Duty to Die: Author Says Too Few People in Oregon are Requesting Assisted Suicide

being mortal

How about this for piling on.

Here are my brief thoughts about someone else’s article. That article is kind of a review of a book review.  More like a response. And I just happened to finish that book, and I really enjoyed it. The book is called, “On Being Mortal” by Atul Gawande the Harvard trained surgeon who has produced a number of good books in the last decade. I have read them all 🙂

Anyway, Gawande’s book is about aging and dying and how the healthcare system has not done a very good job in actually helping people live better lives during the last phase of their journey. He spends a few pages talking about assisted suicide, and I would disagree with what he says (he thinks it is OK under some circumstances). But regardless of your position, he makes what I think is a compelling point. In America, and other countries, we are making huge strides in palliative care and hospice services.  And contrary to popular conception, those treatment modalities are not about helping people die as much as to live as well as they can during those difficult days.  People with painful and  incurable diseases are choosing to live out their days with family and finding more dignity than they knew was possible. And it is worth mentioning that how we live when we are dying is an important part of the human journey. How the story ends is truly important.

But it seems that in the Netherlands, the availability of assisted suicide has become the quick fix that has railroaded more promising alternatives. Rather than developing health care systems that can help people live full lives to the end, they have opted instead for something more sinister in the name of “dignity.”  Here is a quote from Gawande’s book, ”

 “I fear what happens when we expand the terrain of medical practice to include actively assisting people with speeding their death. I am less worried about abuse of these powers than I am about dependence on them.”

“The implication is that we might begin to substitute assisted dying for palliative care and hospice. He points to the experience in the Netherlands, where he says the fact that “one in thirty-five Dutch people sought assisted suicide at their death is not a measure of success. It is a measure of failure.”

The author of the article at LifeNews.com, Wesley Smith J.D. makes a point that is even more disturbing. Marcia Angell, an author who is an advocate for assisted suicide, has been quoted as saying, “I am concerned that too few people are requesting it. It seems to me that more would do it. The purpose of a law is to be used not to sit there on the books.”

Is this debate about presenting options that people want, or imposing your choice on others?

Source: Duty to Die: Author Says Too Few People in Oregon are Requesting Assisted Suicide | LifeNews.com

Paramedic Lessons on Motivation in Learning

This is a photo taken by a friend of mine of a pile up on the Cajon Pass that happened when I was working in Victorville. If you have ever wondered why you should pay attention in class this picture is worth a thousand words.

After several years as a paramedic I decided to get involved with training. Many of the classes I took to become an EMS instructor spent a lot of time on theories of “adult learning.” Adults learn different than children. One important emphasis is on motivation. If adult students don’t see any value in learning the material you are presenting, then most of them will drift off. I had this theory drummed into my head, and tasted it in the many classes I taught.

I personally had sat through so many lectures and CE classes (continuing education) that were a form of legalized torture. The teacher was boring and ineffective. The students were rowdy and everyone wished they could go home. Often it was worse than a just a waste of time because there were few precious hours available to “raise the bar” of health care provided by EMT’s and Paramedics. I hated sitting through classes like this, and probably muttered a vow to myself that I would never teach a class like that. My classes would be worthwhile….My students would learn…My students would even enjoy it! Easy to say, hard to do.

I have always had good grades, from the elementary years, through high school, and into college. But much of the time I still felt like I was faking it, not really learning. It was not until I went to paramedic school at Mt. Sac in 1995 that I feel like I really “learned how to learn.” For the first time in my life I felt like I had to remember something that was for more than just an exam. Our instructors intentionally rattled our cages with a healthy amount of stress. Stand and Deliver. I felt like I needed to know this stuff or people might die. And that was true. So I studied and buried myself in the material. My Goal: mastery. Well of course you can’t master anything until you have gone out and done it for a while. But my hard work in school did pay off, and many years later I was still reaping the benefits of the knowledge I had gained. Some of it was above and beyond. But there were many times when I was able to pick up on some piece of information in an assessment, from a patient’s history or medication list that might have gotten missed. And it was because I had worked hard in the class room. And after School I was committed to keep on learning. And when I became an instructor I was determined that I would keep my students interested.

I mention this because I have often heard people belly-ache in various classes about what they have to learn. Even if they pass, they leave ignorant because they are not convinced that it matters. Who needs to know that stuff. It is stupid. I don’t want to deal with all of these details, I want the glory! Yeah, uhuh. And who wants you to come to their rescue, Mr. I just barely passed by the skin of my teeth.

