I am not afraid of being dead. Our four grown children are thriving, each in their own way making the world better. If I am wrong in my faith that Jesus is preparing a wonderful place for me, I will never know it. I do dread the process of dying, and COVID-19 would be an awful way to go. Most people have mild symptoms, but mortality skyrockets above the age of 50. I am well past that age. Twice retired after 40 years in medicine, I feel like a horse out to pasture within earshot of the bugle call at the racetrack. I feel guilty about being on the sidelines. My current mission is to merely to keep well—to avoid contributing to the burden of disease. I have considered declaring that I would decline ventilation, should I find myself in respiratory failure from COVID-19. According to a recent study published in JAMA, my chance of surviving ventilator support could be less than 3 percent. The process of intubation would require exposing someone to my virus-laden breath. I shudder at the thought of putting someone else at risk for a slim chance of my survival. Yet I recall what it was like to stand by someone at death’s door and think Not on my watch. Or times when people declined blood transfusions for religious reasons. I have known the hollow despair of seeing a life slip away despite my best efforts. I would not want to put someone else in the position of being forced to give up before all reasonable efforts have been exhausted. Years ago, my mother had a sudden sinking spell after brief anesthesia for a minor procedure. Our family gathered around her bed, deliberating whether or not we should consent to cardiac catheterization. She had made it clear that she did not wish her life to be prolonged by futile measures. She had COPD and was in the midst of chemoradiation for esophageal cancer. But her physician pointed out that the study could reveal something potentially fatal that could easily be corrected with a balloon. We gave our consent, and my mother survived. Two years later, we celebrated our parents’ 50th wedding anniversary, and she enjoyed a ribeye steak. My mother had clearly heard the conversation as we wrung our hands beside her bed. Paralyzed, with a tube in her throat, she could not speak, but wanted to scream, “Forget the living will! I want to live.” I realize that if I ever find myself struggling to breathe, I would, like my mother, grasp at any chance to live. Of course, I might not be cognizant enough to make that decision. And so, my advance directive is that I will trust my physicians to use their best judgment. I make only one demand. Don’t wake me up to say goodbye. My mother had clearly heard our conversation when we were all gathered around her ICU bed. Paralyzed, with a tube in her throat, she could not speak, but wanted to scream, “Forget the living will! I want to live.” Like my mother, I want to live. I want to share our children’s joys and sorrows. I want to see my grandchildren grow up. I want to be there for my daughter’s wedding. I want to get back to volunteering in our County Health Clinic. I want to return to Tanzania to continue helping to train doctors there. I want to write more stories. I want to savor the golden years with my husband. I realize that if I ever face a situation, struggling to breathe, I would, like my mother, grasp at any chance to live. Of course, I might not be cognizant enough to make that decision. Gayle E. Woodson is an otolaryngologist. Source
