Few people are prepared to deal with some of the terrible decisions they will have to make. The New York Times today called it "The Ultimate Family Quarrel" How do adult children decide whether a parent lives or dies when faced with a crisis like Geraldine Reardon's. A terrible situation that more and more of us will face.
Just when a family should be coming together, supporting each other with full hearts, disagreements about what to do and what Mom or Dad would want because of the lack of a health care proxy can split families totally.
This inevitably exposes or creates family conflicts, which then make urgent medical decisions even more difficult, a wrenching cycle that can tear families apart. In addition, doctors often disagree about how to treat such patients, and living wills often fail to resolve critical questions.
"Every hospital in the country has families going through this all the time now," said Dr. Erik Steele, vice president for patient care services at Eastern Maine Medical Center in Bangor, where a recent case involved four siblings so divided over whether to keep their 88-year-old mother alive that they first put her on a respirator and then took her off it.
"This is going to be an issue more and more for us, and I think it's an issue almost unique to our generation," Dr. Steele said. "For the first time, we have this degree of technical ability to keep people alive without the ability to always restore them to good health. At the same time we have a much higher expectation of what health care can do." ------
While families often seem to pull together when dealing with treatable illnesses, they often splinter over an end-of-life decision, experts say. Old frictions surface and new ones form, based on family relationships and different ideas of what makes a life worth living. Living wills, advance directives and health care proxies are intended to resolve crucial questions about what a patient would want, but they often fall far short.
Such a life and death decision is fraught with the emotion of the circumstances and conscious and unconscious emotions of the children. While health care proxies are designed to deal with this situation, some try too much to control future medical decisions. I wrote about the recent study by the Hastings Center in Is the Living Will Dead?
A lawyer friend for whom I have a great deal of respect said the most important thing with health care proxies was to give one person the authority to make all medical decisions. The worst thing is not to have a health care proxy and to burden all the children with making such a terrible decision.
"The pursuit of legacy is a libidinous quest." writes David Wolfe. It is how we recreate ourselves in the second half of life. "The first half of life favors objects and activities that support the physical recreation of self" he writes in his blog Ageless Marketing "Our legacies extend our beingness beyond the time of the flesh"
Wolfe says legacy has become an important marketing theme and uses as an example the new "Begin your own tradition" ads from Patek Phillipe.
John Kotre calls it generativity -- this feeling of mattering, of creating lasting value, of passing your very self on to others. It's creating something that would have a life and identity outside of a single self. For boomers, it's evolving from ME to BEYOND ME.
Kotre's book "Make It Count" is about how to generate a legacy that gives meaning to your life. He sees Generativity as a way, a path to an interior state of great value to yourself, your family and your world and also a state of great joy.
Kotre talks about a process of identity formation that is receptive as well as active. “Those who become generative seem to experience a kind of inspiration or imperative that claims their inner nature and tells them not only who they are but what they are to do, and what they are to do next. You become the channel and are used. When identity formation is both passive and active, the voice that speaks to you becomes the voice with which you speak. Identity becomes a calling."
When you read the story of Miriam in "Dead But Not Gone", you'll understand how a 102 year old woman is the very example of generativity with her influence that now proceeds downward through the generations
I spend a lot of time cleaning up spam from my comments. Before I learned how to do it, I inadvertently deleted some earlier posts. I don't know who Rose was but her legacy has now circulated widely on the Internet influencing far more than her fellow college students.
The first day of school our professor introduced himself and challenged us to get to know someone we didn't already know. I stood up to look around when a gentle hand touched my shoulder. I turned around to find a wrinkled, little old lady beaming up at me with a smile that lit up her entire being.
She said, "Hi handsome. My name is Rose. I'm eighty-seven years old. Can I give you a hug?" I laughed and enthusiastically responded, "Of course you may!" and she gave me a giant squeeze.
"Why are you in college at such a young, innocent age?" I asked. She jokingly replied, "I'm here to meet a rich husband, get married, have a couple of children, and then retire and travel."
"No seriously," I asked. I was curious what may have motivated her to be taking on this challenge at her age. "I always dreamed of having a college education and now I'm getting one!" she told me.
After class we walked to the student union building and shared a chocolate milkshake. We became instant friends. Every day for the next three months we would leave class together and talk nonstop. I was always mesmerized listening to this "time machine" as she shared her wisdom and experience with me. Over the course of the year, Rose became a campus icon and she easily made friends wherever she went. She loved to dress up and she reveled in the attention bestowed upon her from the other students. She was living it up.
At the end of the semester we invited Rose to speak at our football banquet. I'll never forget what she taught us. She was introduced and stepped up to the podium. As she began to deliver her prepared speech, she dropped her three by five cards on the floor.
