Who Gets to Decide, on that Final Passage of, Life?

How do you, RESPECT our elder’s wishes of, DNR, this is, difficult, because, if we do, then, we would carry the names of, being, cruel, as children, but if we don’t, we’re, equally, unfitting, so, this is, very hard, to, do…from the files of a nephrologist, translated…

With the Many Medical Advancements of Today, being a Medical Professional, I’d Often Seen that the Patients, Getting to the Terminal Stages of Their, Lives, with No Chances, while Their Families Still Wanted Us to Try and Save Their, Lives………

We can’t choose when we were, born, but can we, choose when we would, die?  As we get to the, end, would our own decisions be, altered, by our families’, “kindness”, or, will the ones we loved, although unwilling to let us go, but still, chose to, respect our, wishes?

Finding that Balance Between the Patients’ Will & the Medical Treatment, Means

My mother’s ninety-five this year, with four generations of, offspring, and we’re all, around her, her life is happy, it’s what most envied.  But with the coming of her, years, her system started, malfunctioning, her long-term diabetes, with the combined kidney disease, the loss of her muscles, causing her to start, deteriorating, away.  Last year, she was hospitalized because of an infected wound, for almost, a whole, week.  At the beginning of this year, he was diagnosed with her breast cancer which had, come back, again, but, the unpleasant experience of her hospitalization last year, getting her shots every single day, it’d caused her to reject the hospitalizations.  Sometimes, we would see her, use her scarf, wrapped it around her neck, and she’d looked like she wanted to, hang herself, and we’d asked her why, she’d not wanted to, burden us anymore, and this made us all feel, awful.

illustration from UDN.com

Since the start of the year, when Lien-Jing’s mother had contracted CoVid-19, she’d become, bedridden most of her time now.  at the end of February, we’d found her to sleep for the entire day, reduced her food intakes, as I’d heard, I’d worried that she may have the electrolyte imbalance, or the lowering of the immunities, which will cause her to become, easily, infected, I’d suggested to the family to take her to the hospitals, to check, and to get her the proper, treatments.  But, Lien-Jing’s whole family, decided to follow their mother’s wishes, only kept her at home, and, fed her small amounts of liquids, the rice soups, the milk.

One day, the elderly fell into, a coma, they’d notified the daughter who is in the U.S. to come home quick, and prepared for the clothes for her final passage.  I’d gone to visit, found that she was breathing evenly, that she had normal circulation of her lower extremities, that she can be, treatable, so I’d, talked it over with Lien-Jing.  And yet, considering the elder’s wishes, in the end, they’d still decided to keep her at home, with NO invasive treatment, measures being performed.

Several days later, Lien-Jing’s mother’s health seemed to be in a stasis, after discussing it with the local medical systems providers, the medical teams were willing to go to her home, to put her on the drips, to get her enough nutrients, electrolytes too, the physicians also made the scheduled visits.  And so, in not going against the elder’s wishes both sides found a way that, worked.

Who is it For, What the Patients are Weathering, in Their, Terminal, Stages of, Life?

As hard as it is, this family still, NEVER went against the elder’s wishes, kept her at home, to care for her.  They’d stayed by the elder twenty-four hours a day, and, whether it be flipping the elder over, feeding her, massaging her body, baths in bed, the members of the families, did themselves.  When I saw Lien-Jing by his mother’s bed, holding his mother’s hand, calling out to her, telling her everything they’d gone through, together, hoping that with his voice, he could, somehow, wake his mother, up again, I was, truly, moved by him.

A month passed, the elderly slowly became, awake, and could start eating on her, own, and could, recall the past with Lien-Jing too.  It’s just, that she’d mentioned to her daughter, “I don’t want to live anymore”.

With the medical advancements being available to all, as a physician, I’d often seen the patients, getting to their, terminal stages of life, with the families, desperately, trying to, get them, back to life.  And in the end, the patients were connected to the tubes, with the ulcers inside their, oral, cavities, edema, the hands and feet, turning, black…………toward this, I can’t help, but wonder: is the terminal treatments in one’s life, for oneself only, or, is it, for the, benefit of, the loved, ones?

would you want your loved ones to live out the rest of her/his life, like this??? Photo from online

In after seeing a ton of the offspring, with the names of filial piety, putting their elders through the unnecessary tortures, turning “patients’ will” into, an, illusion, I’d become, totally in awe of Lien-Jing and her families’ way of handling her mother’s, final, passage: allowing her mother to decide how she wanted to, die.

