Compassionate, informed advice about healthcare decision making

Archive for April, 2021

A REAL Newspaper — How I Miss It

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I actually touched a REAL newspaper last week. We were staying at a hotel across the river from Washington, D.C., and they gave us a FREE Washington Post. I could smell the newsprint and ink. My fingers started to take on an inky hue. I miss that feel and smell.

Hank’s father, Hampton Dunn (R), looks over his AAA newspaper as it is being printed

I grew up in a newspaper family. My father, Hampton Dunn, referred to himself as “only a newspaper guy.” He dropped out of college because he got his dream job as a reporter for the Tampa Daily Times, Tampa’s evening paper. More on my dad in a moment.

I still read newspapers every day: My former hometown paper, The Washington Post, and The New York Times. I find it curious that sometimes, when my wife asks me what I am reading on my phone, I say, “Reading the paper.”

Paper? It’s glass and silicon and plastic — no paper in it. These newspapers are no longer limited to a “final” edition with all the news that happened overnight. Now they update events “live” in real time.

The death of the daily newspaper

Like all major cities in the 1950s, Tampa had a morning and evening paper, the Tampa Tribune and The Tampa Daily Times, respectively. People stopped reading the evening paper because they could get the day’s news on network television. So, the Tribune bought the Times and dad was out of work — and out of the daily newspaper business.

He eventually became public relations director for AAA in Tampa and published their monthly Florida Explorer.Although many motor clubs were going with a slick magazine format, dad insisted on his being a real newspaper — on newsprint in a tabloid format. I remember him telling me, “When people get a newspaper in their hands it just feels like you have to read it now. It is NEWS. Not so with a magazine.”

He didn’t live long enough to have a phone that effectively begs you to READ THIS NOW, THIS IS NEWS. Where once it was in the paper morning and evening, now the breaking news is constant. I miss the slower pace of news.

Are we better?

Am I better because I know news sooner? Have we lost the ability to ponder what we have read simply because there is ALWAYS something new? And what else could I be doing if I am not reading the latest on my phone? Reading a book? Praying? Meditating? Talking to my family or friends? Walking out of doors?

In 1854, Henry David Thoreau cast a critical eye on newspapers and news at the post office. He wrote, “We must learn to reawaken and keep ourselves awake, not by mechanical aids, but by an infinite expectation of the dawn, which does not forsake us in our soundest sleep.” And further, “Our inventions are wont to be pretty toys, which distract our attention from serious things.”

Poor guy. He didn’t have an iPhone.

Looking for a Sign… Calming Amidst Grief

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I had NEVER seen a street sign like it – “TRAFFIC CALMING AHEAD” – and I collect photos of unique street signs.

Like the one we saw driving home from the Memphis airport the other night: “THIS IS YOUR SIGN TO BUCKLE UP.” (The folks at the Department of Transportation do try to make us smile.)

Or the one I saw years ago when I was speaking in Boulder, Colorado. It was February. I went out one morning for a walk on a pedestrian path. I approached an underpass and could see some patches of ice in the shadows of the bridge.

Not to worry! This progressive, free-thinking university city put up a sign to warn me: “ICE MAY EXIST,” it read. I thought, “This is SO Boulder!”

The sign begged more questions. Ice may or may not exist, correct? Do I exist? If I do exist, how did I come into being? What is the nature of existence? What is the nature of non-being?? Goodness! I was just going out for a walk.

Obvious signs

It’s not just in Boulder that I pondered the meaning of life upon seeing a road sign. While driving home from church in Northern Virginia, I saw a sign that read, “ROUGH ROAD AHEAD.” Ya think? Here I imagined Buddhists writing the road signs with their idea that “life is suffering.”

Then there are the obvious signs. I saw a “WARNING — ALLIGATORS” sign as I put my kayak in the Hillsborough River outside Tampa. The authorities-that-be felt the need to put another sign right below: “NO SWIMMING.” Really? Who was thinking of swimming with the alligators? The people in Florida really are crazy.

 

I was a chaplain for a hospice in Ft. Pierce, Florida, which had a hospice house for patients to spend their last days. There were tables and benches on the grounds for patients, their families, and staff to take a break outdoors. Beside a nearby pond, there was a sign, “WARNING BEWARE OF VENOMOUS SNAKES.” Good Lord, these dying folks have enough to worry about.

Family calming ahead

The “TRAFFIC CALMING AHEAD” sign was on a quiet, tree-lined suburban street in Alexandria, Virginia. This sign was followed by one that said, “SPEED CUSHIONS AHEAD.” I’ve heard them called “speed bumps” or even “speed tables” but “cushions”?

My wife, Sally, and I were in town to attend a funeral for a friend who died after living with ALS for years. Sally had known his wife since before they were married. Over the weekend we twice visited the widow’s home — once the night before the funeral and then for a gathering afterward – and saw the signs.

As we drove to her home, the words on the sign morphed in my head to “FAMILY CALMING AHEAD.” Indeed, it was. The widow and her two college-age children welcomed mostly family into their home the night before the funeral. There was lots of hugging and laughter. The scene was repeated after the service with a larger gathering of friends, business colleagues, and more family.

The grief process can be a rough road for many, but these calming events in the first days are a good place to start the journey.

Could COVID Be the New “Old Man’s Friend”?

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Here’s the question: Should a nursing home resident with dementia get the COVID-19 vaccine?

There is no question that nursing home residents are at a high risk of dying should they get the coronavirus. That also goes for the underpaid and overworked staff who care for these vulnerable patients. One might think, “Of course, vaccinate them all.”

Not so fast.

I started thinking about this after reading a recent article from the bioethics think tank The Hastings Center, “Too Taboo to Contemplate? Refusing COVID Vaccination for Some People with Dementia.”

Just a month ago I wrote a blog post, “Making End-of-Life Decisions for Dementia Patients.” In it I wrote, “Here’s the question families of dementia patients face as they consider end-of-life decisions: Shall we save his life so he can become more demented and slowly decline further or shall we let him die peacefully?

Dena Davis, J.D., Ph.D., takes a similar approach in her Hastings Center article. She states the obvious: that if a person had declared in an advance directive that in the case of advanced dementia, they would refuse vaccines for flu or pneumonia, then that would also apply for COVID-19 vaccine. But, what of the patient who does not have a written advance directive or has failed to give such specific verbal directions?

Dr. Davis refers to several surveys where people expressed their preference to die sooner rather than spiral down with dementia. In one survey, more than half of the respondents were either “very unwilling” or “would rather die” than live in a nursing home. In another study of seriously ill but cognitively competent people a majority believed that either incontinence or “being confused all the time” were states equal to or worse than death.

We hardly need a scientific study to convince us that losing our minds and being totally dependent on others is a state almost all of us want to avoid. Now, a novel coronavirus comes along that is especially hard on elderly nursing home patients. It is also hard on the caregivers and vaccinating patients is partly to protect these folks and their families.

I agree with Davis’s personal preference that if she had dementia and was confined to a nursing home, she would give her surrogates instructions to withhold vaccines. Me too.

Once, pneumonia was thought of as “the old man’s friend” – a relatively peaceful way for the elderly to die, a welcome visitor. Dr. Davis speculates, “Could the novel coronavirus be today’s old man’s friend?”

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