Frustrated and a little embarrassed she leaned into the microphone and simply said, "I'm sorry I'm so jittery. I gave up beer for Lent and this whiskey is killing me! I'll never get my speech back in order so let me just tell you what I know." As we laughed she cleared her throat and began, "We do not stop playing because we are old; we grow old because we stop playing. There are only four secrets to staying young, being happy, and achieving success. You have to laugh and find humor every day. You've got to have a dream. When you lose your dreams, you die. We have so many people walking around who are dead and don't even know it! There is a huge difference between growing older and growing up. If you are nineteen years old and lie in bed for one full year and don't do one productive thing, You will turn twenty years old. If I am eighty-seven years old and stay in bed for a year and never do anything I will turn eighty-eight.
Anybody can grow older. That doesn't take any talent or ability.The idea is to grow up by always finding the opportunity in change. Have no regrets. The elderly usually don't have regrets for what we did, but rather for things we did not do.The only people who fear death are those with regrets."
She concluded her speech by courageously singing "The Rose." She challenged each of us to study the lyrics and live them out in our daily lives.
At the year's end Rose finished the college degree she had begun all those years ago. One week after graduation Rose died peacefully in her sleep. Over two thousand college students attended her funeral in tribute to the wonderful woman who taught by example that it's never too late to be all you can possibly be.
Remember GROWING OLDER IS MANDATORY, GROWING UP IS OPTIONAL.
Dan Squires, a retired welder from Newfoundland, was reading the paper when he came upon his own obituary. Dan Squires realized then he was late, late, late for a very important date.
He went to his sister's house and she fainted. He called his daughter on the phone who was watching as his casket was being loaded on a hearse at the Toronto funeral home where his family had gathered to mourn his death. The Associated Press reports
"She totally, totally lost it," Squires' brother Gilbert said.
"She said, `There's a ghost talking to me on the phone. Please somebody try to make sense out of this because I'm losing my mind.'"
Squires was initially identified as the man who was hit by a commuter train last Friday night. The body was badly mutilated in the accident but still fit Squires' description, police said. Authorities haven't yet identified the victim.
"I've had eighteen straight whiskies, I think that's the record . . ."
When on September 11, 2004, we reflect on the attacks on the World Trade Center three years ago, we can read the New York Times, Portraits of Grief to remember the lives of the people who died. We can watch news specials and see again images of the plane flying into the tower and remember some of what we felt in those awful days. CNN's special included pictures considered too awful to broadcast then of people jumping to their deaths, some 200-300 we are told. A flash presentation made a few months after the attack brings it all back home. Michele Catalano was galvanized to set up the Voices project< collecting first hand accounts of that terrible day. Joe Katzman has done a remarkable job of putting together the best of the blogosphere in 9/11: Rising from the Ashes at Winds of Change
A common reflection of most men if they have never been under fire, is how they would react if they were.
Today, I wonder how I would react if I had been there, in the burning towers. Would I go so willing up the stairs to calm the people going down the stairs as the firemen did?
Would I refuse to leave until I was sure all my people were out like Rick Rescorla?
A Vietnam vet who some call the bravest man they ever knew Rescola was the VP in charge of security for Morgan Stanley. Ignoring the initial advice of the Port Authority for people to stay at the desks, he said, "Piss off, you son of a bitch. Everything above where that plane hit is going to collapse, and it's going to take the whole building with it. I'm getting my people the fuck out of here." Calling his wife 15 minutes later, he said, "Stop crying I have to get these people out safely. If something should happen to me, I want you to know I've never been happier. You made my life."
Over 2600 employees walked out of the south tower and into the rest of their lives that morning. Rick did not make it out. Neither did two of his security officers who were at his side.
Would I stay behind to help a disabled friend?
Abe Avremel Zelmanowitz was called "the saint of the burning towers" "A few minutes after the first plane hit the World Trade Center where Zelmanowitz was working, he rushed to see how his friend and colleague, Ed Beyea, a paraplegic, was managing. Beyea was left completely paralyzed by a diving accident 20 years earlier and was always accompanied by a nurse. Zelmanowitz urged her to leave the burning building immediately, promising to remain with his friend. Zelmanowitz then called Beyea's mother and held his cellular telephone up to Beyea's mouth. Beyea assured his mother everything would be okay and said his friend, Abe, was taking care of him.
Havah Zelmanowitz said Monday that she and her husband had managed to speak to Avremel a short time before the end. "He told Yankel and I that everything was alright. He said he had enough air. We urged him to leave the building as soon as possible, but he said he had to remain behind to help some people. A few minutes later, the building collapsed."
Would I vote to charge the cockpit?
Like the passengers on United Flight 93? Who voted, then prayed, and charged the cockpit in their last moments alive to foil the hijackers' plan to crash into the Capitol or the White House.
