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July 29, 2010
Attentiveness Matters For Us All
We have a lot to keep up with these days, a lot of crosscurrents in a busy, politically rancorous nation at a time when traditional media aren't the focus they used to be. Newspapers and magazines helped organize things for us, but now we have to look more widely, to the Internet, blogs, and various other social media. The danger of missing something important seems greater, as I realized in reading a gripping article -- "Annals of Medicine: Letting Go" -- in the Aug. 2 issue of The New Yorker magazine. ("Old media," yes, but The New Yorker often comes through.) I'd call this keeping-up problem "attentiveness relations." You have to be aware of what's actually going on before you can relate to it well.

The New Yorker's piece is on end-of-life treatment options. It was written by Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston and an associate professor at Harvard Medical School and the Harvard School of Public Health. It concerns a subject, how best to approach death, that all of us will be concerned about one day.

What caught my attention, especially, was Dr. Gawande's discussion of the nature of the conversations we ought to have, and the options to expensive "heroic" treatment that are available, as death nears. Some of those conversations aren't so easy to focus and they can be prolonged in complex cases. But they often lead to alternatives like hospice care that can provide a fuller, more peaceful final experience than "heroic," technology-based measures.

Here's the point: For me, the most ghastly sentence in Dr. Gawande's article was enclosed in parenthesis: "(The new health-reform act was to have added Medicare coverage for these conversations, until it was deemed funding for "death panels" and stripped out of the legislation.)" Is that what the "death panels" ruckus in the debate over "Obamacare" was about? The ability of many people to hold highly advisable, difficult, and extended conversations with their medical advisors and families as a terminal illness tales hold? How dare anyone trifle with that?

Death panels? I shrugged off the term as overzealous posturing when I first heard it and turned elsewhere. But, turns out, it was worse than posturing -- it was deceptively misleading to people who need a keener sense of the options as the end of their lives, or those of loved ones, approaches. That will be all of us. It's a subject that no way deserves being cheapened, and if I had realized at the time that that was what was being done, I like to think I would have grabbed hold of it then. After reading Dr. Gawande's description of  medicine's frequent inability on its own to deal compassionately with dying, I'd say the enhanced Medicare funding needs to be put right back into the health insurance law, pronto. (I didn't read much of Elisabeth Kubler-Ross, either, but I'm older now.)

Yes, knowing where to focus, what's really important, as we seek to relate to the unfolding scenes of this life is crucial. We can have all the technique in the world, but if it's applied to secondary matters, it's at least partially wasted. Death panels? Spare us any more of that, please. 

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Doug Bedell has a background in journalism and PR and is the owner of Resource Relations LLC in Central PA, focusing on organizational and crisis communication. He’s the community manager of SimplyFair.net, a social network on fairness. On the Web, Doug’s at www.ResourceRelations.com. On Twitter, he’s @DougBeetle.
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