BykrBayb

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In memory of a genuine American hero, who served with true valor.

“If someone loves a flower,
of which just one single blossom
grows in all the millions
and millions of stars,
it is enough to make him happy
just to look at the stars,
he can say to himself
'Somewhere, my flower is there'."

~ Antoine de Saint Exupéry

The sky in mourning, for the passing of one of its most ardent admirers, and a true hero.

FREE CHEESECAKE, TOMORROW!!!

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THAT TIME I SPENT A WEEK WITH REX TILLERSON

December 13th, 2016

This is a post from Emily Roden, the smarter and more attractive Roden, about her brief few days with Rex Tillerson, Trump’s nominee for Secretary of State…

Nine years ago, I showed up to the Denton County Courthouse for jury duty and got myself picked for the job. A young girl had accused her mom’s boyfriend of sexual assault and the case was being brought to trial. If you’ve ever served on a jury trial before, you understand the almost immediate, yet very temporary bond that ties 12 strangers together who are randomly chosen from each of their private lives in order to fulfill a very solemn public purpose.

One of our first tasks was to choose our jury foreman. Perhaps it was his business suit, his impressive stature, or his charisma, but almost everyone in that jury room suggested that this middle-aged man with greying hair was likely the most fit for the task.

“Thanks, but I decline. I’m not interested in the spot light,” he told us. I didn’t think anything of it.

I had just bought my first BlackBerry and used my breaks to catch up on all the emails I was missing from my week at the courthouse. I recall leaving the jury room on a break with this man and remarking how busy I was and how much work I had to do. He smiled as he sat and read the paper.

From the first day of jury selection, we all noticed another suited man always present in the courtroom. His presence was intriguing due to the ear piece in his ear. While grabbing lunch at Denton County Independent Hamburger on the square the 2nd day of the trial, we noticed this mysterious man dining with our fellow juror who declined the foreman spot. The intrigue grew and it was the talk of the jury – who were these men?

Finally, during a break in the jury room, one juror had the nerve to ask; “Who are you? And what do you do?”

Our fellow jury member was reading the paper again and pointed out an article with Exxon in the headlines.

“I work for them,” he said humbly. “There are a lot of people in this world who hate me for what I do, so they give me and my family guys like that to protect me.”

I immediately felt embarrassed for complaining to him the other day about how much work I had to do. It didn’t take long before a few internet searches revealed that I was serving on this jury with the CEO of Exxon Mobile, Rex Tillerson.

The trial concluded and it was time for the jury to deliberate. The story was heartbreaking and the facts of the case were clear enough to make the majority of the jury convinced of the guilt of this sexual offender of a little girl. But the defense did a good enough job to create a couple of hold-outs. As our deliberations came to a close, it appeared we might have a hung jury.

That’s when Mr. Tillerson began to speak. Humbly, delicately, and without an ounce of condescension toward those who disagreed, he began walking us all through the details of the case. I even recall being moved by his thorough explanation about the nature of doubt and the standards set forth by our justice system. With great patience, this man who strikes multi-billion dollar deals with foreign heads of state brought our scrappy jury together to bring a sexual predator to justice and to deliver justice for a scared and deeply wounded little girl.

A local nonprofit was instrumental in fostering that young girl through this process, providing her counseling and legal help. I was so struck by their mission that I toured their facility the week following the case in order to learn how I could donate and volunteer to their cause.

On a whim, I decided to reach out to Mr. Tillerson to encourage him to do the same. I found an email for him online and sent him a note, touting the role this agency played in our trial and urging him to consider supporting the great work that they do. To my surprise, I received an email back thanking me for my note, my jury service, and ensuring me that he would contact the agency. I later received a call from the director of that nonprofit to let me know that Mr. Tillerson followed-through and gave a generous donation.

I didn’t vote for Trump. This is not an endorsement of Mr. Tillerson for Secretary of State. I’m sure that the coming days and weeks will be filled with speculation and political discussion over this clearly controversial pick for Secretary of State. I certainly appreciate those concerns and the process that ensures significant scrutiny for this important position.

But during a news show tonight, I heard the term “corrupt” applied to this man who I spent five days with back in 2007.

All I know is that this man holds one of the most powerful positions in the world and clearly has the means and ability to side step his jury responsibilities, served as a normal citizen without complaint or pretense. I know that a scared little girl who was finally convinced to come public with her account of abuse was inches away from a decision that would have sided with her abuser, yet this man put his negotiation skills to a very noble use and justice was served. All I know is that this man and his myriad of aides could have ignored an unsolicited email from a girl in her 20s suggesting that he donate to a local cause, but he took the time to respond and opened up his pocket book.

My five days with Rex Tillerson is all I know about this man and his character. And in light of the recent news, I thought this a relevant story to tell.

