There's still time to attend the AHA conference!

If you have delayed registering for the American Humanist Conference  in New Orleans, here are the rates for June 7-10. If you want to attend but can't swing the full registration, there's an "a la carte" price list:

$179 = Full Registration Only (access to all breakout sessions, no meals)

$60 = Day Pass (access to all breakout sessions for one day, no meals)

$20 = Single Session Pass, Award Ceremony Pass (attendance at one session or one award ceremony, no meals)

$65 = Friday Night Banquet
$45 = Saturday Luncheon
$65 = Saturday Night Banquet

These rates are not available online. You must make your payment by phone at 1-800-837-3792. If you are a student, you can find out more here. You may register for only $25 if you produce a valid/current student ID.

A Glimpse of Rationality

For anyone who has followed Jessica Ahlquist's endeavor to remove a religious banner in her public high school in Cranston, RI, (and followed it in the recent NOSHA spring newsletter), you're no doubt familiar with the other bizarre twist that occurred as a result: "Floristgate".

Various secular organizations tried to send Jessica a spray of flowers to celebrate her legal victory and found that several of the florists refused to comply with their order, saying because they didn't agree with the teenager's efforts, they weren't going to accept the business.

While I don't want to rehash the entire ordeal, I did want to share a letter from the florist who eventually did fill the orders, Glimpse of Gaia. The Freedom From Religion Foundation profiled this in the January/February 2012 issue of Freethought Today. This is the response to one of the few negative emails he received and it touched on some very important principles. Sean deserves his own big bouquet of flowers.

Feel free to liberally apply this reasoning whenever possible!

Thanks for writing. I realize that the Cranston West prayer banner lawsuit and resulting abuse of Jessica Ahlquist has been a heated issue in Rhode Island. I am sure that you respect our Constitution and the laws which prevent discrimination on the basis of race, gender and religion. I understand that you disagree with Ms. Ahlquist’s position on the banner, so I would invite you to perhaps think about it another way.

Imagine that instead of asking to take the banner down, she had asked for a Secular Humanist expression to be put up. Perhaps next, some Islamic students could request a prayer banner that reflects their beliefs. Likewise, Hindu students could ask for something to represent them. Perhaps Evangelicals would want a banner to distinguish from the Catholic message. I am sure you see the problem this creates. I suspect you would agree that we don’t want the walls of our public space littered with competing dogma, all of which would need to be paid for and maintained by those same public institutions. Instead we have private space, including your place of worship, car, home, Facebook and Twitter pages etcetera, which you can use as you like to express your beliefs, whatever they may be.

I would like you to imagine another small change to this situation. Instead of flower delivery being denied, it was something more important. Should this young lady be denied food because of her, legally expressed, opinion? What about housing? How about fuel when her car is close to empty and it’s a frigid evening? What about medical care?

Let’s go one step further and imagine that it is you or your loved one who needs to purchase something, but is denied the opportunity because the seller doesn’t like your beliefs. Is this the kind of society in which you would want to live?

Of course companies can deny service for certain grounds, but not any grounds. A store can refuse to sell products that they know you will use illegally. They can deny service if you are belligerent or intoxicated etcetera. However, they cannot deny you service because they don’t like how you think. This is not just a matter of opinion, it is the law.

Those laws are here to protect us. Our Bill of Rights guarantees fair treatment of everyone, even against the will of the majority. It is a foundational premise of our great country. We have rights. We’ve been incredibly lucky to have been born with those rights, hard won by our forebears. I think we should respect and protect them.

Thanks for your interest and attention. — Sean

To Live at All Is Miracle Enough

I came across this by chance the end of December and had intended to post it sooner. (You can see the original post by  Faisal Saeed Al Mutar.) It reminds me how lucky I am, we all are, in fact, and is something that I should read every once in a while when I'm feeling stressed about what I'd like my world to be. Doesn't Monty Python have something similar to say?

