Now when you talk permanence and historic preservation, that is a Guinness records entry.

In this country, we get excited about saving a building or other landmark that is 100 years old. We do a pretty good job. Architecturally.

But in my travels around Oregon and the Northwest, I find another heritage we are losing, and not enough attention is being paid to the loss.

In community after community, a lot of Elks, Eagles and Moose lodges are either closing their doors forever or becoming semipublic clubs trying to stay financially viable. Many Masonic halls, without that public option, are closing or, if they can, merging with nearby lodges. Many of our Grange halls sit abandoned across our state. And elsewhere. Nearly all are victims of a society that has moved on.

We are the poorer for it. Much poorer!

In our technology-filled world, with increased personal mobility, we have no time for ritual, no time for regular attendance. We’ve lost the patience to learn the deep, historic community truths of our own past from neighbors so we can share them with the next generation.

In Bend, my parents were lifelong members of Elks, Masons, Eastern Star and Amaranth. In high school, I was a DeMolay. No choice. That’s how you were brought up. That was expected. I went. I resisted. I was wrong!

Traditionally, when you walked into a lodge hall or a club room, you immediately, and without introduction, were in “community.” Whether you personally knew anyone else there was not important. Whoever was there would likely share many of your values, have about the same level of volunteer and civic participation as you and would know others of similar interests locally and in surrounding towns.

You probably knew their kids, saw these folks in church, helped build the new bleachers at the high school together, gave blood, pulled the float in the homecoming parade, shared vegetable garden excess, cut and stacked wood for someone who needed help, went fishing or hunting together, chopped and dug out stumps to clear land for the new church wing.

Now I’m not a technology hermit. I enjoy my computer, the Internet, my cell phone, DVD’s, hi-def TV and my fax.

But none of that … NONE of that … involves me in the same sense of community with my neighbor as an hour or two “at the hall” in time spent playing cards or bingo or in ritual at a Masonic meeting. My “neighbors” and my “community” now are ethereal. We share. But we share only what is on the lighted screen before us or in a brief call. We have commonality, but it is without community.

If you have to ask why both are important, don’t. The answer won’t mean anything to you. We are starting to see this same social erosion in many service clubs. Some churches, too. Volunteers aren’t as easy to come by. Attendance is often in decline. Even some work projects that used to be volunteer labor now may be hired out to others paid to do the job. Too often, electronic messaging and bulletin boards are the links; not handshakes and face-to-face conversation.

Over the years, I’ve been a Lion, Kiwanian and a Rotarian. I’ve done my share of committee work at chambers of commerce. But my offspring, all in their late 40s this year and successful in careers, have no experience in any of this. What’s more, decent persons though they may be, they don’t see any of this as being meaningful or adding anything to their lives.

An architect friend once described restoring old buildings this way: “Some are eligible. Some aren’t. Like humans, some have bones that are too brittle; some have veins or arteries of utilities not salvageable. They are lost. But the healthy ones: those we can work with. They will be the links we can save.” That’s good as far as it goes. But if saving “things” is the way we continue our heritage, we are falling short. It is not “things” that define us. It is “community.”

Seeing a Grange or lodge building in disrepair is sad. But knowing the community that was represented by those structures has disappeared is tragic. It does us no good to save real estate when what we are losing is the community of our life.

Put this down to “suspicions confirmed.”

I took Barb’s car to the dealer this week for regular service. While there, as men are wont to do, I wandered the new car lot to marvel at what technology and government bailout dollars hath wrought. Marvelous what a few billion tax dollars can build.

Then something happened that snapped me back to reality. But first, a little background.

Having lived in several Southwest Oregon communities, I’ve gotten used to the beyond-conservative voices in our wilderness. Some have a tenuous grasp on reality in the 21st century; some are confused, looking to make sense out of a world that is changing too quickly for them; others are just your typical crazies.

We’ve had our share of the phony “tea parties” at local seats of government. Got to keep those Washington DC Republican consultants employed in the off-season. You’d never know these events were “sponsored” under the table unless noticing the handwritten signs at your local version matched the words of the handwritten signs on TV from the other states.

But I digress. Back to my “un-epiphany.”

As I roamed among the “bargains” being offered under the “cash for clunkers” program, I came across a couple of familiar faces.

Now, where had I seen them before? Oh, they looked so familiar.