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http://www.terrisfight.org

Terri Schiavo Blogs

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Dred Scott and Terri Schiavo
The Long and Tortured Death of the 14th Amendment At the Hands of the Federal Judiciary
by Gary Amos

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Excerpts from Alfred Binding and Karl Hoche: Die Freigabe der Vernichtung lebensunwerten Lebens. Ihr Maß und ihre Form, [Allowing the Destruction of Life Unworthy of Existence. Its Extent and Form.] Leipzig 1920.

"Are there lives that have forfeited their individual legal protection because their continued existence has permanently lost all value for the person himself, and for society as well? Simply posing this question brings up an uneasy feeling in anyone who has become accustomed to evaluating the value of a particular life to both the individual concerned and to society.... If one simultaneously thinks about a battlefield covered with thousands of dead young men, or a mine where a violent thunderstorm has buried alive hundreds of diligent workers, and compares it to an institution for imbeciles with its care for its living inmates, one is deeply shocked by the blatant dissonance between the sacrifice of the greatest treasure of humankind on one hand, and on the other, the greatest care being given to existences that are not only absolutely worthless, but that drag other worthy beings down negative existences ..." (page 27)
"There are two main categories ... of individuals that may be considered for killing as well as an intermediate group:

1. ... incurables dying from disease or injury, who, fully understanding their situation, urgently wish to be released and have given some sign of this ... (page 29);
2. The second group consists of congenital idiots, whether they were born this way or have become much like those in the last stages of a paralyzing disease. They have the will neither to live nor die. Thus they cannot consent to their killing; on the other hand, there is no will to live that would have to be broken ... (page 31);
3. I spoke of an intermediate group, which I define as those who, while mentally intact, have lost consciousness due to some event, such as a very grave, unquestionably mortal wound, and who, if they should regain consciousness, would awaken to an unspeakable misery ..." (page 33).

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"60,000 Reichsmark is what this person
suffering from hereditary defects costs
the community during his lifetime.
Fellow Germans, that is your money,
too. Read 'New People', the monthly
magazine of the Bureau for Race
Politics of the Nazi Party."

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In 1999, 10.4% of the severely cognitively impaired residents of the United States were starved and dehydrated to death.

In 2000, 11.0% of the severely cognitively impaired residents of the United States were starved and dehydrated to death.

In 2001, 11.4% of the severely cognitively impaired residents of the United States were starved and dehydrated to death.

I haven't found data yet for other years, but I think it's a fair guess that the killings continue to climb.

This doesn't represent a percentage of patients who died (which would be bad enough). It doesn't mean that 11.4% of the patients who died were starved and dehydrated. It means 11.4% of all the people living in the U.S.A. with severe cognitive impairments were killed this way. And it doesn't include the ones who were killed using other methods, such as denial of antibiotics for simple infections, removal of breathing assistance, etc.

The standard used for determining severe cognitive impairment for the purpose of this study is a score of 5 or less on the Mini Mental State Examination (MMSE). Patients in a coma or PVS cannot possibly score 1, much less 5. You've probably seen people in the grocery store with a score of 5 or less. So these killings include a wide range of brain damaged people. I wonder how many thousands of people are living with a score of 5 or less. And for every 1,000 people living with a score of 5 or less in the year 2001, 114 of them were starved and dehydrated to death that year.

All I have before me are the percentages. I'd like to see the corresponding numbers. Or would I?

Following is the breakdown by state for 2001. Notice that Rhode Island tops the list, with just over a third of that population exterminated this way. That might have something to do with the fact that RI has appointed the pro-euthanasia group Choice in Dying the official State agency in charge of informing the public about “end-of-life choices.” They supply forms for “living wills” and “assist” the public in filling out those forms. This is what happens when you put the fox in charge of the henhouse.

Believe it or not, Florida and Texas are both below the national average. Every state is on the list. Georgia is at the bottom of the list, exterminating only 1.30% this way.

RI - 33.80%
OR - 32.50%
MI - 28.30%
MT - 28.00%
WI - 27.20%
CA - 23.40%
UT - 23.40%
AZ - 20.90%
PA - 17.40%
MN - 17.20%
AK - 17.10%
CT - 15.40%
WY - 14.90%
MD - 14.60%
NM - 14.20%
SD - 14.10%
WA - 13.20%
OH - 12.90%
ID - 12.30%
IA - 12.10%
MO - 11.90%
National Average - 11.4%
VT - 11.20%
HI - 11.10%
DE - 10.80%
ND - 10.80%
MA - 9.90%
IN - 9.70%
ME - 9.20%
NH - 8.70%
NY - 8.50%
NE - 7.70%
CO - 7.20%
AL - 7.10%
TX - 7.10%
IL - 6.70%
WV - 6.70%
KY - 6.60%
SC - 6.50%
TN - 6.30%
FL - 6.20%
NV - 6.20%
AR - 5.70%
NC - 5.20%
KS - 4.80%
NJ - 4.80%
OK - 4.10%
LA - 3.70%
VA - 3.60%
DC - 3.10%
MS - 3.00%
GA - 1.30%

Facts On Dying ~ This study was funded by The Robert Wood Johnson Foundation, who adamantly opposes the rights of vulnerable people to continue living. So if any trolls show up, complaining that the data is skewed in favor of life, check the facts and get back to me.