I don't know. I hope I would. Today, I am only grateful for these stories of remarkable courage and selflessness in the moments before death. They show me what is possible, how brave people act, are good so many people are.
I've been following closely the stories coming out from Baslan. So has Allison Kaplan Sommer, a blogger. She read a story in the Hebrew Press and when it wasn't translated into English, she translated the story herself because she felt that Yanis Kanidis deserved to be remembered and admired by as many people as possible.
There are few true heroes. Their stories exalt us all. The courage and bravery of Yanis Kanidia are his great legacy to Russia and all of us.
Here it is: The Teacher Chose Death by Dimitri Prokopiev and Natasha Mazgobia
In an act of unlimited devotion and dedication, to the bitter end, an elderly teacher insisted on remaining with his students. He protected them, bandaged their wounds, and with his death, saved their lives.
Children who escaped from the school told of how they owed their lived to elderly Yanis (Ivan) Kanidis, age 74 – a man of Greek origin who worked as a gym teacher at the school. He was among the hundreds of teachers, students and parents taken hostage last week when Chechen rebels invaded the large school.
On Thursday, in what was an unusual humanitarian move in the midst of the horror, the terrorists agreed to allow a group of women and babies to leave the building. The commander of the terrorist squad, saw Kanidis -- a sickly elderly man -- and offered to allow him to walk free as well.
But Kanidis refused. “I will stay with my students till the end,” the teacher insisted.
“Whatever you say,” said the terrorist, dismissing him with a wave of the hand.
“He was just like Janus Korzchak, who accompanied his pupils to Auschwitz,” said one of the students who was saved.
Like Korzchak, Kanidis didn’t just accompany his students, he guarded their lives. On Friday, when the children began to lose consciousness from the stuffy air and their thirst, Yanis went to the terrorists. “You have to give them something to drink, at least to the smallest children,” he insisted angrily. One of the terrorists hit him with the butt of his rifle, but the teacher continued to yell: “How dare you!? You claim you are people of the Kafkaz region, but here in the Kafkaz even a dog wouldn’t turn down the request of an old man!”
His efforts bore fruit. The terrorist allowed the teacher to wet one of the bibs of the children and pass it around to dampen the mouths of the little ones who were choking from thirst.
The hostages who escaped told how the teacher repeatedly risked his own life in order to save the children. He moved explosive devices that the terrorists had placed near the young students, and tried to prevent them from detonating others. When the first bomb exploded next to the windows of the school, parents and children began to run out. The terrorists, trying to prevent their escape, threw a grenade at them. The elderly teacher ran to the grenade to prevent it from exploding on the children. One of the terrorists shot at the teacher to try to stop him and Yanis was wounded in the shoulder – but didn’t give up. With the last of his strength, he continued to run, jumped on the grenade, covering it with his body. The grenade exploded, and the body of the teacher absorbed the explosion, protecting the children around him from injury.
Anyone reading about the horrific events at the school in Baslan where terrorists took a school and more than 1000 people hostage must imagine, if only for an unbearable moment, could it happen here.
People did what they could to take care of themselves, shedding clothes to cool down, and tearing apart textbooks to use as fans. "For two days I was continually waving my arm to fan my children," Ms. Bekoyeva said. The terrorists also gradually restricted access to the bathroom, first allowing five hostages at a time to use the toilets, then three. With little chance for their turn, the younger children could not hold back and relieved themselves in the crowd's midst. "We had them urinate into bundles of cloth," Emma said.
Ms. Bekoyeva said she handed six or seven children out the window, as older children scrambled past. Then she went out. She and her two sons ran to a shed, took shelter in it as the bullets flew by, and then Azamat punched out the back window, and they scrambled through it. After another sprint they came to the Russian police officers and soldiers. Most of them realized they were safe, but all did not. Seeing the police, Emma was confused. "I got scared and thought they were other terrorists,' she said. "But one embraced me and said, 'Do not be afraid.' "
Asamaz stopped when he reached a covered place near the police, and as the battle raged a few yards behind them, he snatched grapes from the trellises and handed them to the children with him - the first food they had had in more than two days.
Now lying in bed, he winced as his aunt Zalina Basiyeva put a traditional medicine on his burns. Outside their window, people clustered in the courtyard, waiting for news. Everything the people of Beslan thought they knew about living, his aunt said, had changed. She rubbed bits of the filament of eggshell onto the boy's blisters and burns, and said the lesson was indelible: "We never knew how happy we were."
Even If the government can protect the so-called "hard targets" like government buildings, nuclear plants, major financial buildings or airports, what about the "soft targets" -like schools?
We can hope for front line protection and good information from those in charge. In the event of a natural disaster or God forbid, a terrorist attack of some sort, we must realize that ultimately, in those first days, we are responsible for ourselves, our loved ones and those around us.