Ernest Hood/Death With Dignity story part 2
Emotions sway decisions Continued from Page 1 A In several studies, the match between what a patient would want and what a trusted trusted family member would choose for them was no greater than what could be determined by a coin toss. Family most often erred on the side of providing unwanted treatments. That shouldn't be surprising, because family family members have to make the treatment decisions decisions under the worst possible circumstances. circumstances. Doctors say families are so distraught distraught that they need help with such simple decisions as whether to stand up or sit down. Doctors can't help them by providing solid facts. They are unable to say, Tour loved one will die in 20 minutes if you choose this option," option," or, "Just do this, and he will survive." Medical information comes in percentages. Loved ones have to make life and death decisions decisions on the basis of probabilities, likelihoods, likelihoods, odds. Even when a patient can dictate and sign a living will and repeat a request for aid in dying, there's still a chance that withdrawal is not the patient's true wish. Doctors worry that patients make that decision decision during a fleeting depression or because greedy children or bill collectors are pressuring pressuring them and that they feel a duty to die. Opponents of doctor-assisted doctor-assisted doctor-assisted suicide worry about that. Even relying on a doctor often isn't advisable. In some respects, doctors are the least likely likely people to cope with the complicated emotions emotions surrounding death. The profession attracts attracts them because they hope to control death. Their training supports that illusion. Even those most willing and able to help families through their difficult choices admit they sometimes are haunted by doubts. Dr. Don Girard, who teaches at medical school, lost four patients in December and had to participate in difficult choices with each. "It becomes a micro-dissection micro-dissection micro-dissection of what you did," he said. "Did I judge this right or judge that right? It's a fine line between constructive constructive introspection and destructive introspection. introspection. You could really get down." Consistent values Sometimes families cope better than the doctors do. Barbara Glidewell, a patient advocate advocate at Oregon Health Sciences University, has seen doctors so upset about a choice that families are moved to comfort them with, "Doctor, you did everything you could." The only way to tell if a decision is right is to view it in the context of the patient's life and see if it is consistent with lifelong values. Doctors found a clear case with Ernest Hood. Hood grew up in Portland during the big-band big-band big-band era. As a teen-ager, teen-ager, teen-ager, he picked up a guitar guitar and began laying down rhythms for a band that worked dance halls and hotel ballrooms. ballrooms. The band was successful enough to be booked on a world tour. But one day after rehearsal, Hood fell down and never got up. It was the beginning of polio, which put him in an iron lung for a year and in a wheelchair and leg braces for the rest of his life. -.- -.- -.- But those were only a small part of the ways the experience changed him. He became became a sharp observer of the world. He delighted delighted in sharing the details that other people people missed. And he loved the radio. In 1960, Hood helped start Portland's first jazz club, The Way Out, under the Hawthorne Hawthorne Bridge. Its nightly concerts were broadcast live on KWJJ, which played jazz at that time. A decade later, he joined the community community radio movement and helped start KBOO. Hood's own show, Radio Days, aired on KBOO and KOAP. It consisted of aural postcards, postcards, where he described scenes from his travels through Oregon, being careful to capture capture the sound of the place and enlivening it with recordings from the 1920s, '30s and '40s. For many elderly and disabled people, isolated isolated in their homes, the program was a line to the world. Condition deteriorates But when Hood reached his 60s, he developed developed Post-polio Post-polio Post-polio Syndrome, which progressively progressively weakened the muscles in his body, gradually affecting his arms and his lungs. His breathing grew labored, and then one day it ceased. He was rushed to the hospital, where the doctors inserted a respirator tube down his throat. One day when daughter Laurel came to visit, the doctors removed the tube for a while, and Hood was amused at what it had done to his vocal chords. It reminded him of a Mickey Rooney movie, and he said "Gee, I guess 111 have to shave." It was the last time Laurel heard him speak. The doctors cut a hole in his throat, a tracheostomy. tracheostomy. The procedure kept him alive but robbed him of his ability to talk. - s h i a i-r i-r i-r t k. MM I i M V - 1 - ' f i. f CAFE 4 w - si it. ..... . i 'm if r ''.'. i I: Photo by J.L Clark ABOVE: Ernest Hood helped start Portland's first jazz club; a decade later he joined the community community radio movement movement His radio program program was an open line to the world for many elderly and disabled disabled people. LEFT: The land where Laurel Hood tends her vines is were her father last had a chance to run freely before being stricken with polio when he was still a Timothy J. GonzalezStatesman Journal young man. His condition continued to worsen. He caught shingles. Fluid built up in his lungs and around his heart. He was moved to an intensive care floor at Oregon Health Sciences Sciences University. When he first arrived at the hospital, he could write messages, but he soon grew too weak to hold a pencil. Instead, he spelled words, letter by letter, with an index finger on the opposing palm. So Hood, a man who cherished saying precisely precisely what he meant, was reduced to mouthing mouthing words, which his family only could understand understand partially. The effort would bring tears to his eyes. He didn't want to go on. Laurel told hospital officials that her father father wanted them to remove the respirator and allow him to die. They responded that they were forming an ethics committee to hear just that kind of request, but it wouldn't be ready for six more months. Hood told his daughter that he wanted her to take him home so that he could disconnect the machine himself. She was scared for him, but she also was afraid for herself because she felt that as his daughter she would have to honor his request. He called her to his bedside and indicated that he wanted her to write something down. He spelled letters into his palm and mouthed the syllables to an unfamiliar word, "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U "A-B-S-O-L-U . . ." "I'm trying to work out these letters. A, B, S, O, L, U, T, I, O, N. Absolution. Does he want a priest or what? But what he wanted to do was absolve us of being guilty for anything. anything. Dying was his choice," she said. But before Hood's family acted, Barbara Glidewell, the hospitals's patient advocate, came into the room with the news that the officials had reconsidered and that the ethics committee would take up his request immediately. immediately. Hood mouthed the word, "Finally." "Finally." Complete silence, calm In the absence of Hood's original doctor, whose name the family has kept to itself, doctors doctors Susan Tolle and Miles Edwards joined the group at the bedside. Laurel held her father's father's hand, and he smiled up at her and mouthed the words, "You are a good one." Tolle's hands trembled, but she squeezed a near-fatal near-fatal near-fatal dose of morphine directly into his bloodstream, while Edwards pulled away the ventilator tube. Hood managed a shallow breath about once every three minutes, but the drug dose was sufficient and he did not struggle for air. He was as calm as his daughter dared wish. "He had his eyes closed," Laurel said, "and he was slowing down and slowing down, but at the last minute he opened his eyes and looked right at me he was so far away because because of the morphine and it was like he had the biggest question I've ever seen. "I think it was . . . I'll never know what it was . . . "I think he wanted to know if it was OK to leave us, and so I told him it was OK to go." Nobody moved and the room was utterly silent. Laurel realized she was holding her breath, they were all holding their breaths, while the doctors watched, and everyone waited for something more, and the stillness in the room grew, until a child broke through with a flat observation: "He's dead."