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Kate Adamson

Testimony given on April, 19, 2005 ~ I was on life support and received all my food through a tube, at one point in time my tube was turned off for eight days and I suffered all the pains and agonies of starvation. I was in excruciating pain, in silence. I was on the inside screaming out; I DO NOT WANT TO DIE. DON’T STARVE ME. I WANT TO LIVE, FEED ME SOMETHING. And if you asked me today if it was worth going through everything I went through to live, I would say without a doubt, and without hesitation, “Yes!” As a disabled person my life is as important as any life. My children love me as much as any children love their parents; my husband loves me as much as when I had the full use of 2 good arms and 2 good legs. When I waged my fight to get treatment, the way life was viewed in this country was a potent weapon in my husband’s fight to save me. It would not be so today.

Eleanor Centonze ~ Died mysteriously at the home of Michael Schiavo and Jodi Centonze, days after being diagnosed with cancer in September 2004.

Andrea Clarke

Maia Coral Comas

Toddler Drowns After Parents Ask About Killing Her ~ 'Can you help me?'' the mother asked a social worker. ''I want to get an injection to put her to sleep.'' A recount from one of the investigators in the case is chilling: "[The father] said that [the girl] was dragging us down. [He asked during a meeting with DOCS workers] why do they keep disabled children alive?" The father also told a social worker: "What do we do with it? It's like a sentence, like we're dead.''
Coroner expresses disbelief that pool was not search for missing toddler ~ "Why do they keep children with these disabilities alive?" Mr Comas had asked one social worker. "I cannot cope with it . . . we are two hippies living in a house playing guitar." Concerned how Mr Comas and Ms Razniak had been handling the news of Maia's illness, family members had sought help from DOCS, who had met with Ms Razniak on September 11, 2007. "I don't want her, she's mentally and physically retarded," Ms Razniak had told a DOCS worker, the court heard. The family again contacted DOCS on November 22 when Ms Razniak had threatened to jump off a cliff with Maia in her arms. Six days later, Maia was dead.
Children love the water to death Neighbours say she practically learned to swim before she could walk...
Tragic portrait of drowned baby Maia ~ The family set up the plastic pool on the weekend and told neighbours they were keeping a close watch on Maia.
Police investigate death of baby in inflatable pool ~ Maia was found dead in a 30cm-deep inflatable pool in the front yard of her family's home...
Another child dies in a family swimming pool ~ A neighbour tried to resuscitate her before paramedics arrived.
Maia Coma's mother says an inability to perform CPR made her feel like a murderer ~ The toddler was to be placed into temporary foster care the week after her death... "We said we don't know how we're going to live with Maia ... you want your child to grow normal."
Mum didn't want toddler to become 'monster' ~ ...Samantha Razniak told a social worker she would rather her daughter "die now than die slowly"

Samuel Golubchuk - Samuel Golubchuk Dies Naturally, ‘Peacefully’, after Family Fought Hospital’s Dehydration Plans

Sun Hudson

Gregory Jacobs

Arthur "Ace" Johnson

Gerhard Herbert Kretschmar

Raleane "Rae" Kupferschmidt

Ora Mae Magouirk

Joseph Maraachli ~ ~ BREAKING: Baby Joseph is home: defies critics by breathing completely on his own

Paulo Melo

Rachel Nyirahabiyambere

Edwarda O'Bara ~ ~ "Promise you won't leave me, will you, Mommy?" "Of course not, I would never leave you, Darling, I promise. And a promise is a promise!"

A Family's Torment - Terri Schiavo ~ Incidentally, the manner in which the Schindler family was made aware that Michael was engaged to another woman while still married to Terri was receiving the obituary of Michael’s mother, Claire Schiavo, when she died in 1997.
CNN LARRY KING LIVE Interview With Michael Schiavo ~ SCHIAVO: Removing somebody's feeding is very painless. It is a very easy way to die. Probably the second better way to die, being the first being an aneurysm. And it doesn't bother me at all. I've seen it happen. I had to do it with my own parents.

Terri Schindler Schiavo

William Schiavo

A Family's Torment - Terri Schiavo ~ This happened once again in 2001 when Michael Schiavo's father passed away.
CNN LARRY KING LIVE Interview With Michael Schiavo ~ SCHIAVO: Removing somebody's feeding is very painless. It is a very easy way to die. Probably the second better way to die, being the first being an aneurysm. And it doesn't bother me at all. I've seen it happen. I had to do it with my own parents.

Aruna Ramachandra Shanbaug

Scott Thomas

Yenlang Vo

Bradley Whaley ~

Another Disabled Young Person Dehydrated to Death in Terri Schiavo’s Hospice
For three years, a free spirit was silenced ~ There was a chance his condition would improve. But it didn't. Infections kept landing him in a hospital. Finally, his family transferred him to the Hospice of Florida Suncoast, where Terri Schiavo died. They removed his feeding tube, and his mother lay in bed beside him. He died July 2, 2008.