And so, this, is on being caught between being, unfitting as the offspring, or, to let our loved ones, stop, suffering, and unfortunately, in these Asian society, we’re all, too often, kidnapped by the beliefs of, filial piety, and, we put our elderly loved ones, through the hells that they don’t, deserve but gladly, this family, didn’t.

Thirty-Percent of the Hospice Care of N.T.U. Hospital, Weren’t Cancer Patients

A choice, for the terminally ill, to live out their, final moments, with their, dignity, intact, allowing them to choose how THEY want to, go!  Off of the Front Page Sections, translated…

For those who are, terminally ill, hospice is the choice to help them live out their final days with as little pains as possible.  The C.E.O., Cheng of Taiwan Hospice and Medical Pathology Association, stated, take the N.T.U. Hospital for example, there are close to thirty-percent of the patients in the program who aren’t cancer patients, and, of these, mostly were those with dementia.  Last year, the national health insurance agency added the terminally ill elderly, and other conditions and three other qualifications for those allowed in the hospice programs.

The Smile He Had on His Face When He Passed, Became What Helped His Widow Carry on with Her Life

“That smile on his face as he’d passed away, still gave me the needed drives to carry on with my life”, Mr. Lin at age forty-two was diagnosed with liver cancer, he’d gotten to the terminal stage, and moved into the hospice of N.T.U. Hospital, his widow, Ms. Lee told, that she struggled with the decisions of placing her husband into the hospice program, worried, that he might die sooner, but, her husband and families, in the help from the personnel of the hospice program, readied themselves for his departure, and, as her husband passed, there’s that light smile on his face.

A sixty-year-old ALS patient, due to how his conditions had worsened too quickly, signed the DNR, wanted to be taken off the machines, but his wife couldn’t accept it, and, as the hospice professionals mediated, then, the patient was in the at-home care programs for three years, then, passed on.

And, this is how we can, give dignity to the ones we love, allowing them, to choose their own, terminal, care, but we don’t do that, because, in our views, we want our parents, our grandparents to stay with us, for as long as they possibly can, because, losing them is simply, unbearable, and it will be, too painful for us, to, bear it, but, we forget, that we’re the ones, dragging their ailing bodies, keeping their souls TRAPPED, and that’s just, inhumane, and yet, we can’t decide to just, let them go, because we feared being labeled as, unfitting as their offspring.

Think about it: how fitting will you be, if you’d made your own loved ones, suffered, for more than they had to?

The Case of the Overturning of the Nanny Accused of Abuse, Lesson to be Learned: We Should Leave the Investigations to the Professionals

The public still have the tendencies to become the judge, the jury, AND the, executioner here, and this is, really, bad, because you hadn’t gotten ALL the FACTS straight yet, and you’d, rushed to, conclusions, dragging the woman’s reputations through the mud, and now her name had been cleared, but, her reputation is still, in the M-U-D, even IF it’s proven, that she’d not done, anything wrong, with the angry mob mentality, taking the public, over!  Off of the Front Page Sections, translated…

Two years ago, an eleven-month-old infant girl fell in her nanny’s home and died, the parents suspected the nanny for abuse, and as the famed youtuber told of the case, the online community had, gone against what the nanny had, done, and the parents of the young infant girl became, vigilantes too.  But awhile ago, the autopsy of the infant girl found residuals of ketamine, that the infant’s father tested positive for the substance also, turning the case around, the cause of death is “by second hand use of illegal substances”, that the nanny didn’t neglect her duties, and the charges were dropped against her, which turned over the “local community’s trial” of her.

the program includes…found online

Actually, this is not the very first case of the people acting as the judge, the jury and the executioner, and it won’t be the, last, as the online community loved playing the roles of the judge, and the, investigators.

The psychological experiments showed, that if you constantly suspect that your neighbor’s kid was stealing from you, anything s/he does, made her/him, suspicious; but as you’d found what you’d, misplaced, the child’s behaviors, don’t make her/him seemed like, the thief.