But Richard Dawkins is eloquent in his observations and everyone should be reminded how unintentional life really is. So many people talk about how much they honestly believe that they should be guaranteed some power and importance in this world. Maybe religion helps alleviate the fear that arises when some of us recognize how unlikely that is: however I can say religion offers me nothing when I consider how brief our time is.

When you think about it, the planet existed long before our consciousness ever sparked and it will go on for a very long time after we're no longer here. Whatever happiness we have is right now and if we're to live fully, we need to embrace the majesty that the natural world provides us. It is fleeting and sometimes very harsh, but it can be so much more if we don't squander it on the illusions modern society pushes on us.

Enjoy!


Excerpt from Chapter I, “The Anaesthetic of Familiarity" of Richard Dawkins 1998 book Unweaving the Rainbow

To live at all is miracle enough. ~ Mervyn Peake, The Glassblower (1950)

We are going to die, and that makes us the lucky ones. Most people are never going to die because they are never going to be born. The potential people who could have been here in my place but who will in fact never see the light of day outnumber the sand grains of Arabia. Certainly those unborn ghosts include greater poets than Keats, scientists greater than Newton. We know this because the set of possible people allowed by our DNA so massively exceeds the set of actual people. In the teeth of these stupefying odds it is you and I, in our ordinariness, that are here.

Moralists and theologians place great weight upon the moment of conception, seeing it as the instant at which the soul comes into existence. If, like me, you are unmoved by such talk, you still must regard a particular instant, nine months before your birth, as the most decisive event in your personal fortunes. It is the moment at which your consciousness suddenly became trillions of times more foreseeable than it was a split second before. To be sure, the embryonic you that came into existence still had plenty of hurdles to leap. Most conceptuses end in early abortion before their mother even knew they were there, and we are all lucky not to have done so. Also, there is more to personal identity than genes, as identical twins (who separate after the moment of fertilization) show us. Nevertheless, the instant at which a particular spermatozoon penetrated a particular egg was, in your private hindsight, a moment of dizzying singularity. It was then that the odds against your becoming a person dropped from astronomical to single figures.

The lottery starts before we are conceived. Your parents had to meet, and the conception of each was as improbable as your own. And so on back, through your four grandparents and eight great grandparents, back to where it doesn’t bear thinking about. Desmond Morris opens his autobiography, Animal Days (1979), in characteristically arresting vein:

Napoleon started it all. If it weren’t for him, I might not be sitting here now writing these words … for it was one of his cannonballs, fired in the Peninsular War, that shot off the arm of my great-great-grandfather, James Morris, and altered the whole course of my family history.

Morris tells how his ancestor’s enforced change of career had various knock-on effects culminating in his own interest in natural history. But he really needn’t have bothered. There’s no ‘might’ about it. Of course he owes his very existence to Napoleon. So do I and so do you. Napoleon didn’t have to shoot off James Morris’s arm in order to seal young Desmond’s fate, and yours and mine, too. Not just Napoleon but the humblest medieval peasant had only to sneeze in order to affect something which changed something else which, after a long chain reaction, led to the consequence that one of your would-be ancestors failed to be your ancestor and became somebody else’s instead. I’m not talking about ‘chaos theory’, or the equally trendy ‘complexity theory’, but just about the ordinary statistics of causation. The thread of historical events by which our existence hangs is wincingly tenuous.

When compared with the stretch of time unknown to us, O king, the present life of men on earth is like the flight of a single sparrow through the hall where, in winter, you sit with your captains and ministers. Entering at one door and leaving by another, while it is inside it is untouched by the wintry storm; but this brief interval of calm is over in a moment, and it returns to the winter whence it came, vanishing from your sight. Man’s life is similar; and of what follows it, or what went before, we are utterly ignorant. ~ The Venerable Bede, A History of the English Church and People (731)

