My favorite part of the day is waking up to coffee and reading the morning newspaper. A couple of weeks ago (Az. Republic 11/13/10) the cover story was about Arizona’s budget cuts to its health care system that denied a man his chance of getting a liver transplant. Francisco Felix, 32, was in the hospital ready to receive the perfectly matched liver that was donated to him, but the State’s health budget wouldn’t cover it. Because Francisco couldn’t come up with the $200,000 to pay for the procedure, the liver was given to someone else.

This scenario is going to happen again and again, because modern medicine is good at putting off life-threatening illnesses and death. Francisco will die because he couldn’t pay for his cure; the morality of that just boggles my mind. Most of us will never be faced by this kind of life-and-death dilemma, we will die from the complications of aging and/or incurable diseases, and I want to tell you can’t afford to pay for those either.

Aggressive intervention can lengthen the days of dying. 25% of healthcare spending goes to people who are in their last year of life (most of them in the last couple of months). The soaring cost of health care is the greatest threat to this country’s long-term solvency.

I’m sipping coffee, nibbling on biscotti, reading about Francisco and mulling how I would come to my last days? Will I scratch and claw for every breath, try every experimental drug, get fed by tubes and IV’s? I don’t know. I do know that I’m not one of those who subscribe to the theory that everyone goes through stages of dying culminating in dignified acceptance. I have been with people who raged against the dying light to their last breath.

Our biological impulse is to fight for life; so I’ve made out an advance medical directive, which states how much intervention I want. I encourage you to make one out, and to donate your organs.

I have also talked to the people I love and who feel my soul, about when I’ve had enough. In the words of Mary Oliver…

To live in this world
you must be able to do three things:
to love what is mortal; to hold it against your bones;
knowing your own life depends on it
and, when the time comes to let it go, to let it go.