The case of the elderly couple who’d owned the café at Danshui was broadcasted fully and overtly by the media press, and most of the public believed that the landlord was an, accomplice, that he was good at, faking his, innocence; as the police conducted the investigations thoroughly and completely, and the evidence showed the landlord had absolutely, ZERO involvement, how he’d looked, down-to-earth, and honest then, this is, the interactions of people’s stereotypes with the halo effect.

As I was younger, I’d lacked the allowances, and longed for the snacks, and so, I can only, steal from my own mother, and surely, I got, found out, but, after a certain incident my mother’s “crime-solving means” became, more careful, because she’d mistaken my older brother as the one who’d, stolen her, keys.

When my mother had worked during the harvest seasons to make the extra cash, she’d not ridden her bicycle for a long time, parked it under the roofs, and worried that someone from the neighborhood by steal it, or take it for a ride, and she’d kept the keys inside her winter coat pocket, and one time she’d come home, and couldn’t find the keys to her bicycle lock, and she’d stubbornly believed, that it was my older brother who’d, stolen it, and beaten the crap out of him, and as he’d fallen asleep from crying, she’d, waken him up, and beaten my brother up again, then she’d, remembered, that she’d, hidden the keys, and felt bad for what she did to my older brother, and she’d, “treated” us out.  And, after this incident, my mother became doubtful of herself, as she couldn’t find her money, because dad didn’t believe her, had her rummage through her things once, to NOT “scapegoat” on the rest of us, and, I, who’s the, real thief, started laughing secretly, like I’d, dodged the cannons of a war!

And, all of these scapegoating cases tell us, that we all need to have that balanced mind of judgment when we watch the news, the national news, the international too, we can easily make a mistake, following the crowds.

And so, this is on how we are, easily, misled, by the news media, and, in the end, by the time these accused individuals finally got their innocence proven, they already got their reputations dragged through the mud, and no amount of repatriation (payment from the government for making it up for accusing you wrongfully!) will be enough, because the reputations is, completely, gone, like the case of the drugging of children in the preschools of Hsinbei city from awhile ago.

You’d Become a Fish, in a, Fish Tank…

You’d become a fish, in a, fish tank now, with all your family members, “tuning in” to that webcam they’d asked the nurses at the hospital to set up for them, to help them, surveil you, at those, designated, times.

You’d become a fish, in a, fish tank, only, you can’t swim freely like the fishes in the confines of that tank, instead, you’re, STUCK in that bed, with the tubes going in and out of you, that oxygen mask on your nose and, mouth.

what the elder, became…photo from online

You’d become, a fish, in a, fish tank now, only for those who cared about you, to “view”, at those, designated, time slots.  And, there’s, nothing you can say, or do, to take the control of your life, back, as you’d become, incapacitated already…

You’d become, a fish, in a, fish tank, and I feel sorry for how your loved ones, treated you like, some rare species of living creature they’re, trying to, keep, alive………

You’d become, a fish, in a, fish tank, as you are, living out, these, final moments, of your, life…………

Do We Resuscitate, or Do We, Let, Go?

The end is, near!!!  As the moment came to decide, and all of you, her children can’t, reach, that consensus to unplug or to keep her “plugged in”…translated…

That was, a day of chaos, of trials!  At the start, my eldest brother posted the message of mom experiencing stomach pains in the Family Group on LINE, in the afternoon, everything started, losing, control—mom was in a coma with a high fever, my eldest brother called up the ambulance, took her to the E.R., the E.R. said her blood pressure’s too low, needed a shot, C.T., the physician diagnosed our mother as shock from sepsis, and multiple organ failure, inflammation of her gall bladder, to the medical professional’s asking us if we want intubation, or use the defibrillator………..as all five of us arrived outside of the I.C.U., we were, faced with the signing of the D.N.R., to NOT have the medical professionals perform C.P.R. on her.

The nurse told us, “you guys should discuss this, these are the measures that the hospital will perform for the emergency resuscitations, there may be intubation, injection of the emergency life-saving medicines, shock, and chest compressions, etc., etc., etc.  If you all don’t agree to these measures, then, sign on this piece of paper.”