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Michael Schiavo said Terri's brain implant was successful.

Saint Petersburg Times St. Petersburg Times St. Pete Times St. Petersburg Beach has special day for coma victim [CITY Edition] St. Petersbury Times - St. Petersburg, Fla. Date: Feb 17, 1991 Start Page: 3 Section: CITY TIMES Text Word Count: 151 Document Text This city has proclaimed today Terri Schiavo day. Last year Mrs. Schiavo, 27, suffered a loss of potassium in her body that caused her heart to stop beating and resulted in a coma. She underwent surgery, performed by Dr. Yoshio Hosobudhi of the University of California at San Francisco in December, to implant a stimulator in her brain. The brain stimulator implant was a success, said her husband, Mike. Mrs. Schiavo is slowly emerging from the coma at the Mediplex Medical Center, a neurological care center in Bradenton, he said. She will undergo at least a year of speech, occupational and physical therapy. A Feb. 9 Valentine's dance, sponsored by the Vina Del Mar Island Assocation, raised $1,575 for the Theresa Schiavo Trust Fund. To contribute to Terri's trust fund, send a check payable to the Theresa Schiavo Trust Fund to First Union National Bank, 5250 East Bay Drive, Clearwater 34624.

Google archive of hardcopy image here.

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2002, fall - Jodi Centonze gives birth to her first child, Olivia, with Michael.
2004, spring - Jodi gives birth to her second child, Nicholas with Michael.

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VOICE: He's lying. No Sandman ever ran.
2ND VOICE: You don't run. You kill runners.
You have killed runners all your life.
LOGAN: Yes I have.
Now it's my turn. And I want to live.

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The Hospice of the Florida Suncoast, criteria for exterminating patients with dementia: (update: now includes patients with cancer or heart disease.)

.

RISK FACTORS

Identified risk factors to be scored for 6-month mortality include:

Activities of daily living score = 28

Male sex

Cancer

Congestive heart failure

Oxygen therapy needed in previous 14 days

Shortness of breath

Less than 25% of food eaten at most meals

Unstable medical condition

Bowel incontinence

Bedfast

Age greater than 83 years

Not awake most of the day

Mitchell, Kiely, Hamel, et al Journal of the American Medical Association

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Image stolen from Popman

To: Psycho_Bunny; wagglebee

Death Channels

February 21, 2011 - 2:33 pm - by Zombie

Advance Health Care Directive
If the extension of my life would result in an existence devoid of cognitive function, with no reasonable hope for normal functioning, then I do not desire any form of life-sustaining procedures, including nutrition and hydration, unless necessary for my comfort or alleviation of pain.
…
My agent shall consent to and arrange for the administration of any type of pain relief, even though its use may lead to permanent damage, addiction or even hasten the moment of, but not intentionally cause, my death…

That’s the document my Uncle Larry signed fifteen years ago when he first got his HIV diagnosis. He had always seemed like a devil-may-care sort of guy who planned to live fast and die young. Linger for months, attached to tubes and machines? No way! “Just shoot me now” was his signature expression, often used to express sarcastic disapproval of anything unfashionable, but taken literally in the case of his “Advance Health Care Directive.”

I actually knew very little about my uncle (whom I’ll dub “Larry” here to maintain his privacy) until he collapsed in public a little over a month ago. He never got along with his brother (that is, my father), and he lived 3,000 miles away on the East Coast, so he rarely showed up at family events. But on those rare occasions he did, he fawned over me, called me his “favorite,” and once I had grown up he told me that I was the only relative he could stand to be around.

As a gay man, Uncle Larry never had any children of his own, nor did he (as far as I could tell) ever have a long-term romantic relationship; so I shouldn’t have been surprised that when the time came for him to name an “emergency contact” on various health-care forms, he wrote my name down.

But he never informed me of this. So when I got a call in the middle of the night last month from a hospital on the other side of the country, with the news that Larry was deathly ill and that it was incumbent on me to make health-care decisions on his behalf, I was taken aback. I’d always been somewhat fond of my uncle, but hadn’t given him much thought in the last decade, as he’d fallen out of touch with the family.

Before I knew what was happening, I put my own life on hold, jumped on a plane, and flew to be by my uncle’s side. At the hospital, I was asked to sign a flurry of documents, granting approval for all sorts of seemingly trivial medical procedures. Do I consent to be the decision-making agent for this unconscious patient? Sure. Is it OK to give him an X-ray? Yup. Permission to transfer him to a different room? Connect an IV? Give him him this drug and that drug? Yes, yes, yes.

