28 December, 2005

"When the Grim Reaper Misses"

V29 had this very interesting comment on Part 3 of my visit to the VA Hospital:

Sometimes, when the Grim Reaper takes a swipe and misses, the result is somehow more terrible and terrifying. Creating a living hell, if you will.

One of the men from MOPH said something similar on the way to the VA Hospital. He said it quietly and almost hesitatingly, probably for fear that we would not understand his meaning.

We were talking about how modern body armor was doing such a good job of protecting the torso that people were surviving blast injuries (such as from IEDs) that would've killed them a few years ago. He mentioned that is a very good thing in most cases because people are surviving with "only" missing or damaged limbs and that the technology of prostethics and various devices of modern life allowed them to live very full and independent lives once they recovered from the initial mental and physical trauma. However, he added that he feared that sometimes modern technology and military medicine has been able to save or resuscitate people that maybe they shouldn't have, and that he had "very mixed feelings" about that (keep in mind that this was from a man who had a purple heart, wore the name of a fallen comrade from 1967 on his wrist, and reguarly visits veterans in many hospitals). You could see in his face that he was anxious, and mentally focused on things he'd seen. He seemed relieved when I agreed with him and said something about modern medicine making for difficult choices.

Several of my blogging friends have encountered that difficult choice recently: Lex confronted the knowledge that his sister had chosen to end her life in hospice care without significant measures taken to extend her life, and Jack had to make the decision to sign a Do Not Resuscitate order for his father who was dying from cancer. In my own family, we had been asked to make a decision in the case of my father's coma, but were thankfully spared that. But my mother and her sister made that decision for their father when his brain and body had been stolen by Alzheimer's.

In the summer before I attended college at age 18, I prepared a print-ready copy of a collection of essays about euthanasia and end-of-life issues for a professor. Some of it was rather radical in my eyes, but given my family history a lot of it made sense to me, especially the idea of modern medicine sometimes able to prolong the body's function long after true life is over.

I do not support active euthanasia (such as is practiced in Northern Europe), but I also firmly believe there comes a point where we let nature take its course, or "Let God decide," as others have phrased it. I don't think anyone can really know where that point is except those who love and care for each particular patient, in consultation with medical caregivers. That makes it a very cloudy legal and ethical issue, but I can't see any better way to find an answer. Modern medicine is a double-edged sword.

These issues were very clear in my mind as I learned the young couple's story I have related on this site. I have neither the knowledge of his case nor the expertise of a doctor to judge the situation or know the likely expectations for recovery. But I couldn't help but wonder how the doctors that had reportedly spent 30 minutes trying to revive him felt about the current situation. He had started with "simple" IED injuries to his legs, perhaps suffering from mild Traumatic Brain Injury, but nothing worse. But two days later something had gone horribly wrong, and after heroic efforts to revive him he now he laid there facing a case where the best hope was that what made him him might be trapped in a severely damaged mind and body, and that someday--somehow--he might be able to break through that.

Did the doctors know of these possibilities as they worked to revive him? Would knowledge of the results he and his family are now coping with have had any effect on their heroic efforts for thirty minutes? Is it even right for me to be thinking such horrible thoughts? I try to put myself in his shoes or his relatives', but I cannot. Thankfully, I am not qualifed to make decisions of life and death and "Miracles" do happen...

Please understand that I am not advocating that doctors should've taken a different course of action in the case of the young couple I wrote about, just recognizing that these unanswerable questions come up. I sit here hoping with all my heart that the wife's devotion, courage, and sheer willpower will culminate in the result everyone wants for that loving family. But I also recognize that despite our great knowledge and technology, and even the strength of the human spirit, so much is out of human control.

These are horrible thoughts and horrible questions. We live in a very challenging world... Oh, for omnipotence to know the answers!