Art of Dying Volume II - Page 15

We’ve taught sex education,  but there's been no instruction for death and dying. revisited depending on someone's state of health and what's going on in their lives. If at 55 you pull out a living will and you designate a healthcare proxy and state your wishes, you need to review  from time to time and make sure that it's still consistent for you. For some people it’s enough to breathe without having any way to communicate or to take in nutrition via mouth or even move their body.  That’s enough for them and that's okay. I'm not insisting that what's suffering for me has to be suffering for you. I'm not here to place a judgment on someone's decision, but I do my very best to explain to people what that life might look like, as much as one can. Most of the time, people don't want that. With a realistic understanding,  they opt out of it.  To tell you the honest truth, I have mixed feelings about California’s End of Life Option. People will often get a prescription for the drug that would end their lives, but they don't use it. Maybe just having it gives them a sense of control and a sense of calm that is powerful within itself. My friends and I in the world of palliative care are torn. On one hand it makes sense for people to have this autonomy, but on the other hand it's like we've skipped the progress we’ve made in making sure that every single human being has access to good quality care with an emphasis on easing suffering. We are making great advances in alleviating the reason why people are wanting to end their life. It's tricky. For younger people, I think the distance from what they see as the likely end of their life actually can be powerful. You're not as fearful of death because you see it as far away. To normalize death as a part of life early on is the right thing to do. There are some fantastic groups creating death education programs in middle school and high school. We’ve taught sex education,  but there's been no instruction  for death and dying. I am fascinated that here are many young people interested in this topic outside of healthcare. This is not something that I would have come to if it weren't for my personal experience of taking care of patients. I’m thrilled to see millennials and younger people thinking about death and innovating this field.  We're just at the beginning of a social movement, a groundswell. The real shift in understanding and practice is going to come from the consumer;  from the patient and the caregiver, not necessarily from the healthcare facility. That will make the biggest change within the system. DR. SHOSHANA UNGERLEIDER is an internist practicing hospital medicine at California Pacific Medical Center in San Francisco. She received her medical degree from Oregon Health & Science University in Portland, OR and completed residency at California Pacific Medical Center where she is now on the teaching faculty and serves on the Foundation Board of Trustees. In her spare time, Shoshana enjoys traveling, exercising and eating great food. She lives with her husband in San Francisco. VOLUME II | 15