The Country of Medicine

I recently met a woman on the Lower East Side who related a cautionary tale about the end of life.

A decade ago her parents, New Yorkers in their early 80's - let's call them Jane and Frank, had been in relatively good health. Despite their frailties they enjoyed their apartment, their neighborhood, and city life in general, and traveled together to see grandchildren a few times a year.

Jane was then diagnosed with breast cancer. I will stop here and just say that, all other things being equal, the highest risk for developing cancer is advancing age. So the diagnosis wasn't surprising from that standpoint. Still, Jane and Frank were caught by surprise and soon found themselves coping with a cascade of confusing tests and treatments, along with an often dizzying array of difficult decisions relating to Jane's care.

On the advice of her doctors, Jane quickly embarked on a precipitous medical journey of chemotherapy and multiple hospital admissions, a journey of three years during which she never again felt well and her family was never at peace. As things went from bad to worse, Jane wanted to get off the merry-go-round of doctor's waiting rooms, emergency room visits, and days (and sleepless nights) in the hospital. The family wanted to honor Jane's wishes. They wanted to keep her home and comfortable. But they didn't know how and they didn't know where to turn for help. Jane died in the hospital, her body a battleground and her family exhausted and traumatized.

This story is a familiar one. But the next thing that happened is a surprise. After seeing first-hand the over-medicalized life Jane had endured in her final years, Frank - again, also in his 80's - left New York and moved to Central America. I'm sure the weather is better but that's not why he moved. He left the States because that is how he felt he could best protect himself from the suffering he'd seen Jane, and the rest of the family, go through at the end.

Frank didn't want to die that way. He didn't want to live that way. And the only way out as he saw it was to leave the country. 

I am here to say there are other options.