This is another respect in which we are lucky. The universe is older than a hundred million centuries. Within a comparable time the sun will swell to a red giant and engulf the earth. Every century of hundreds of millions has been in its time, or will be when its time comes, ‘the present century’. Interestingly, some physicists don’t like the idea of a ‘moving present’, regarding it as a subjective phenomenon for which they find no house room in their equations. But it is a subjective argument I am making. How it feels to me, and I guess to you as well, is that the present moves from the past to the future, like a tiny spotlight, inching its way along a gigantic ruler of time. Everything behind the spotlight is in darkness, the darkness of the dead past. Everything ahead of the spotlight is in the darkness of the unknown future. The odds of your century being the one in the spotlight are the same as the odds that a penny, tossed down at random, will land on a particular ant crawling somewhere along the road from New York to San Francisco. In other words, it is overwhelmingly probable that you are dead.

In spite of these odds, you will notice that you are, as a matter of fact, alive. People whom the spotlight has already passed over, and people whom the spotlight has not reached, are in no position to read a book. I am equally lucky to be in a position to write one, although I may not be when you read these words. Indeed, I rather hope that I shall be dead when you do. Don’t misunderstand me. I love life and hope to go on for a long time yet, but any author wants his works to reach the largest possible readership. Since the total future population is likely to outnumber my contemporaries by a large margin, I cannot but aspire to be dead when you see these words. Facetiously seen, it turns out to be no more than a hope that my book will not soon go out of print. But what I see as I write is that I am lucky to be alive and so are you.

We live on a planet that is all but perfect for our kind of life: not too warm and not too cold, basking in kindly sunshine, softly watered; a gently spinning, green and gold harvest festival of a planet. Yes, and alas, there are deserts and slums; there is starvation and racking misery to be found. But take a look at the competition. Compared with most planets this is paradise, and parts of earth are still paradise by any standards. What are the odds that a planet picked at random would have these complaisant properties? Even the most optimistic calculation would put it at less than one in a million.

Imagine a spaceship full of sleeping explorers, deep-frozen would-be colonists of some distant world. Perhaps the ship is on a forlorn mission to save the species before an unstoppable comet, like the one that killed the dinosaurs, hits the home planet. The voyagers go into the deep-freeze soberly reckoning the odds against their spaceship’s ever chancing upon a planet friendly to life. If one in a million planets is suitable at best, and it takes centuries to travel from each star to the next, the spaceship is pathetically unlikely to find a tolerable, let alone safe, haven for its sleeping cargo.

But imagine that the ship’s robot pilot turns out to be unthinkably lucky. After millions of years the ship does find a planet capable of sustaining life: a planet of equable temperature, bathed in warm starshine, refreshed by oxygen and water. The passengers, Rip van Winkles, wake stumbling into the light. After a million years of sleep, here is a whole new fertile globe, a lush planet of warm pastures, sparkling streams and waterfalls, a world bountiful with creatures, darting through alien green felicity. Our travellers walk entranced, stupefied, unable to believe their unaccustomed senses or their luck.

As I said, the story asks for too much luck; it would never happen. And yet, isn’t that what has happened to each one of us? We have woken after hundreds of millions of years asleep, defying astronomical odds. Admittedly we didn’t arrive by spaceship, we arrived by being born, and we didn’t burst conscious into the world but accumulated awareness gradually through babyhood. The fact that we slowly apprehend our world, rather than suddenly discover it, should not subtract from its wonder.

Of course I am playing tricks with the idea of luck, putting the cart before the horse. It is no accident that our kind of life finds itself on a planet whose temperature, rainfall and everything else are exactly right. If the planet were suitable for another kind of life, it is that other kind of life that would have evolved here. But we as individuals are still hugely blessed. Privileged, and not just privileged to enjoy our planet. More, we are granted the opportunity to understand why our eyes are open, and why they see what they do, in the short time before they close for ever.

