Monday, March 26, 2012

Dick Cheney's Heart

Business Week had a piece online today that dealt with the issue--Who gets hearts for transplants?  Is Cheney too old (at 71)?  Here's the quotation ... (in red: you know--blood and all?).

Medical advances have made it increasingly common for older Americans such as Dick Cheney to receive heart transplants, extending their lives. The trend may make it more difficult for younger patients as aging Baby Boomers compete for available organs, top cardiologists say.

All political questions aside (like easy comments about Cheney's lack of heart--or musings about what his co-pay was for the surgery--and what his health-care coverage is like--and whether he was "in-network" or not), I'd like to think a bit about this whole notion of end-of-life decisions--and who makes them.

A few years ago, Christopher Buckley wrote a satirical novel (Boomsday) about a plan to grant incentives for baby boomers to off themselves (all for the public welfare, of course--i.e., the welfare of younger folks).  I met Buckley after a talk he did in Cleveland in November 2009 (he was signing some books for me!) and later I wrote to him about an earlier novel, Anthony Trollope's The Fixed Period, that had a similar idea.  (He didn't reply.)

Trollope's novel--which I read in 2006--was published in 1882 and was one of the last books he lived to see published (he died in December that same year).  It's a novel unlike a lot of his other works--fanciful and futuristic and dark.  In it, a group of idealistic colonists decide to populate an island where they will live in harmony.  Until age 67 (my age now! the "fixed period" of life).  At which time, the person would go into a facility (a pleasant one) and at some point ... gently ... be dispatched.  The people were New Zealanders who relocated to the island of "Britannula."

Well, everything goes along just great--while everyone is young.  But as the first folks begin to reach the termination of the fixed period, well, they had trouble my friends, right there in River City ...

All of this, of course, deals with a significant public moral issue that we'd rather not talk about too much: how much, medically, do we do for older folks?  How much should we do?  And what is "older," anyhow?  A certain age?  A "fixed period"?  We've all known people who were "old" at 50, "young" at 90.

So far we've been unable to come up with much but nonsense about "death panels" and cautious comments from politicians, who know that older people are not only old; they love to vote.

Perhaps Cheney's transplant will nudge the issue forward ... perhaps not.

But I'll leave you with an image: my 92-year-old mother, unable to stir easily from her chair, reading a new novel, thinking about it, talking about it ... laughing and crying and transported by words.

2 comments:

  1. The whole issue devolves for me to the case of Cora Vincent, an ancient Hiram dowager who lived through and benefited from two (count 'em) hip replacements after aetatis suae 95. At 100+ she was still baking bread; on her 105th birthday (Oct. 30, 1986) she walked from her house to the Hiram Church where she read the psalm appointed for that Sunday from the lectern. She died at 107--after hip replacement #3, which she in fact survived. She gently made her quietus talking with a young nurse who was congratulating her on her hardiness.

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  2. Oh, for a minute I thought you were going to be boldly political. Say, at last Cheney is getting a heart.
    As you know, my mom died at 94 this winter. My dad at 87 said he had lived past his expiration date and refused to go to the hospital when he was having some issues. Even the doctor suggested that a living will would not suffice--if he were to enter the hospital, they would find a way to keep him going . . .
    Without going into the details, I would say that the problem is 2-fold. Both a lack of respect for one's own wishes to let death come, and-- for the caretakers--not knowing what and when one should stop treatment.
    I think we all hope we will be able to make that choice. I am afraid I won't be as aware as my parents were.
    Me? I am looking into procuring some hemlock, just in case. Honestly, I think one should be able to exit at will. Of course, that's not what this post is about . . . But think how much money it would save the country if we could leave if we had a terminal illness and were done with suffering . . .

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