healthcare, social media, viral

“A time to be born… a time to die…”

It’s Monday again, and I’m sitting here pondering a discussion I got into yesterday after a nursing friend shared a viral meme about cardiopulmonary resuscitation (CPR). Right now, people are talking about CPR. Professional football player, Damar Hamlin, collapsed on the field and received CPR, which saved his life. I don’t watch football, so even if I had been in the United States when it happened, I probably would not have seen it happen live. But a number of people on my friends list saw it.

CPR saved Damar Hamlin’s life. There’s no doubt about it.

Damar Hamlin is reportedly now doing much better. He will have to recover from this incident, but as a young athlete, he’ll probably be fine. However, as one nurse pointed out, CPR doesn’t always end well for every patient. She made a meme, and it went viral.

A fair point.

I saw this meme because one of my nursing friends shared it. It made me remember a blog post I wrote in 2013. Back then, it was in the news that an 87 year old woman, who lived at an independent living facility in Bakersfield, California, had collapsed. No one rendered CPR to her. Instead, a supposed nurse at the facility called 911. The nurse explained to the 911 dispatcher that it was against the facility’s policy for employees to perform CPR on residents. A lot of people seemed shocked that this was a policy at a place where it seemed like there would be emergency medical assistance available for residents.

The dispatcher, upset that the “nurse” wasn’t acting, reportedly pleaded:

“Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby,” the dispatcher said. “This woman is not breathing enough. She is going to die if we don’t get this started.”

But the nurse refused to render aid, and followed the protocol set by her employer. An ambulance arrived a few minutes later, but the woman died at the hospital.

It outraged a lot of readers that the nurse simply let this 87 year old woman die without a fight. Many people posted that the woman’s family should sue. Some felt the “nurse” should be fired and lose her nursing license. Some seemed to think police should arrest the “nurse”.

Inspired by some of the more vitriolic comments, I decided to blog about the situation. In that post, I wrote:

As someone who has studied public health and social work, and lived abroad several times, I was amused and amazed by the comments that came with that article.  There’s quite cultural statement made about this situation.  Look at it.  The woman was 87 years old.  That’s an impressive life span.  CPR is a very traumatic thing to do to another person.  Even if you’re young, CPR can cause cracked or broken ribs, a broken sternum, and internal bleeding.  At 87 years old, I would imagine this woman was a lot more fragile than your average adult is.  Moreover, CPR done to elderly patients doesn’t actually have an impressive success rate.  It’s an emergency intervention and doesn’t usually turn out the way it does on TV shows like ER.

CPR done correctly might have saved her… just in time for her to spend days or weeks in the hospital, hooked up to machines and running up big medical bills that perhaps she had no means to pay.  At age 87, she was likely on Medicare.  She might have made a full recovery… or she might have suffered brain damage, because the CPR wasn’t done correctly and she went without oxygen for too long. She might have lapsed into a coma, where doctors and relatives would have to decide when the appropriate time to let her go would be.  But here in America, we are taught from a young age that we should spare no expense to save a life, even a life that has been well lived and is about finished.  You are seen as a criminal if you opt for death.

I remember posting about the case on my Facebook page. At the time, I had a lot more “friends”, and some of them were argumentative types. The thread about this case got heated, fueling the post even more. I continued:

…there are many places around the world where no one would have raised an eyebrow at what happened to this lady.  In many places around the world, family members or neighbors care for the elderly.  And when death comes, it’s not always seen as something that has to be fought.  Death is a part of life, and it will happen to everyone at some point.

While I can see why it’s distressing to think of a person just watching someone die while on the phone with 911, I can also understand why that assisted living facility has the policy they have.  You can bet it has a lot to do with litigation and insurance. 

It’s hard to think of sitting on your hands in a situation like this.  It is a little unnerving to think about when a person’s life is no longer worth saving due to advanced age.  But I think in this case, it’s likely that this woman had a better death than she might have.  I wish we could come to some kind of consensus as to how we can let people die with dignity.  We can’t have everyone living until they’re 100, though.  The system can’t and won’t support it. 