Despite all this, the doctors were a little cagey in revealing to me exactly what was wrong with Uncle Larry. Apparently his immune system had finally collapsed after living mostly symptom-free with HIV for at least 15 years, and as a result he had not one but several life-threatening conditions all arising at once. Infections here and here, cancer there and there, organ failure top to bottom — the more the doctors looked, the more they found. When I asked precisely what it was that was killing Larry, one doctor summed it up by shrugging and saying, “Everything.”

Even so, Larry’s body was stubborn. Despite numerous predictions of his near-immediate demise, he kept living. Unconscious, bed-ridden — but still breathing, blood still pumping.

After three days in the hospital, I was told by the staff to “go home” and get some rest. But home was thousands of miles away. So I took Larry’s keys from the “Patient’s Possessions” bag and spent the night sleeping in his apartment.

The next morning I realized just how sudden Larry’s collapse had been. There was perishable food still sitting out on the counter. His dog had finished off what was in the dog-food bowl and was now starving. There was a movie in the DVD player, still on “Pause” apparently from when Larry had stopped it momentarily to go down to the corner store.

On the kitchen table was a pile of half-opened mail, half of which were overdue notices for various bills and debts. I went downstairs and opened his mailbox to discover it stuffed with more envelopes marked “Urgent Attention Required!”

I returned to the hospital but his status was unchanged. I sat by his bed for a while, watching him breathe, until a trio of grim-faced men appeared in the doorway. They ushered me into an office. It was time for The Discussion.

The trio consisted of Larry’s physician, a “hospital social worker,” and the head of “hospice care.” They informed me that, in their opinion, Larry was not going to survive, and that only the most extreme measures could prolong his life, and even then it would probably only be for a short time. Furthermore, any operations or chemotherapy or other treatments could very well kill him more rapidly, considering his delicate condition. Considering all this, they recommended transferring Larry to “palliative care.”

When I seemed confused by this term, they explained that “palliative care” meant that the hospital would no longer try to diagnose or treat his condition, but rather would just let him drift toward death at his own pace. The only steps the doctors would take would be to ease his suffering with potent painkillers.

I must have hesitated, because the hospice guy whipped out the “Advance Health Care Directive” which Uncle Larry had indeed signed in 1996, part of the standard “end-of-life planning” the hospital insists on for all elderly and sick patients — especially people diagnosed with an HIV infection, as Larry had been.

When I again hesitated, I was informed that in this case, my consent was not needed, because Larry had himself left explicit instructions, which overrode any opinions I might have on the topic.

I read the whole document, which actually ran to over three pages, and conceded, “Well, if that’s what he wants, that’s what he wants.” I signed the form for Larry to be transferred to a hospice facility.

He was supposed to last only a couple of hours in hospice — a day or two at most. Oh no, but not Larry. Days turned into weeks, weeks rolled on to over a month. He was like the Terminator of patients: he just…wouldn’t…die….

What was I to do? Fly back home and leave him there? Believing the prognostications that he would expire at any moment, I stayed, and stayed, and stayed, calling California every now and then to try to keep my own life from falling apart.

I ended up spending a month living in Larry’s apartment, deciding what to do with his personal effects. I searched the place for a will (which I never found), but in the process learned the truth about my uncle.

Where to begin? First of all: He was a criminal. I never knew this, but I had always wondered what his “job” was. Turns out he “made a living” by forging checks, stealing people’s identities, embezzling, you name it. I found this out because he wasn’t a very good criminal: he had gotten caught numerous times, and been sentenced to several jail terms over his lifetime, the longest being three years in state prison. Next: having HIV apparently didn’t put a damper on his sex life. From the evidence strewn about his apartment and his computer, he was quite “active” until the day before he fell unconscious.

But the last thing I learned about Uncle Larry was the most significant: He had long been diagnosed as having “bipolar disorder,” what they used to call “manic depression.” Which, in retrospect, explained a lot. Sometimes when he visited my family as I was growing up, Larry was giddy with excitement, spinning me around, taking everybody out to expensive dinners, telling wild stories, buying everyone presents. That’s the Larry I like to remember. But there was another side of Larry I only saw from the shadows: desperate calls in the middle of the night, inconsolable depression, suicide attempts, a near-catatonic passivity in the face of endless financial and legal problems. That was the Larry which had driven my father to distraction, and the reason the rest of the family had cut him off.

And I became convinced that it was this “down” Larry who had signed the “Advance Health Care Directive” quoted above. As I riffled through his disorganized paperwork files, I found that his 1996 HIV diagnosis was followed by a long period of severe depression, including half-hearted suicide attempts, a stay in a psychiatric facility for “observation,” notebooks filled with mostly illegible self-obsessed morose ramblings. It was in the middle of this period that his doctor advised him it was wise to make some crucial “end-of-life care” decisions, and a depressed self-destructive Larry signed the form stating “I do not desire any form of life-sustaining procedures.”