We all started in discussion.  “I think intubation is okay, but no electrodes.”, “Or, no intubation?  Mom’s already eighty-eight……….”, the sniffling of voices started up.  “Let’s think on it some more………”  “Don’t you all want to at least try to save her, once!”  the roar came.  Followed by the, cries, “How can you say that?”

is this, what you want your loved ones to endure in their final stage of life??? This is what intubation looked like! Photo from online

Ahhhhhhhhhh, I’d come back home to visit with mom a few days ago, we’d laughed, and I’d, done some simple exercises with her too, how did the world turn upside down so fast?  We are all, quite aware, that those of us who wanted mom to stay, are because we don’t want to lose her yet, and, those who wanted to sign the do-not-resuscitate, we don’t want to see her suffer any longer.

To keep her alive?  Or to let her, go?  Of course, I’d wanted to, try to save her, once, at least, and yet, I keep seeing how she’d lost her consciousness, with the mask over her mouth and nose, pumping the oxygen into her, and all those, tubes in her body, the ureter bag, with the machines by her hospital, bed……………..I don’t want mom to be kept alive by the machines, I think, what I want, for her, is for her to die, with as least pains as she possibly can.

And so, some of you guys wanted to save her, and some of you don’t want to see her suffer, and you and your siblings are, deadlocked, and, keeping someone alive like this, is, simply, way too, inhumane, think about it, who would want to live longer, if s/he lost consciousness, and is connected by the tubes, to the, machines, and by keeping your mother alive, you’re, keeping her here physically, and elongating her suffering, and she will be trapped longer, by her, ailing body, and that’s just, not, humane, would YOU want to be kept alive on the machines?

Letting Go, the HARDEST, Decision

On difficult decisions of terminal care, because it’s hard, and we will all have to face something like this at one time in our lives or another, maybe with our own loved ones, maybe, when we get older ourselves…translated…

In This Process of “Letting Go”, it’s Next to Impossible for Those Who Aren’t in the Process to Know What Goodbye is Like………

The idiom of “long-term sickness brings NO good son”.  There’d been the news reports on this matter, and, most of the people after hearing, they’d only felt chilled, or, that it was only, matter-of-fact.  But in the medical realm, we watched the younger generations shouldered up the responsibilities of caring for their elders until the end; and yet, with the worsening of the elders’ conditions, the caretakers usually felt burned out, and started thinking of “letting go”.  And, in this process of letting go, the heavy heart of the love for ones’ next-of-kin, and the sense of responsibilities, nobody on the outside can understand.

Insomnia is the Norm

Mr. Chen is seventy-six, eight years ago, he’d started dialysis, because he was the C.E.O. of a company, even as on Wednesdays he was due for the procedures, he’d still gone to his office to make the rounds first, visiting his old clients regularly.

At the start of last year, he’d started feeling the lower back pains, at first, he thought it was sciatica, after he had an MRI, it was the granulomatous spondylitis, and even as the surgery helped alleviate the symptoms, but, because he was bedridden too long after the surgery, his an elder, and a dialysis patient too, losing his muscle mass had greatly reduced his physical activity levels, and in the end, he’d needed his family to help him get through the days of his normal living.

illustration from UDN.com

This authority in business, a C.E.O., suddenly became someone who can’t control his own body, a patient, Mr. Chen’s moods altered as well.  But, as his families considered placing him into a nursing home facility, Mrs. Chen decided to shoulder all of his care on other own.

As she’d come in to get her insomnia treated, I’d asked her, if her body could take it?  She’d said, she’s older, and as her husband hollered, she’d had to go to him quickly, surely, there was, enormous stress on her, in the past six months, she’d started feeling the strains.  But, thinking about “letting go” of her husband whom she’d stayed close to for half a century’s time, she couldn’t, accept that……………

Her First Words Were “I Want to Go Home”

Another elderly woman, Grandma Shih, who had kidney problems due to her diabetes who is a regular at my clinic, I’d been her physician for more than decades, I’d gotten to know her families well, knew that her offspring took care of her living needs daily, so her kidney function was quite stabilized.  Once I’d thought, that she will never need dialysis, but, her heart failed, and at the age of ninety-three, she’d entered the line of dialysis.