So… there I was yesterday, looking at that viral meme, and remembering that 2013 case. When I looked at the comments on the original thread, I found out people still seem to think CPR is always justified, no matter what. The person who originally shared the meme is apparently a nurse, and she’s run many codes on people. A lot of the codes she’s run have been on people who are clearly at the end of their lives. They either didn’t have a “do not resuscitate” order or a living will, or their distraught family members feel compelled to keep them alive at all costs. Family members don’t always realize what goes into a “code”, and how violent and aggressive it can be.

Some commenters were profane in their responses, “bravely” stating that they don’t care about broken ribs if it means another day with a loved one. It’s easy to say that when you’re not in severe pain, or dealing with chronic health issues that make life torture. The fact is, everyone dies. And in every life, there will come an opportunity to make an exit. Sometimes, when a very elderly person collapses, it’s simply their time to go.

Later that day in March 2013, I wrote more about the case. I identified the woman who collapsed. Her name was Lorraine Bayless. She lived at an independent living facility, as opposed to a nursing home or even an assisted living facility. The stories referred to the woman who called 911 as a nurse, but it wasn’t clear if she actually was a nurse. It wasn’t clear if she’d had a DNR, either. Some sources reported that she didn’t have a DNR, but at least one other reported that she did. Experts at the time were talking about how “morally wrong” it was not to render aid to Ms. Bayless. But other people in the know were discussing what happens to a person when they get CPR.

I’m 50 years old, and I live with aches and discomfort every day. I’m not in terrible pain yet. A lot of what ails me is helped with over the counter pain medications, or even a glass or two of wine. Unfortunately, as people age, they tend to hurt more. They become more fragile, and develop health conditions that make it more difficult to recover from illnesses and injuries. And, it’s always sad to bring this up, but healthcare is very expensive, especially in the United States. A very elderly person who is nearing the natural end of their life will run up huge bills, even if they survive another day or two.

As many of my healthcare friends pointed out, it’s uncommon for very elderly people to fully recover from CPR interventions. I’m not saying it never happens, but that it’s rare. And that kind of intervention, which almost always involves broken ribs and severe bruising, will mean significant pain in addition to whatever the condition was that caused the collapse in the first place. The whole point of the viral meme I read yesterday was that people often suffer when they get CPR, along with the suggestion that people talk to their loved ones about what they would like to have done to them if they collapse. One would also hope that they put their wishes in writing, so that medical personnel can honor their wishes without risking their careers or their freedom.

On another note…

One thing I noticed and want to comment about is another one of my “pet peeves”. So many people seemed to be deliberately obtuse about the meme’s message. It was as if people thought the nurse was saying that CPR is never justified. That’s not what she was conveying. She was saying that CPR is brutal to bodies. Some people won’t recover from the physical or mental trauma of the violence and aggression of CPR. People should consider that reality before demanding that medical staff resuscitate their very elderly and frail loved ones who suffer from chronic illnesses.

And also… I wish to God that people would read things before commenting. So many people mentioned cracked ribs and other injuries that come from CPR. I think it’s inconsiderate to post comments without reading the post in question or other people’s comments. Why should I read what someone writes when they haven’t taken the time to read what others have written?

In essence, people who comment before reading are telling everyone that their comments are more important than other people’s comments are. That is quite an arrogant and self-centered statement, in my opinion. Reading before commenting saves time in the long run, because you might find that your comment is unnecessary or, perhaps, inapplicable to the situation. I know that making this statement might make me look “mean” or “rude”, but honestly, I think it’s rude to waste people’s time by making statements that are irrelevant or have already been made umpteen times. Just my opinion.

Anyway…

I hope you have a good Monday. I’ll be watching for new inspirations, as I continue to read my latest book. See you tomorrow.

