When is enough, enough?

Jun 18, 2018

One of my best friends in Denver has been getting a lot of cardiac tests lately because of some things that showed up on routine exams.  At first they were worried he might have pulmonary hypertension. Not a diagnosis that people want to face.

This has been going on for a few weeks.  He finally got in again to see the cardiologist for more tests.  Today, they stepped back from the pulmonary hypertension diagnosis; but, they said that his right ventricle is very enlarged and they now “think” there is a valve issue going on.  Possibly the tricuspid valve.  Repairing that (if it really is that) is not the most dangerous procedure in cardiac surgery.  But it is certainly not one that is easy and routine.

Now here’s the thing: Joe is 74 years old and in incredible shape.  Just last weekend he hiked up to 11,000 feet in about the same amount of time that he did it 15 years ago.  He is feeling no symptoms and doesn’t know if it’s worth chasing the symptoms.  But his doctors want him to keep pursuing this issue and are really worried about it.

Kate Spade

He asked me my opinion on what I thought he should do.  Well hell, I don’t know.  When I saw him in November, I thought he would never die.  And I’ve had my share of medical problems caused by interventions that so many surgeons thought I needed.  If I could go back, I would not do any of them.  So, I’m not the best person to give advice on medical procedures.

I’m telling him to at least have the other tests to see what this really MIGHT be.  And also, to take into account that “asymptomatic” might only be short lived.  So, it’s probably a matter of wait and see what the tests say and make decisions from there.

Anthony Bourdain

I will say that for me this is something that makes me think of the bigger question of, “When is enough, enough?”  Joe and I just had another friend die recently who had decided to end his life after years in assisted living; he suffered from long-term effects of agent orange exposure in Vietnam.  He had been in really bad health for at least eight years and he suffered quite a bit.  So, is his decision justified?  I don’t know.  I’m certainly not in a position to decide someone else’s life choice (and it really was a life choice).  But, I understand why our friend made the choice he did.

Now, there has been a lot about this topic in the news lately with Kate Spade and Anthony Bourdain’s suicides.  I even wrote about suicide in an earlier column back in April.  It is not something I take lightly or advocate.  Anthony and Kate had long histories of depression.  Killing one’s self due to depression is an entirely different issue for me.  I’m not saying that they didn’t suffer as well, it’s just harder for me to see how ending one’s life in that situation is the best answer.

I’m not looking for any argument over this issue.  I personally don’t know the struggles that either of these people went through.  I’m fortunate in that regard.  So, please let me just stick to the piece of this that relates to suicide in extreme health issue situations.

Ending one’s life (in the absence of mental illness) due to horrific health issues really is, in my opinion, a personal decision.  A lot of people will probably tell me that God doesn’t want us to take our lives.  It’s against the Bible.  It’s a sin.  Well, my grandmother decided at 99 years old that she had had enough and stopped eating and drinking.  She died 9 days later.  My grandmother was VERY religious.  And she has a daughter who is a Catholic nun.  Yet she made the decision she did.  Go figure.

A lot of counties have laws against suicide.  Or assisted suicide.  That has always struck me as odd.  Politicians, who feel they have the right to start wars, to execute prisoners, or to shoot “criminals” in the act, have decided that they have the ultimate right to tell someone if they deserve help to end their life when they are suffering extreme physical pain.  Who the hell are they to make those decisions?

Anyway, I’m really not looking to start a big debate or start having people throwing stones at me.  I’m just pointing out that NONE of these decisions are easy.

But, if someone is physically sick, really sick, who are we to tell them what to do?  I’m glad my friend Joe is not really sick now and that he can make these choices about his health care without that hanging over his head.  Unfortunately, not everyone does.  And in the end, they are the only ones who should have the right to decide when enough is enough.

Seems that I can never escape rubbing someone the wrong way with my columns, but please, before anyone throws a knee-jerk response at me, know that I am not claiming superiority or expertise on this.  Actually, I’m just sharing my confusion about it all.

I’m just sayin.’

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