There would be the many situations in the elderly population after the dialysis especially, and, a more complex set of complications compared to the younger generations, for instance, infections from bacteria or virus, or, hemorrhages, it’d made her come in and out of the hospital many a time, she’d become, weakened, in the end, she’d relied on the feeding tubes, and I saw her son, with his eyes red, as he’d, fed the formula into his own mother’s feeding tubes, and I’d felt really bad, and, can’t believe, that Grandma Shih would need this sort of an end-of-life care for her.

As she choked on her own vomit that final time, Grandma Shih lost her vitals on the way to the hospitals, because the conditions were critical then, we’d immediately intubated her, although afterwards, the families held different opinions on intubation, but, at the moment, it was emergent.  Luckily, the elderly pulled through, and started breathing on her own, it’s just that as she was discharged from the hospitals, she’d become, bedridden, and her days and nights were, flipped, causing too much strain on her loved ones, as well as the nurse’s aide too.

Because of necessity, they’d found a facility that can perform the dialysis for her, placed the elderly woman in the home, so she could get the care she’d needed.  At first, as the son went to visit, Grandma Shih remained silent, and her eyes couldn’t focus; but after a week, she’d recalled her son’s name, and started stating, “I want to go home”.  And, this made her son started blaming himself for deciding to place his own mother in a nursing home facility.

In the final passage of her life, Grandma Shih continued staying in the nursing home facility.  Six months after she’d passed, her son told me, “Sometimes I’d regretted it, not known, if I’d done right by her or not”, even if they couldn’t watch over Grandma Shih around the clock—that seemingly easier option became, the road block he tried to cross over his whole life.

Those with the long-term illnesses, are the ones suffering, and, the primary caretakers around them are, too strained, it is a difficult choice, letting go, or not; if you’d chosen to not let go, you’d be straining yourself, and, you have to feel the pains and sufferings of the ones you love dearly; but as you’d selected to let go, you are filled with the unwillingness of letting them die, and this may cause you to regret it for the rest of your lives.

And so, there you have it, this is a difficult decision, that we will all face someday, maybe it’s with our own parents, or, when we get older ourselves, and, there’s still no right or wrong on this, and, that’s just, how life goes, sometimes, we’re, just forced to make these hard decisions for the ones we love dearly, because we don’t want them to suffer anymore, and sometimes, we choose to keep them alive, because we aren’t, ready, to say goodbye yet, and, by doing that, we’re, prolonging their, suffering.

In a Moment’s Time, the Decisions of Not Signing the DNR, She Was Intubated, and Was Saved

Two cases of the means of intubation here, but with, totally, different outcomes, on life and death, off of the Front Page Sections, translated…

In the times of outbreaks, the severely symptomatic had signed their DNR, but, the outcomes were, not the same, some, at the moment of critical conditions, retracted the signing of the DNR, intubated and recovered.  But there were those patients whom, not knowing what was happening, signed the DNR, but in the advices of other physicians from other hospitals, retracted, and transferred, had the ECMO placed in, and still died.

The woman, Chen in her sixties with diabetes, was confirmed of contraction, sent to a specialty ward for MERS-CoV of a major hospital in Taipei, she wasn’t good, had a serious case of pneumonia, with her blood sugar rising up, and kidney malfunction, her conditions worsened, and the hospitals put her on dialysis.

Chen told, that back then, the medical staff members wanted her to sign the DNR, and stated it clearly, “This is for your own good, also, for the sake of your offspring!”, and so she’d, signed it, and, checked the box of “no intubation in emergency resuscitation”.

But, at the other nurses’ advise, she’d, retracted the consent forms, and this decision seemed to have, saved her life, a few days later, she had respiratory failure, the doctors intubated her, and actively treated her, used the steroids, and she’d turned for the better, and was out of the hospital safely in the end.

the medical staff members intubating a patient! Photo from online

The sixty-two-year-old Mr. Shih didn’t have such good luck, he was confirmed of contraction last May on the thirtieth, was hospitalized at the hospital nearby to his home, within two days of admittance into the hospital, the medical staff members tried actively persuading him to sign the DNR, and he’d trusted the medical professionals’ advice, and signed it.