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obits, royals

Queen Elizabeth II is dead after a long lifetime of service and sacrifice…

I knew we were going to get bad news about Her Majesty Queen Elizabeth II when I noticed announcements on YouTube about her doctors advising that she be under medical supervision. Buckingham Palace never makes those kinds of announcements unless something big is about to happen. I soon found myself on Jesus Enrique Rosas’ YouTube channel, of all places. He was having a live stream, talking about Queen Elizabeth’s declining health. Some people in Britain commented that the Queen had already died sometime around 2:00pm, UK time, but they were waiting for all of the family members to arrive in Balmoral before making an official announcement.

How did they know? Some had mentioned that members of the press were wearing black ties. I hadn’t known until yesterday that the black ties were a sign. Apparently, the BBC had regularly rehearsed the announcement of the Queen’s inevitable death for years. I read somewhere that they rehearsed the procedure every six months, and always had black ties on hand for anchormen to don immediately, when they announcement finally came. Below is a video about the protocol that I stumbled across yesterday. It was made in 2017. And here’s an article by The Guardian written on the subject of protocol when “London Bridge falls”.

Very interesting video about Operation London Bridge. I had no idea.
Such a shock… and yes, the anchor is wearing black, as is tradition.

I shed a few tears yesterday when the news was confirmed that Queen Elizabeth had, in fact, crossed the bar at last. My earliest memories are of living in England, although I was not born there. We were living in England when the Queen had her Silver Jubilee in 1977, and my parents bought memorabilia from that event, which was always on display in our home. I always felt a kinship with Britain, and while a lot of Britons don’t care much for the monarchy, I have always been fascinated by it. I especially loved the fact that Queen Elizabeth II was such a big fan of horses and dogs. I have that in common with her.

Queen Elizabeth II has always struck me as a lovely person with a good sense of humor, warmth and consideration for other people, and a remarkable attitude toward service. Just a couple of days ago, she met Liz Truss, Britain’s brand new prime minister. Although this ceremony has historically taken place at Buckingham Palace, because the 96 year old queen had been in poor health and had mobility issues, Ms. Truss visited her at Balmoral, near Aberdeen, Scotland. There were photos of the event, which circulated widely, with the queen smiling and shaking the new prime minister’s hand while clutching a walking stick. Liz Truss is the 15th prime minister to meet the queen, and she is Britain’s third female prime minister. I almost get the sense that Her Majesty waited to do this one last duty before slipping off the mortal coil and meeting her beloved Prince Philip and the countless dogs and horses who predeceased her.

With the Queen’s passing, Britain now has a new King– Charles III– and a new Queen Consort, Camilla. Prince William and his wife, Catherine, have now become the Duke and Duchess of Cornwall and Rothesay, in addition to Cambridge. They have inherited Cornwall and Rothesay from Charles and Camilla. I suspect that very soon, Prince William and his wife will also inherit the title of the Prince and Princess of Wales, although that isn’t a given, since that title isn’t one that passes automatically. Maybe I shouldn’t care about these things, since I’m an American. But, as I mentioned before, I spent a lot of time in Britain, and had it not been for my ancestors, I would be a Brit myself, based only on my overwhelmingly British DNA.

They are about to be even busier than they ever were.

Prince Harry wasn’t able to get to Balmoral in time to say goodbye to his grandmother before she passed. He and Meghan have been in Europe on a speaking tour. They’d had plans in London, but obviously, those had to be canceled. Meghan is said to have stayed in London, which was no doubt the wisest thing to do, under the circumstances. I’m sure that in time, there will be a documentary about all that went down yesterday, and it will be interesting to see. For now, it just seems so surreal that Queen Elizabeth II is gone. She always reminded me so much of my own Granny, and I’ve always admired her for so many reasons– from her love of horses and dogs, to her colorful sense of fashion and style, to her sense of humor, to the way she always seemed to keep a stiff upper lip, no matter what. I’m glad for her that she was able to pass in the place where she reportedly felt most comfortable– in Scotland. I can’t blame her for feeling that way. Scotland is a wonderful place. It was especially fitting to see that there was a double rainbow over Buckingham Palace yesterday, just after the queen’s passing– even though she passed in Scotland, not London.

