But she insisted on dialysis, saying, “Some life is better than no life.” Really?  Maybe, Maybe not.  When I was a nurse I came to realize we are good at what we do.  In the field, we could bring people back from death.  Of course, we did not always bring back the whole patient, but (s)he was breathing.

As a person ages some organs get “tired” before the rest.  We do not live well and then die.  As organs begin to fail, the slack may get picked up by other organs.  When the lungs become not so good at packing oxygen into our blood, the heart picks up the pace and moves the red cells, that are carrying oxygen around, faster so that the rest of the body doesn’t notice.  We call that compensation.

Of course, when compensation isn’t possible, we die of this or that organ failure.  One organ that fails slowly is the heart, with and actual disease called heart failure.  We have left heart failure, and right heart failure, and finally Cor Pulmonale.  When the pancreas fails and we can get diabetes.  When the kidneys fail we end up in renal failure.  From acute renal failure we can recover sometimes by watching our diet.  Chronic renal failure can only be cured by a kidney transplant.

We can also transplant hearts, lungs, and livers.  We can also prolong the end game by treating pancreatic failure with insulin, heart failure with lasix, and kidney failure with dialysis.  All of these treatments can extend our life by years.  But, at some point it becomes a bit more difficult.   As we age, we are often treated to several organs failing.  Some times it happens to us at a younger age.  Regardless, when it comes, we die.

We all do.  We used to say, “It’s as inevitable as death and taxes.”  Well, now taxes not so much, but death is, inevitable.  Get used to it.  Hopefully you have lived your life to the fullest and you face it without regrets.  HOWEVER, if you have regrets, end of life is NOT the time to make up for them.  At end of life it is time to die.

When the heart can no longer compensate for the lungs, we die.  I took care of a patient once who had cancer in his bladder.  His doctor would not permit him to stop treatment and go on to hospice.  Eventually he began hemorrhaging into his bladder.  At first it was slow.  When his hemoglobin dropped to 7 we would get him transfused.  It was not long before we were running blood in almost as fast as it was running out, the transfusions stopped, and he was allowed to die.  At some point we stop prolonging life and begin prolonging death.

The point between life and death is not fixed.  It is somewhat subjective.  Often we have multiple organs on the brink of failing and we get something like a urinary tract infection, which raises our temperature and the body’s need for oxygen.  If our lungs or heart are compensating to the max, that may be all that is needed to tip us over the edge.  Pneumonia is often referred to as the “old man’s friend.”  The old man is allowed to die.

At some point, that POINT, our quality of life becomes an issue.  I guess what I am saying is that if it takes all we have just to breathe, why bother?  For me that point is much earlier.  How about you?  It is a hard question to answer and only you can do it.  It is best to do it while you still can.  Leaving it to others really isn’t fair.  Who ever it is, I do know that it should not be the GOP.