Turns out he had gone on an “end-of-life care” binge, as I found several similar documents he had also signed, some with doctors, some on his own, including:

Durable Power of Attorney for Health Care Decisions
Medical Treatment Desires and Limitations
I do NOT want efforts made to prolong my life and I do NOT want life-sustaining treatment to be provided or continued: (1) if I am in an irreversible coma or persistent vegetative state; or (2) if I am terminally ill and the use of life-sustaining procedures would serve only to artificially delay the moment of my death; or (3) under any other circumstances where the burdens of the treatment outweigh the expected benefits…

…and…

Physician Orders for Life-Sustaining Treatment (POLST)
A. Cardiopulmonary Resuscitation (CPR):
Do Not Attempt Resuscitation/DNR (Allow Natural Death)
B. Medical Interventions:
Comfort Measures Only
Use medication by any route, positioning, wound care and other measures to relieve pain and suffering. Antibiotics only to promote comfort.
C. Artificially Administered Nutrition:
No artificial nutrition by tube.

In the midst of his depression, Larry saw a way out: suicide by withheld treatment.

But when his HIV infection did not progress to AIDS, and he remained healthy, Larry’s mental state improved. And improved. Within two years of the original diagnosis, he was back on a high, jetting off to resorts in South America and Asia, getting involved in ever-more grandiose shady financial schemes — punctuated by the occasional arrest and conviction, or getting prescriptions for anti-psychotics and mood stabilizers, or entanglement in this or that disastrous love triangle. He lurched from crisis to crisis, from ecstatic highs to miserable lows.

In recent months, however, he seemed to be on a high. The overdue bills which would have been hair-raising for the average person were of little concern to Larry; his bills were always overdue (as far as I could figure), so it was par for the course. The sudden onset of AIDS and the collapse of his immune system seem to have blindsided him.

And now here he was, unconscious in a hospice care facility, an “Advance Health Care Directive” clipped to his chart instructing everyone to let him die.

On my daily visits over that month, I began to wonder: Had Uncle Larry changed his mind? Did he still want a “Do Not Resuscitate” order to prevent anyone from saving his life? From what I could tell, he had signed all the “end-of-life instructions” while in a state of passing depression, and then had likely forgotten all about them once his mood had lifted.

I’ve studiously avoided the word “coma” to describe my uncle’s condition, because in fact he was not in a coma. He often slept for days at a time, but he would on occasion wake up — or at least open his eyes. Even so, he never really was able to speak. He’d look around, and now and then weakly move his lips, but no sound came out. I once put a pencil in his fingers and rested it on a pad, to see if he could at least write something, but his hand remained limp.

The hospice facility was an independent company, subcontracted by the hospital to house patients in their last days of life. It was owned and almost entirely staffed by Filipinos and Hispanics, all of whom were staunchly old-school Catholic; pictures of Jesus hung in the hallways, and every corner had a shrine to the Virgin Mary or some saint.

It was these orderlies who took care of the hospice patients. The (secular no-nonsense) hospital sent around a low-level nurse for daily inspections, doing the rounds for an hour or so to make sure the staff was following the care orders properly. And then once or twice a week a doctor would visit and do a quick assessment of each patient. And that was it. Mostly, care was left to the hospice staff, who were poorly paid, did not have medical degrees, and in many cases only barely knew English.

But they all had another attribute which was surprising, considering their profession working at what was essentially the waiting room for Death: They valued human life above all else.

You may have noticed that the instructions quoted at the beginning of this essay which Larry signed said “…I do not desire any form of life-sustaining procedures, including nutrition and hydration, unless necessary for my comfort…”. If this was the case, how was Larry surviving for a month, with no food?

Well, the answer was simple; the hospice staff were giving him food, against doctor’s orders. Once a day they’d gently wake him up, and hand-feed him soft foods like Cream of Wheat and applesauce. Larry was able to swallow, even though he often didn’t even open his eyes.

Furthermore, he had been prescribed morphine to remove any pain he might be experiencing. When I later asked a nurse what evidence they had that he was experiencing pain at all, she told me that a morphine prescription went hand-in-hand with a palliative care order, and that it was presumed that all patients here were suffering pain, either physical or mental or both. Getting transferred to hospice meant getting morphine, period. That was the whole point.

But then one day, about a week before Larry finally passed away, everything hit the fan. A new nurse happened to walk in at the exact moment one of the orderlies was feeding Larry.

“What are you doing?” she yelled. “Can’t you read his chart? No nutrition!”

“But he still able eat,” the orderly replied.

“That doesn’t matter. You’re violating direct care instructions. I’m calling my supervisor right now.”

While she was on the phone, I discussed things with the hospice staff. Turns out the previous nurse had been inattentive and lax, and either didn’t notice or didn’t care that they had been feeding Larry (as well as several other patients) in direct contradiction to various Health Care Directives. Furthermore, the staff confessed to me, they had not been giving the prescribed morphine to some of the patients who in their opinion didn’t need it. Why not? Because, they explained, morphine suppresses the heart rate and the breathing rate, and while it may alleviate suffering, it usually accelerates the patient’s moment of death. The hospice staff felt it was immoral to give a patient morphine if they weren’t visibly in pain, because by giving them morphine you’re basically killing them in slow motion.