Queen Elizabeth II was not born to be a queen, but had that duty thrust upon her. She handled with with grace and sobriety, leading through so many eras during her incredible 70 years on the throne. No matter what one might think of the monarchy, Queen Elizabeth II was an amazing woman who showed great fortitude in good times and bad. I will miss her for many reasons. She was a role model to me, even though I’m not one to follow role models very well. I hope she’s resting in peace, reunited with Prince Philip in paradise… but I realize that no one really knows what happens when death occurs. If she can’t be in Heaven with everyone she’s ever loved, animals included, I hope she at least enjoyed some beautiful hallucinations as she drifted away.

Something else was on my mind yesterday. Just before our walk yesterday, I noticed that the lymph nodes in Arran’s hind legs appeared to be enlarged. I felt them, and they are, in fact, swollen. We just passed our third anniversary of our sweet beagle, Zane’s, death from lymphoma. My first clue that Zane was so sick was noticing that he had swollen lymph nodes under his jaws and hearing him bark with hoarseness. Both Zane and Arran had suffered from mast cell tumors, and lymphoma is a known complication of that disease. We didn’t know Zane was so sick because we had been on vacation in Scotland, of all places, and lymphoma can be deadly very quickly. We lost Zane just one week after we found out about the cancer.

I do worry that Arran might also have lymphoma. He has a vet appointment today, because he’s been acting lethargic. However, unlike Zane, he seems to have improved since my initial concern, the swollen lymph nodes notwithstanding. He wanted to take a walk yesterday, and is eating well, if not a bit slowly. Just now, he went outside, drank some water, and parked himself behind my office chair. Hopefully, the swollen lymph nodes are not caused by cancer this time– especially since they so far seem confined to his popliteal nodes. The right one is noticeably larger than the left, rather than uniform, as they were with Zane. His eyes are bright, and his mast cell tumors have never affected him the way they did Zane. But, just as the queen was, our Arran is quite elderly at about 14 years old. Eventually, we will have to say goodbye to him, too.

One thing I have noticed is that ever since Arran encountered the resident hedgehog in our backyard, I have seen some fleas. Hedgehogs are notorious for having fleas, although the kind they have are breed specific and don’t infest household pets. However, hedgehog fleas do still bite, and Arran did have some blood work done recently that indicated a slightly low level of red blood cells. Perhaps that could be related to Arran’s current state. I gave both dogs baths yesterday, just to see if I saw any telltale evidence of an actual flea infestation. Unfortunately, having grown up in Virginia in the 80s with dogs, I have seen my fair share of the pesky little fuckers. But there weren’t any fleas, nor was there any evidence of “flea dirt” in the bath water. Arran is an old guy, though, so if fleas are biting him, that could conceivably affect his blood work. He doesn’t have the resilience he once had, when he was a young dog. I was worried about him being lethargic, and slow to eat, although he always does eat eventually. Anyway, we’ll see what the vet says. With any luck, we can get him back to feeling like his old self for awhile longer.

Bill comes back from his business trip today. It will be good to see him. I always miss him when he’s gone, but I especially missed him last night, as I heard the news about the beloved British monarch, Queen Elizabeth II. It will be interesting to see how Charles carries on as King Charles. His reign is bound to be short, though. He probably won’t even make it to the Silver Jubilee that my parents attended all those years ago, when we lived in Britain. I wish Charles luck. I know a lot of people don’t like him because of what happened between him and Diana, but I’ve always thought of him as sort of a tortured soul. It’s been nice to see him obviously much happier with Camilla, who should have been his wife from the beginning. They are clearly soulmates. So I wish them both the best, as they have a huge undertaking, following the second longest reigning monarch of all time, and the longest reigning British monarch. I hope William is preparing, too… because I suspect it won’t be too long before he’s called upon to follow his father. He won’t be waiting 70 years; that is for certain.