Mrs. Shih had been confirmed of contraction days earlier, and was treated at a different hospital, as she’d learned of her husband’s signing his DNR, she’d discussed it with friends, of them, one who is a physician advised against it, reason being that her husband isn’t elderly, nor did he have any serious illnesses.  And so, she’d tried hard to persuade her husband to get the DNR retracted.

A couple of days later, Mr. Shih’s conditions took a turn for the worst, his primary treating physician called Mrs. Shih up, “Intubation or not, it’s a hope, it’s quite painful for the patients to be intubated, so many patients who’d been intubated didn’t make it.”

The following day, the physician called again, “if you don’t sign the papers, when the time comes, we will, shock him with the electrodes, and, the CPR we perform on him may break his ribs.”, but Mrs. Shih decided to get her husband intubated.  A couple of days later, the hospital told her that her husband needed around-the-clock medical care, and transferred him to a medical center up north.  But because of the critical condition Mr. Shih was in, they’d put the ECMO in, but the sudden internal bleeding, even as the paramedics did their best, he still passed.

And so, this is on the decisions of life or death, made on a dime, and we are faced with these difficult decisions about our loved ones, especially the elderly family members, and, there’s still no right or wrong way to approach this, and, usually, these moments came too quickly, that we won’t get the time to make that list of pros and cons, and then, decide what we want to do for our, loved ones.

This, Final, Mile…

In the, “home stretch”, and, we’re, almost, there…

This, final, mile of life had been, too, difficult for you, you’d been, in and, out of the hospital, and, you’d, “survived” through each and every one of your, emergency visits.

This, final, mile, is still, not yet done for you, but, as you grow weaker by the day, I’d, wondered, when will your, suffering, end?  And, how much longer, must you be, tortured, like so?

This, final, mile, it wasn’t, supposed to be, easy, not for you because you do NOT deserve, an, easy death.  This final, mile, you’d been, admitted, released, readmitted, rereleased, from the hospital, again, and again, and again.

in this, “home stretch”…

photo from online

And your families, get, trapped, in the signing of your DNR, over, over, over, and over again, and each and every single time those E.R. nurses asked about whether or not you’re, DNR, they would, battle with themselves, as well, as each other.

They don’t want you to suffer, but, having you for one more day, well, that’s, one extra day they will get, with you………

Decisions

The decisions to stop treatment, or to, continue it, weighing the pros and cons of it, over, over, and over again, in our minds, and, we can only pray that in the end, we’d, made the, right choices by our loved ones.

Upon reading Marcie’s “Difficult Choice” on August 25^th, I was moved, this hard-to-master lesson of life, is, harder to solve than the, mathematical, equations.

I was forty-two on the year, thought of how at age forty-two, my father caught me, who let out the very first cries of my life, and how time flew quickly by, turned all our hairs white, made him hunched in the back, and, eroded away, his aging, skins.  I’d squatted down, helplessly, in the hallways of the hospital, with my arms around my knees, I’d, broken down and cried.  The sun still radiant outside, while my world had, crumbled down, no longer, is it, a full-circle again.

this…

photo from online

After the marrow was extracted, the biopsies on his liver done, I’d, pushed him back to his ward.  “Ouch!” that was the only word he’d, mumbled aloud after he came to, following that, he’d, drifted into that cycle of, never-ending, eternal, waking and sleeping.

The eyes behind the glasses, with that genuineness about it, said, “sir is too elderly and too weakened in physical strengths, I’m afraid, that he won’t able to get through the chemotherapy or the surgeries, you and your families must make up your minds, don’t leave the regrets for tomorrow, the patients are in pain, the families, in even more, pain.”  The young resident stated these words, that, made my heart twisted up even tighter, can it, not be, a “multiple choice” question?

Three years ago, my eldest uncle fell seriously ill, my older cousins couldn’t let him go, his life was, spared, but, he was kept alive, with all those, tubes going in and out of his body, it’d, made the families, relatives, and friends wondered, can we, tie him down with love, to save his body, because we don’t want him to go?  Then, two months later, he’d gone, and, my older cousin kneeled down in front of the altar, and cried like hell, and blamed himself for making the wrong decisions to save his own father then, that he shouldn’t have, put his own father through those two more months’ worth of, trials in the body.