Here, it seems to me, lies the best answer to those petty-minded scrooges who are always asking what is the use of science. In one of those mythic remarks of uncertain authorship, Michael Faraday is alleged to have been asked what was the use of science. ‘Sir,’ Faraday replied. ‘Of what use is a new-born child?’ The obvious thing for Faraday (or Benjamin Franklin, or whoever it was) to have meant was that a baby might be no use for anything at present, but it has great potential for the future. I now like to think that he meant something else, too: What is the use of bringing a baby into the world if the only thing it does with its life is just work to go on living? If everything is judged by how ‘useful’ it is — useful for staying alive, that is — we are left facing a futile circularity. There must be some added value. At least a part of life should be devoted to living that life, not just working to stop it ending. This is how we rightly justify spending taxpayers’ money endangered species and beautiful buildings. It is how we answer those barbarians who think that wild elephants and historic houses should be preserved only if they ‘pay their way’. And science is the same. Of course science pays its way; of course it is useful. But that is not all it is.

After sleeping through a hundred million centuries we have finally opened our eyes on a sumptuous planet, sparkling with colour, bountiful with life. Within decades we must close our eyes again. Isn’t it a noble, an enlightened way of spending our brief time in the sun, to work at understanding the universe and how we have come to wake up in it? This is how I answer when I am asked — as I am surprisingly often — why I bother to get up in the mornings. To put it the other way round, isn’t it sad to go to your grave without ever wondering why you were born? Who, with such a thought, would not spring from bed, eager to resume discovering the world and rejoicing to be a part of it?

One of Us



Amid curls of smoke, Christopher Hitchens and
his famous matte of fur from his Vanity Fair days.

“Isn’t that so sad,” I said more as a declaration than expecting someone to agree.

“Well, not really. I mean, it was expected,” said my always witty friend, so matter-of-factly. “It would have been sad if it wasn’t, don’t you think?”

I had to admit, my friend was right and his perspective made me pause to think more about the heartache that was palpable on the web. It would have been stupefying if he had passed away suddenly and without warning. But we had warning and the man I was lamenting had brought us along with him during his final year and a half with his usual critical brilliance and unwavering nerve.

The man I’m referring to, of course, is Christopher Hitchens who died in December. And his death, while talked about openly by Hitchens himself, nevertheless made many of us entreat (dare I say pray) that death would spare him for as long as possible.

One night a week or so after his died, I found myself wide awake and fitfully dozing and drifting as is often the case when dawn is close. After rolling through my standard litany of minor worries (that always seem worse in the dark and cold), I found myself thinking about Hitchens and was astonished at how quickly my eyes were welling up. After a few minutes, my cheeks were wet and I whispered to myself, “…just what brought that on?”

I was genuinely sad and mystified because it seemed embarrassing on some level. I didn’t know the man and, while I followed his progress since he announced his illness, I had assumed he would be here for several more years yet. We lost a couple of his books to the Katrina floods, so maybe it was my sentimentality getting the best of me. But when I saw the video of him at an atheist convention in Texas in October, the limitation of a cure and the cancer’s persistence had made it impossible to pretend that he could have gone on much longer, much less beaten it. He was a mere slip of himself, but the thrill he could still evoke in the crowd was manifest. I wish I’d been in that crowd.

When these same tears occurred again a few weeks ago during another sleepless night, I realized that maybe I should write my own version of a tribute, since all secular websites worth anything have posted something about this lost horseman of non-belief. I can start by saying that, while his death wasn’t unexpected, the finality is what gripped me and made me mourn openly someone I have never met.

A fond memory of Hitchens that makes me smile every time is his strange and glorious observation that appeared in one of his early columns for Vanity Fair in September 2010 when he candidly talked about his June diagnosis. “The Topic of Cancer” was a bold and fierce examination of cancer and, while I could never hope to pull off such vulnerability and acute descriptions with as much defiance, Hitchens made it a cerebral partnership for us all.