One last thing… I am a child of the 70s and 80s, so I can’t help but remember an infamously rude 1986 era song by The Smiths about the monarchy. The song is called “The Queen is Dead”, and it’s definitely a song of antipathy. I have a feeling it may catch on in the coming weeks, as some people are already making tasteless jokes about the queen’s passing. While I don’t agree with the song’s sentiment toward the monarchy, I have to admit to liking The Smiths… this song included.

The lyrics are pretty damning.
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complaints, disasters, mental health

What’s the point?

This morning, as Bill and I were waking up to another day of COVID-19 life, I read a couple of articles in The New York Times about the plight of today’s youth. The first article was about how the United States might hope to reopen schools soon and why it’s so necessary for the mental and emotional well-being of young people. The second was about the youth of Europe and how many of them are becoming despondent because of the toll the pandemic is taking on their budding lives. In both articles, mental health issues were cited as major reasons why young people are suffering so much right now.

Both articles hit home for me, even though COVID-19 was not on the radar when I was young. I remember my teens and twenties as an especially difficult time for me. I suffered significantly from anxiety and depression during those years, mainly because I wasn’t sure what my place in the world was. I didn’t have tons of friends or boyfriends, so those years weren’t especially fun for me in terms of a social life. I did have some fun, mind you, and compared to a lot of people, I was fairly privileged. But I wasn’t doing what most young people do when they’re young. I worried excessively about the future and dwelled a lot on the past. It all kind of came to a head when I was in my mid twenties. I had a crisis and felt compelled to seek psychiatric help. I remember wondering back then what the point of living was.

Remembering what I was like in those days and how anxious and hopeless I felt, even if I did appear to be resilient, I think about what it must be like for the young people of 2021. These young folks have been raised in very anxious times. For most of their youths, they’ve had to worry about violence in the form of school shootings and foreign and domestic terrorism. Today’s twenty year olds were born around the time of 9/11, which is when the world really seemed to change a lot. They grew up hearing about people being kidnapped and beheaded in faraway lands. Maybe some of them saw their parents go off to war, never to come home again. All the while, the cost of living kept rising.

From the very beginning of this COVID-19 crisis, I’ve had a soft spot for the young. This should be the time when they’re allowed to be free… to explore relationships, try new things, travel, make life altering decisions. They should be enjoying school, dating, learning to drive, starting their first jobs, taking field trips… But thanks to the pandemic, along with the chaos that comes from having incompetent and criminal world leaders like Donald Trump, those normal milestones are being curtailed or delayed for most of them.

In my day, if young people couldn’t find a job in a field they enjoyed, there was always restaurant work. Waiting tables is a great skill– one that’s usually portable and plentiful. But thanks to COVID-19, a lot of restaurant and retail work has been sharply curtailed. And while some young people might be glad for the extra free time, bills still have to be paid. Some of these young folks are halfway to earning college degrees that they may or may not ever get to use or be able to pay for. In the case of the article about the European young people, a lot of them were saying they didn’t see the point of continuing their educations, given the lack of jobs. Many of them report feeling suicidal, and those who have mental health issues are having worse problems. Some of those who were mentally healthy are developing depression, anxiety, and eating disorders, and mental health experts are hard pressed to be able to help them. Inpatient beds in psychiatric wards in European hospitals are full.

I think about athletes who have been preparing years for the 2020 Olympics. The Summer Games were postponed until this year, and now it looks like they could even be canceled. I think about someone like Simone Biles, who is a great gymnast who’s fighting the same enemy of all great gymnasts… time. She’s in her early 20s. This is when a lot of female gymnasts retire because their bodies don’t cooperate as well as they used to. She was hoping for another Olympic bid, but may not get her chance if the pandemic doesn’t come under control soon.