I read some of the Horatio Hornblower books several years ago and a statement in one of the books has stuck in my mind. One of the sailors said, “for every 2 minutes of excitement in battle, there are 2 weeks (or was it months?) of monotony at sea.” This is definitely true of medicine, and EMS in particular. Much of it is routine, even boring. But it is in those in-between hours of average work, of routine, of study, and diligence in mundane things that no one notices; this is what really defines who you are as a person, and a professional. It will define your reputation, and establish the habits (or ruts) that will bleed over (pardon the pun) when the heat of battle rages on. You may only get one shot to make it big.

Sadly, I have had many instructors who do not make the subject matter exciting. They have lost connection with the idea of motivation and purpose. Want to be successful? Convince yourself that you NEED TO LEARN when you are taking classes. Ineffective teacher? In my opinion, it is during these times that we have to motivate ourselves with a sense of the significance of study, and remind ourselves why we are learning. Furthermore, being able to learn from a bad teacher might be the most valuable thing you gain. If you can learn from a clod, you can teach yourself. Stay motivated, even if you have to tell yourself a lie like, “I really need to know this for the future! Maybe there will be a job interview question about this someday.” Truth is, it probably isn’t a lie. I have heard of stories about that, “oh I see on your resume, that you have taken a class in XXXX, tell us about YYYY…”

Stay motivated. This is one of the keys for learning for adults ( and I think kids too).


Hurricane Katrina

I have spoken to some friends about my paramedic experience, and thought it would be helpful to add some info about this stuff.

In fall of 2005 I was working for AMR in Victorville and had the amazing privilege to be part of a huge rescue and recovery effort following Hurricane Katrina. We drove 30 ambulances from Riverside to Baton Rouge, where we helped to set up a major “temporary ambulance operation” during the weeks that followed the hurricane. We were there for about 3 weeks. It was a great privilege, and I would say it was a defining experience in my life. I had been a paramedic 10 years and like anyone in EMS that amount of time, I had seen enough to give me nightmares for a lifetime. But being there was different. It was not the normal 911 mode of doing things where there are a few people at a time in the midst of crisis. almost everyone there was experiencing some degree of chaos, or was related to someone who was. I felt like the purpose of my life to help others was just as clear as it has ever been.

The first picture is of me and Phil Titsworth. He was a supervisor for AMR in the Antelope Valley then, and I think he still is. He is a great guy and we developed a pleasant friendship while we were there. We were partnered up the day of this picture. Location: We were in the Omni hotel in the French quarter, and we were detailed to an improvised clinic there. We had a doctor, a nurse, and a bunch of paramedics. Most of the citizens were gone, and the people that remained were mostly relief workers of one kind or another. Police, Fire, Militar, and various workers. So people would come in and we would help with vaccinations, and give all kinds of care….a lot like an urgent care. We did many different things, and each day was often a different “mission.” Some helped with backing up 911 units, some transferred patients to other hospitals, some worked at refugee centers, some helped with search and rescue teams, some helped with body recovery….we did all this and everything in between.

When the water went down and they opened one of the freeways in N.O. we drove through and saw this makeshift “dock.” It was a place where many of the citizens had taken their boats into the water to rescue the stranded. When the water receded they leaned over onto the ground where they were tied up…amazing….

Some lessons I learned:

  1. Texas is a very big state, you just drive and drive and drive, and you are still in Texas.
  2. Don’t count on the government to save you, even when the resources are just a few miles a way. No kidding, things were very disorganized. At one point I was so frustrated I was fighting back tears. In my personal experience, the state of Louisiana should bear the greatest brunt of the blame, right after the personal failure of individuals who ignored warnings..
  3. Listen when you are told to evacuate, and do at least something to prepare yourself for disasters. It is really easy to throw stones at all those idiots in New Orleans isn’t it? But how many of us in Cali, right up the street from the San Andreas Fault are really prepared for the big one. They have hurricanes, we have earthquakes. We should give some thought to preparing for emergencies.
  4. There are lots of great people in America that rise to the occasion during disasters. I was overwhelmed by the kindness of the southerners. I met a doctor who volunteered to go out there and help. She said she had student loans, and a struggling practice, but that she just HAD to go to help the people there. Wow! I saw lots of that and felt humbled to be among so many sacrificial people. I was also very proud of AMR. They have their problems, but in disasters they do the right thing.
  5. I was amazed at the power of God. I saw destruction right in front of me, the news doesn’t compare to seeing miles after miles of destruction.
    Psalm 46:8 Come, behold the works of the LORD,
    Who has made desolations in the earth.

I have lots more to say, but this is all for now.