His comments on the side effects of chemotherapy: “Or for the way that my newly smooth upper lip would begin to look as if it had undergone electrolysis, causing me to look a bit too much like somebody’s maiden auntie. (The chest hair that was once the toast of two continents hasn’t yet wilted, but so much of it was shaved off for various hospital incisions that it’s a rather patchy affair.)”

Chest hair! I have no doubt that it was enjoyed by many admirers on two continents (maybe more). My brother said while he was dealing with prostate cancer, which uses estrogen therapies to combat its progression, mentioned that he also noticed the loss of body hair and he joked heartily at how smooth it made his skin. Humbling to the core, it’s refreshing that Hitchens could remind us how damning and precious those memories are.

Another interesting tidbit is my own "one degree" of separation. A colleague I used to work with at a weekly publication (and to whom I was once tethered during one of those arduous team building adventure/climbing courses) wrote about having drinks and conversation with Hitchens one on one. “J.” was at an industry convention and won a category in which his writing had been judged by none other than Hitchens himself. He was also a featured speaker that day and while J. had tried to edge close enough to speak with him afterwards, the adoring onlookers made it impossible.

In what may be one of the most spectacular feats of daring that I’d like to think I would have done if I’d been in his shoes, J. decided to call Hitchens at his home to request a few moments to express his appreciation. That Hitchens’ home phone number was listed in a Washington, D.C. phone directory is like something out of a Hollywood script, don’t you think?

To his astonishment, Hitchens returned the call and suggested that J. come on over. Let me repeat that slowly. A personal invitation to Hitchens’ house! What a splendid memory to have. (Things like this make me consider that even as a non-believer, if this had happened to me, I just might start believing there was a God after all.) It seems Hitchens was every bit the over-the-top drinker and intellectual that we’ve been led to believe. And J. was there to soak up every minute that he could. It was truly momentous that Hitchens could still entertain mortals; it's possible that one day, J. may return the favor to an unsuspecting writer himself.

When my father was dying of lung cancer, I remember my brothers and I discussed that a parent’s death, at whatever age you are when it happens, makes you very aware that you are next. It might not happen for another 50 years, but you are mortal and here’s the proof. One thought that kept popping into my head was that Hitchens’ was one of us and now he is gone. He was an unlikely guardian for those of us who enjoyed and needed to hear his thoughts on being an atheist. In spite of the criticisms that he probably deserved, he made us proud to call him on of the tribe. And he slipped away, but not before he moved us with his humanity and intelligence.

If you missed the final tribute in Vanity Fair by his long-time friend, Salman Rushdie, here it is. I think we all want to be loved by our good friends as much as Rushdie clearly did Hitchens.

I still wonder what provokes my tears for him even today. But I'm at an age where I wantonly hate that we're all mortal. I like to think that Hitchens made our movement, if I can call it that, stronger and more invincible, just like the man himself.

“Tho' much is taken, much abides; and though

We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;”

~Ulysses, Alfred Lord Tennyson

Want to present at the AHA Conference in New Orleans, June 2012?

Or do you know of someone local who might be an excellent candidate?

The AHA is proud to hold its 71st Annual Conference in the great city of New Orleans, hosted by the New Orleans Secular Humanist Association (NOSHA).

Call for Speakers Now Open

If you are interested in leading a breakout session, speaking on a panel, of if you are an entertainer, send a proposal, outline, complete text, audio, video or web link to Brian Magee at bmagee@americanhumanist.org  (Please include your name and complete contact information with your material. Also indicate your audio visual needs, if any.)

We are particularly interested in sessions that cover gay rights, women’s rights, minority outreach, political issues, human rights, the right-to-die movement, the environment, community issues, humanist activism, international issues, science, and critical thinking.

All program suggestions must be received by January 27, 2012 to provide the planning committee adequate time to review submissions, allot space, and prepare a final agenda.

Conference speakers are volunteers who will receive complimentary conference registration (banquet meals not included). If, however, there are special financial requirements that come with your proposal, such as travel or lodging expenses, please indicate.