AS my younger brother heard the surgeon’s statements, he’d exclaimed aloud, “of course, SAVE him!”  “my father’s a military man, he would NOT want to live on like this, I want to save him too, but, as his daughter, I know I can’t be, so, selfish”, I’d, finally, got those, words out, and after that, my heart had a hole in it.  My youngest sister cried, shook her head, and waved her hands no too, she was, my father’s, favorite, youngest child, it’s, simply, too difficult, for her, to voice her thought on the matter.

or this…

saying their, final, goodbyes…and letting go…photo from online

I’d, pushed that hospital bed, with all his belongings, took him to the hospice ward.  It is, very hard to describe what it’s like in there, there are the hopes and expectations of getting out one day on all the other, floors, while here, the patients are, walking, a step closer to death by the day, but it’s, not just that.

As we entered into the hospice, my crying, stopped, the sorrows are, all over the places, but my father looked, more at peace, and, as he woke, he’d said, apologetically to me, “it’d been trying on you”.  my foolish dad, can you, breathe, a bit longer, so, your children can, hold you in their arms, longer, so I can, be a daughter, with a father still?

After a full month in the hospice, I took dad home.  In the company of his children and grandchildren, without those tubes going in and out of his body that made his life even harder, he’d gained, an, extra month, two days after Father’s Day, he’d selected to, fall, into, that eternal, sleep, and thus, our, scents of, missing him, started, rooting downward.

So this would be, one of the, hardest decisions that someone is forced to make, to save the loved ones or to just, let them go, I mean, there’s, a lot to, consider in the matter, are you, willing to, try your loved ones longer, just so you can have them with you longer, or, would you be willing to, say your, goodbyes to them, and, leaving, no love unsaid, and, just, let them go?

That Day, Unknown

On watching her husband, suffer, with his terminal illness, waiting, for death to come and, claim him, translated…

That day, my husband was, wheeled into the treatment room, had a “smooth ride” of his cancer treatment processes, no loss of hair, no losing all his weight, he’d only, complained of aches and pains more often, and as the primary treating physician visited his ward, he’d only, begged him for more pain meds, but, after the pains subsided, another sort of illness, took him over.

One afternoon, I’d, rushed off to the hospital, it was the call of the caretaker from the bed next to his.  I’d never seen him like this before, lips trembling continually, kept apologizing repeatedly, I’m sorry, I’m, sorry, the group of doctors hovered over his bed, and started discussing, and because my husband was in and out of comas, and started calling aloud things that don’t make sense, fearing that it might affect the other patients who shared the same room as he, they’d decided to wheel him into the treatment room.

as he’d, become like this…photo from online

And after that we’d, taken, that downhill slope toward, the bottom, he could laugh and chat at first, but, with his getting diagnosed with acute pneumonia, he had an intubation, and because of how the hospital worried that he might hurt himself, they’d, restrained him with the cloth bands to his bed, and his elbows now, bruised up, with the days that came and went, his skins ulcered.  Every day, he’d slept, waken up, waken up, and slept, and can only, stare at the ceilings, as he’d come home from work from before, he’d, ranted, incessantly on what went on during his work day, he can, no longer speak a single word now, and it must be, too, trying for him.

At first, my husband mapped out his, recovery plan, placed it at the bottom of his, desk drawer, he had a strong will to survive then, was optimistic on this path to, defeat cancer, and yet, months passed by, the life and death that came and went in the hospital wards, the elderly who was still there on the next bed, got wheeled out with a white cloth covering the bed today, my husband also, transferred from the normal wards, into the I.C.U., and connected to the machines to live now.

Once, I’d, gotten closed to his ears, told him, “if you still want to live, nod”.  And it wasn’t, as I’d expected, a nod, he’d shaken his head then, for a very, very, long time, with the tears that stained up a huge chunk of his, pillow.  While I, too selfish, can only, struggle within my own self, after I’d made up my mind, I’d still, tried to keep the moments of visiting him in the hospital afterwork, again, and again, and again, hour by hour, and, begged for that, unknown day, to finally, come.

And so, this, is how difficult it is, to watch someone you love very dearly, get tortured by his, illness, and, at the start he had this strong will to survive, thought he was going to, overcome, but, as time went by, he grew weaker, sicker, and now, he can only, lie in his hospital bed, and wait for death, and there’s, nothing you CAN do for him, save for, sign that DNR on his, behalf now.