Then “ah ha!” The “tea party!” A few weeks ago, they’d been carrying signs decrying taxes and wanting government out of their lives. Matter of fact, these two had written dozens of letters to the local newspapers for years, blasting government and all practitioners thereof.

Yet, here they were, hubcap deep in the latest government-sponsored tax giveaway of the season. They were here to grab their $4,500 check with both hands and drive off in a new pickup.

Deep in my soul, I wanted to cry out “WHERE IN HELL DO YOU THINK THAT $4,500 IS COMING FROM?”

But, no. Common sense prevailed. I turned silently away. If by now they hadn’t figured out their improved lives were securely intertwined with Corps of Engineers flood projects, rural electrification, new highways, satellite communications, safer food, improved health care, veteran’s benefits, tax rebate checks and a lot of other stuff … well … what chance had I to explain “cash for clunkers.”

Instead, I drove away thinking that not all clunkers have four wheels.

For over half a century, I’ve been a strong believer in and an ardent practitioner of first amendment protection of freedom of speech. Even when I don’t like or agree with some of the speech.

But “freedom of speech” is not “freedom to lie,” not “freedom to distort” nor “freedom to deliberately frighten.” Thus, two items in the news these days make me boil right down to the soles of my feet!

The first is the “kill granny” crazies deliberately lying about end-of-life discussions with your doctor as the subject appears in one of the five health care overhaul bills being considered in the congress. The scurrilous, outright lies appearing on the Internet and shoveled along by right wing radio make a mockery of free speech.

The only … I repeat … the only “end of life” portion of any of these deals with physician billing under Medicare for conferring with patients when patients request such counseling. The only issue being discussed is whether the professional can bill Medicare for such counseling more than twice in a five year period. Period!

And, again, there are five bills on the table, only one of which will be selected for a final House vote. The subject of such counseling may … or may not … be a part of it.

But if you listen to the gaseous Limbaugh or the flatulent Larson, Reagan, Beck and others, the government is trying to force suicide on the elderly to hold down health care costs! With their approval at best … and their leadership at worst … thousands and thousands of seniors are being needlessly scared. Think not? Talk to AARP offices coast to coast. Talk to some doctors.

The issue of end-of-life care should be on the table because it is in our last days we cost so much to keep alive. Those final months, weeks or even days can cost hundreds of thousands of dollars to simply hold off the inevitable another day or two. Or a few hours.

People in Oregon should be smarter than many Americans because we’ve been through this subject many times. Our “Assisted Suicide” law already addresses end-of-life decisions for all sorts of reasons: comfort, personal control, escape from endless pain and suffering, draining family resources, etc.

The lying “kill granny” voices come mostly from that terribly small minority of those scared of government in all its forms and who unreasonably believe they can live without it or the freely and democratically adopted laws we need to survive as a nation.

But there are other voices. The nut broadcasters who give it both air time and, thus, credence. Lying … intentionally lying … is NOT a first amendment guarantee!

The second item deals with the “birthers.” Many of these voices come from the same group as the first item and they are wrong again.

Pres. Obama is a U.S. citizen. A birth certificate copy issued by the State of Hawaii is available on-line. The state’s largest newspaper carried an Aug. 4, 1961, birth announcement as did three others. Congress certified the election and confirmed him. End of non-issue.

To offer credence in any way, no matter how small, to those who spout this lie should be beneath members of congress. But, no. Ten of them are sponsoring a bill to require proof of citizenship before filing for candidacy for public office.

“Not connected,” they say. “Road apples,” says I. The bill will never see the light of day but they’re trying.

Call this garbage what it really is: racism. Many other national political figures have been born outside the continental United States. John McCain, for example, was born in the Panama Canal Zone on a military base. Not even a whisper of challenge to him or any of the others. But they were all white.

Freedom of speech is a marvelous thing. It may be the most important of the amendments. Even when that speech has been offensive or far from our own views and beliefs, it has been the strong glue holding our democracy together for the world to see and envy.

But freedom to obfuscate, distort, mislead, attack without basis or outright lie: NO! Never!

We are living in dangerous economic and life-changing times. We are not just being challenged to get through all this. We are actually facing living our lives under new conditions with many institutions changed completely from what we have known.

These two subjects should be an effrontery to Democrats, Republicans, independents and even non-voters. As Americans first, we need to reaffirm the right to speak freely but to speak the truth.

Neither of these lies meets that test.