Old Man's Friend

To Gary, living meant having an intact mind. So when he was diagnosed with dementia and lost his memory, his will to live went too. But his body continued on; this was not how Gary wanted it. Eventually, he got pneumonia and his confusion worsened. In the Emergency Room, he dismantled the blood pressure cuff and threw his blankets off the gurney. We tried to calm him, but he just couldn't understand where he was.

"I know this is terrible," his wife sighed, "but I wish he would just die."

I did not think it was terrible. The Gary I knew would rather die than face a long humiliating decline. Besides, wasn't pneumonia sometimes referred to as "old man's friend," a gentler way out when life wasn't worth living anymore?

Gary's wife told the ER doctor she did not want the pneumonia treated; she just wanted her husband to be comfortable.

The doctor said that without antibiotics, Gary would have a miserable death.

"His life is miserable," she pointed out, "and with treatment, he might survive this infection."

She showed the doctor Gary's Advanced Directives. It stated that if he had a terminal condition, he did not want aggressive measures. It even included no antibiotics if he were diagnosed with Alzheimer's . Gary had designated his wife as his decision maker when he could no longer make decisions himself. She was not killing him; she was allowing the natural death he had chosen when his mind worked. She had it in writing with his signature.

Gary and his wife left the antibiotics behind and headed home. With the help of hospice, despite the doctor's prediction, he was comfortable for six days before dying peacefully, surrounded by four children, two dogs and his wife.

The End of Life Option Act requires a person to have mental capacity all the way up to taking the medication. So it would not have been an option for Gary. However, filling out Advanced Directives afforded him the control he wanted and the dignity he deserved. This is legal, right now, and something we all owe ourselves.

With a Perspective, I'm Molly Bourne.

Molly Bourne is a family physician practicing in Marin.