She Had Pulled the Plug on Father, & Readied Herself to Serve the Time in Prison Back Then

The choice, to decide how we will, leave this world, it’s, an important one, signing the DNR, lessons that life have to, offer, off of the Front Page Sections, translated…

“The Right of the Patients’ Selves” was signed last January, and Taiwan marches, one step toward “dying easily”.  The honorary professor of the Changgong University Medical School, Chiao recalled her own caretaking experiences from forty-two years ago, how she had, prepared herself for being charged with “murder”, pulled the plug on her own father.  And now, she’s a terminal cancer patient herself, and set up her own DNR, and planned to “leave the world naturally”.

Her father was a retired army general, gone to war, she clearly remembered her father’s beliefs about life, not going against what’s natural, not forcing life along.

instead of this…

photo from online

Chiao told, that at age seventy-three, her father started having memory issues, but they couldn’t find a reason, they’d not known it was dementia, her father and older brother lived in Taoyuan, one day her father disaprpeared, and seven days later, the police called, told the families that her father had, wandered to Yilan, which was, over hundreds of kilometers away, covered in his own urine and fecal matter, and he couldn’t tell them how he got there, what he had for food, or where he’d stayed.

At eighty-six, her father had a cold, which caused pneumonia, and sepsis too, he was hospitalized, Chiao told, that there were tubes connected to her father’s body, with the tracheal tubes as well, the doctor was about to place her father on life support, she’d discussed the matter with her older siblings, and, decided to honor the way their father lived, and signed the DNR.

Chiao graduated from the nursing department of N.T.U., back when she was only thirty, she’d stated the wish for all of her family members, the doctor replied back coldly, “How can you all be such unfitting children, how can you let your father die?”, seeing how the doctor wouldn’t do it, the families asked Chiao to pull the plugs.  For this, she’d read at the medical libraries of N.T.U. for an entire week on the ethics of medical treatment, and proved that her and her families had, made the right decisions.  She said, her father’s heart, liver, lungs, and kidneys had all failed, if he were still conscious, he would certainly, NOT allowed so many tubes to get him plugged in, besides, his weight reduced to twenty-seven kilograms, nothing but skins and bones left, unless there’s a way to transplant all the vital organs in his body, there’s no way to save him, there’s no reason to, prolong his, sufferings.

wouldn’t you rather have…

rather than prolonging the sufferings of someone you love and cared about? Photo from online

“The medical staff members started whispering, said that I was, murdering my own father.”  Chiao took her clothes, a bible, readied herself for prison after she’d pulled her own father’s, plugs.  Before she’d taken her father off life support, the treating physician demanded that she wrote on her father’s medical records, “The daughter, Ko-Shih Chiao pulled the tracheal tubes herself”, and noted the year, the month, the day, the hour, and the second when it was done.

“After the tubes were pulled, my father took a deep inhale, I was so scared, called in all my family”, the family stayed by the father’s side, until he passed away in peace.  Chiao believed she’d made the right decisions, but still struggled with the decisions long.  As she worked as the assistant head nurse at VMH in Taipei, she’d had eight terminally ill patients who were tried by their conditions in her two years of working there, and they’d, taken their own lives, it’d pained her even more.

She was diagnosed with breast cancer at age fifty-eight, and it’d relapsed, she was on the target drugs.  As the legislation of “Patient right” came last year, she’d set up her medical will, “if I can’t be cured, and there’s a lot of pains that come, then, I shall, die naturally, no need to prolong my own, suffering.”, awhile ago she broke her leg, the doctor said if she get it surgically corrected, it will be healed in just one month, otherwise, she’s going to wait for three, four months for it to heal up on its own; she’d assessed, that the drugs she was taking for cancer was causing her white blood cell count to drop, that it wasn’t fit for her to go under the knife, and decided to let time take its course, and if it doesn’t heal properly, it’s the way it’s intended to be.

And so, because of her work, she’d seen a ton of people at the terminal stages of life, and realized how important it is, for the ailing to make ones’ own choices to whether or not to get resuscitated, and, she’d, honored her own father’s wish, despite HOW the outside world perceived her, and she’s, made the most important medical decision of her own life herself too.