By this time a doctor from the hospital had shown up. He was livid about the feeding. He found out about the withholding of morphine as well. He threatened the facility with revocation of their contract and their license if they did not toe the line exactly as instructed. From here on out, he said, we will assign hospital nurses to monitor this place 24 hours a day until this situation is resolved.

From that moment on, Larry well and truly did begin to die. He went downhill rapidly. A rotating roster of hospital nurses were always on had to ensure that the orderlies did not feed any of the patients who had “nil by mouth” (no nutrition) orders. They also personally administered the morphine to each patient, no longer trusting the hospice staff.

There were now frequent hushed conversations in Tagalog and Spanish in the hallways between the upset orderlies. They were concerned about possibly losing their hospice license and their jobs, but it was more than that. Some confided in me that they felt very uncomfortable about being forced to “kill” the patients this way. When I pointed out that the patients had all signed directives to withhold life-extending care and for pain relief, one orderly shook his head, explaining, “The hospital wants to keep them unconscious on morphine so they don’t wake up and change their minds!”

I might have thought this accusation was a little over-the-top had it not been for the attitude of the nurses themselves, in particular the main daytime chief nurse who also confided in me and whom I eventually nicknamed “Nurse Kevorkian.” She flew into a rage whenever she found a hospice worker sneaking food to a patient, going so far as to clean the food out of one patient’s mouth to make sure no more got swallowed. As we sat by Larry’s bed together now and then, she expressed enthusiasm when his vital signs continued to drop, but became annoyed if he seemed to rally with a stronger pulse and more vigorous breathing. She assumed that I too was hoping for as rapid a death as possible for Larry, and complained bitterly about the crazy Filipinos and their weird attitude.

One night, I was alone with Larry in his room, while the night nurse was elsewhere in the building. He was due for another morphine dose in a few hours, so the previous dose was probably starting to wear off. For the first time in days, Larry stirred, and seemed to wake up. He made a faint moaning noise. I got up and leaned closer, and for the only time during the last month of his life, he spoke. It was just two raspy words: “Help me!”

I ran into the hallway and got the nurse, describing to her what had happened. Her response? “He must be in pain!” She came in and quickly gave him another dose of morphine. Before he faded back to sleep Larry made one last gesture: He shook his head, as if to say “No no no.” And then he went unconscious again. He never woke up after that, the nurses ensuring that he was drugged up at all times. He died three days later without saying another word or regaining consciousness.

What killed him? Well, the doctors would likely say he died of AIDS. But the direct cause of his death was, basically, starvation and dehaydration. Which, I later learned, is what actually kills many patients in hospice care, who often die from the withholding of nutrition rather than from the more slow-moving effects of their terminal illnesses.

The Aftermath

I’m still untangling the mess that was Larry’s life, and will likely still be doing so for months or even years from now, which is what happens when someone dies without a will and with a pile of debts and legal obligations.

But more than that I’m still untangling the moral and political ramifications of his death.

In 1996, in a fit of depression, he signed agreements that his life not be “artificially” prolonged should he become severely ill. But I have this terrible nagging feeling that once he came face to face with the real possibility of death, he wanted to stay alive. I suspect that he struggled for a month to wake up so he could revoke the “Do Not Resuscitate” order. But partly because of his condition, and partly because of the drugs he was given, he was unable to speak or move.

When one is healthy and young it’s easy to causally say, “If I get old, just unplug me!” But the young and the healthy can’t imagine what it’s like to stare death in the face and know that no one will save you because you told them not to. The will to live is truly tested and often only becomes manifest when one is at the point of death. Can we trust the wisdom of our 40-year-old selves to know how we’ll feel when we’re about to die?

Furthermore — and in Larry’s case, more troubling — can we trust end-of-life instructions that were signed by someone who may or may not have been in his right mind? Whom do we believe: The depressed Larry in 1996, or the craving-life Larry of 2011? If it can be demonstrated that a person’s end-of-life directives were signed under duress, internal or external, then can they be revoked without the person’s apparent consent?

In unguarded moments during Larry’s last week, Nurse Kevorkian revealed various opinions to me which I found very disturbing. She discussed what she thought was an urgent need for everyone to get “end-of-life counseling” for the explicit purpose of signing these Advance Health Care Directives for withholding treatment when people get seriously ill. Because, she reasoned, without one of those directives in place, doctors and hospitals are legally required to do everything possible to keep a patient alive. The default position is the Hippocratic Oath, under which no harm can be done to a patient, including the withholding of treatment. Thus, there’s no need for anyone to sign any end-of-life care agreement stipulating that the patient desires life-extending measures; that goes without saying. No, we need end-of-life counseling for one reason only, that reason being to convince the patient to consent to having life-saving treatment withheld. Without this, she explained, hospitals would have to spend a fortune on ridiculously expensive diagnostics and operations and procedures for people who are dying anyway.