I think about young ballerinas who have trained their whole lives to be great dancers. But the pandemic forced live entertainment to shut down. What do they do now? The same goes for budding musicians and actors who have spent their whole young lives preparing for a reality that, at least for now, has radically changed. The virus has made it a lot harder for young people to do things like date. This morning, I read a truly nauseating comment on an article about how caution has become “sexy”. Someone said they think masks are “turn ons” because it means a person who is wearing one isn’t a sociopath and cares about others. But face masks cover up the face, which takes away a significant conduit for non-verbal communication. The masks are further isolating and a visible reminder of how fucked up things are today.

For the record, I don’t agree with the idea that a person who doesn’t want to wear a mask might be a sociopath. Mask wearing isn’t normal. It’s not comfortable or convenient. It makes perfect sense to me that many people don’t want to wear them. Not wanting to wear masks doesn’t necessarily make people sociopathic, and while the articles about this phenomenon go into more detail as to why some vehement anti-maskers may have sociopathic tendencies, a lot of people never read beyond the headlines. While I can see the idea that a person who flat out refuses to wear a mask could be considered a sociopath if he or she has other sociopathic traits, I don’t think that’s always true. I think it’s a mistake to promote the idea that anyone who wears a mask is “caring”. That’s also not necessarily true. It could be that they simply don’t want to be fined or harassed. Likewise, I don’t think that all anti-maskers are necessarily people who are uncaring and sociopathic. Some of them are, but not all.

Then there are the mean spirited comments by people who feel the need to shame and lecture young people who are complaining about these unusual and unpleasant conditions we’re living in right now. Frankly, I think anyone who can’t see how difficult this situation is for the young should have an empathy check. It’s true that generations before us have had to deal with terrible adversities. And they dealt with the adversities without the benefit of the technology that we have today. But times were different in those days. The people of the past had some things that we don’t have. I don’t think, for instance, that there was as much pressure to perform or achieve. A person could get by with less. People had closer connections with each other, and there was more of an emphasis on family.

When you’ve grown up in a hyperactive society like ours, where both parents work just to keep the lights on and you’ve been taught since birth that you have to achieve to get into college or find a job– and then all of that is taken away because of a virus– it can be very difficult to cope. It can make anyone wonder what the point is. Especially when, in those other times of adversity, people could literally lean on each other for support. Now, they have to do it on a Zoom call because being in close contact with others is a no no. Humans were meant to touch each other. It’s a need that most of us have. But right now, it’s forbidden, and that’s causing people some real angst.

I understand it, although I wasn’t living in pandemic conditions when I was in my 20s. I felt like I was trying to do so much to make it in the world. I made some good choices that led me to where I am, but I was also very lucky. I have been feeling kind of depressed and hopeless lately, but I also realize that I’m lucky to be dealing with this now, instead of back then… I would have absolutely HATED being locked down with my parents. And even given the fact that I was pretty reclusive when I was single and I relied on my jobs for human interaction, I think I would have HATED dealing with lockdown in my 20s. I was always worried about making ends meet in those days. I think it would be even harder now.

Count me among those who feel great compassion for the young. I think they should get more priority in the vaccination drive. And I am one of those who isn’t going to tell them to “suck it up and drive on”. I don’t think that’s a particularly good or helpful comment in most situations. It often comes from a place of privilege and a lack of empathy for others. Dare I say it? The hyper anal, mask-wearing, middle-aged person who shames a young person for feeling sad and hopeless is probably more of a sociopath than they realize. Personally, I think we should make more of an effort to help the young get back into life. My husband’s daughter is a young mother of two. She and her husband need to be healthy because they have small children to support. The 21 year old college student should be given a chance to launch– to finish their education and get to work. Those of us who have already had a chance should be more mindful of how hard this is for the young.

Once again… I feel kind of grateful to be childless.

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