While we were engaged in one of these discussions at Larry’s bedside, I could see over her shoulder out in the hallway some of the orderlies pointing to us and noting among themselves that she was busy and not paying attention to what the staff were doing. And so very quietly, they tiptoed off to the kitchen and snuck back into another patient’s room with a cup of applesauce, sustenance for life regardless of what the doctor, the nurse — or even the patient — wanted.

In that moment the whole moral conflict of modern society played out in front of me. I listened politely to the nurse as she explained her philosophy, but when she momentarily glanced down at her watch, I looked up at the orderly standing guard in the hallway behind her and I smiled and nodded at him ever so fleetingly, to convey my approval of their illicit life-affirming deeds.

Without realizing it, I had just taken sides. What choice did I have?

28 posted on 02/27/2011 7:10:07 PM PST by Dr. Brian Kopp

[ Post Reply | Private Reply | To 13 | View Replies | Report Abuse ]

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Post #56 ~~has~~ ^had loads of contact info.

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Videos of Terri

Real Player
   Terri watching a balloon  - http://www.multistalkervictims.org/other/video/terri-
balloon.rmm (Freepmail me if you know of an active link for this video)
          Terri's alert eyes        - http://www.hospicepatients.org/terri%20big%20eyes.rm.ram
     Terri responds to cold   - http://www.hospicepatients.org/how's%20that%20cold.rm.ram
Terri responds to her Mom - http://www.hospicepatients.org/terri%20mum.rm.ram
Terri responds to music - http://www.hospicepatients.org/terri%20music.rm.ram
Terri responds to touch - http://www.hospicepatients.org/terri%20swab.rm.ram
Nearly five minute video of Terri - http://www.hospicepatients.org/terrischindlerschiavo08112001.ram.rm
Windows Media Player
A Conversation with Terri - http://gordonwatts.com/ConversationWithTerri.wmv

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http://www.freerepublic.com/focus/f-news/1369496/posts?page=7#7
-snip-
The World's Superpower and Champion of Human Rights around the globe is starving and dehydrating a disabled woman to death and underage children who bring her water are being handcuffed and arrested.
Does that sum it up? Did I miss anything?
If China decides to put a bullet in the brain of all their retarded school children tomorrow, what can we say or do?
Next time we want to whine because Libya or Egypt is on the United Nations human rights council we better learn to bite our lip.
There is your perspective from overseas.

An American Expat in Southeast Asia
expatguy

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Happy Thanksgiving! Today I am most thankful for my family. This morning I was again reminded how lucky I am to be married to wonderful man of strong character, who fought for our freedoms, and not the weasel who is singing the praises of Obamacare in posts to me this morning. My husband served 21 years in the Infantry, so that jerks like "Notary Sojac" could have the freedom of speech to tell me that old people like my husband should just die and get out of the way, and that Obamacare is the wonderful solution to the surplus population problem.

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........... ARMY .................... NAVY ................. MARINES ............ AIR FORCE ..... COAST GUARD ..

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BREATH OF HOPE:
Lung Cancer
The Invisible Disease

In The Forum
To the tune of "In The Ghetto" by Elvis Presley
Rewrite by FReeper Alex Murphy
As the guano flies
On a cold and gray Chicago mornin'
A poor little newbie handle is born
In the Forum
Will the liberal moan?
if there's one thing that he don't need
an objective set of morals that he won't heed
In the Forum
People, don't you understand
this country needs a helping hand
or we'll wake up Socialist some day
Read your Bible every day
"Do not steal" means what it says
will you simply turn your heads
and look the other way?
Well the thread turns cold
and the whiny little boy with the turned-up nose
he types with his feet, and his argument blows
In the Forum
And his anger burns
so he starts to roam the boards at night
and he learns how to covet
and he learns how to fight
In the Forum
Then one night in desperation
this FReeper man goes awry
He spams the threads, tries to break some hearts
bends the truth, but he don't get far
And makes Jesus cry
As the crowd gathers 'round, the angry young man
makes a home in the gutter, throwing temper tantrums
In the Forum
And the young man cries
on a cold and gray Chicago mornin',
another little newbie handle is born
In the Forum

Muzzy nuts roasting on an open fire
Hellfire’s heating up your home.
Turbans and sandals being flung in the air
and their parts are scattered everywhere.

Everybody knows insurgents who are missing toes
Helps to make the season right
Lethal drones flying high, flying low
will make it tough to get some sleep tonight.

They know a Predator’s on its way
It’s filled with lots of stuff to blow their ass away
and back at drone control they’re going to try
to see if taliban really know how to fly.

And so I’m offering this simple advice
to islamists from ten to ninety-two
although it’s been said many times, many ways
Merry Christmas - this bomb’s for you.~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ HTML codes Paragraph break =

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End Right Align = </align ="right"> (This can also be used for left align and center align)

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example: <a href="http://www.freerepublic.com">Free Republic</a> = Free Republic

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