It's Important, So Let's Not Talk About It

This article is too important not to pass on to anyone and everyone who can read above a 3rd grade level. And because the original link to the article is botched, I wanted to make sure that everything came through with ease. If I find a llink that works, I'll repost it.

Because death with dignity is a hallmark of most secular creeds that I'm familiar with, we are constantly fighting the interference of religious people who feel they have the answer about death and that all other philosophies should merely let them have their way in political policy.

Hence the hysterical and misguided information that was spewed about by conservatives during the consideration of the Affordable Health Care Act. There were patently false statements made about end of life issues and this hysteria was perpetuated by people who use religiously motivated opinions to distract and distort this important topic. Talking about the end of life and how we will deal with it is a major key to a more successfully lived life (IMHO).

This physician gives us a brief look into one perspective that is probably a majority of the attitudes held by healthcare workers in general. It's a breath of fresh air that we should embrace and discuss in detail.


********************************************************

How Doctors Die

It’s Not Like the Rest of Us, But It Should Be

by Ken Murray

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home.

He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen—that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo.

To administer medical care that makes people suffer is anguishing. Physicians are trained to gather information without revealing any of their own feelings, but in private, among fellow doctors, they’ll vent. “How can anyone do that to their family members?” they’ll ask. I suspect it’s one reason physicians have higher rates of alcohol abuse and depression than professionals in most other fields. I know it’s one reason I stopped participating in hospital care for the last 10 years of my practice.

How has it come to this—that doctors administer so much care that they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.

To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in a maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes, a family really means “do everything,” but often they just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For their part, doctors told to do “everything” will do it, whether it is reasonable or not.

The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish. Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions.

But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving, possibly hysterical, family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.

Some doctors are stronger communicators than others, and some doctors are more adamant, but the pressures they all face are similar. When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable (as I would in any situation) as early in the process as possible. When patients or families brought up unreasonable choices, I would discuss the issue in layman’s terms that portrayed the downsides clearly. If patients or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital.

Should I have been more forceful at times? I know that some of those transfers still haunt me. One of the patients of whom I was most fond was an attorney from a famous political family. She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs. This didn’t restore her circulation, and the surgical wounds wouldn’t heal. Her feet became gangrenous, and she endured bilateral leg amputations. Two weeks later, in the famous medical center in which all this had occurred, she died.

It’s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litigation and do whatever they’re asked, with little feedback, to avoid getting in trouble.

Even when the right preparations have been made, the system can still swallow people up. One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

Several years ago, my older cousin Torch (born at home by the light of a flashlight—or torch) had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, Torch decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t had in decades. We went to Disneyland, his first time. We’d hang out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He even gained a bit of weight, eating his favorite foods rather than hospital foods. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

Torch was no doctor, but he knew he wanted a life of quality, not just quantity. Don’t most of us? If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like my fellow doctors.

Ken Murray, MD, is Clinical Assistant Professor of Family Medicine at USC.

Fun With Words

 Below is the American Family Association's Statement of Faith, which was mentioned in an article on Rick Perry's prayer rally a few months back. My friend, Will, made some changes to it which are worth passing along.

AFA STATEMENT OF FAITH

1. We believe the Bible to be the inspired, the only infallible, authoritative Word of God.

2. We believe that there is one God, eternally existent in three persons: Father, Son and Holy Spirit.

3. We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory.

4. We believe that for the salvation of lost and sinful people, regeneration by the Holy Spirit is absolutely essential.

5. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life.

6. We believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation.

7. We believe in the spiritual unity of believers in our Lord Jesus Christ.

                                                                              

                                                           

AFA STATEMENT OF FAITH (with modifications)

1. If we strain credulity and countlessly repeat it to ourselves, we can come to believe the Bible (replete with absurdities) to be the inspired, the only infallible, authoritative Word of God.

2. We believe that there is one God, eternally existent in at least three persons: The Father, the Son, and the Holy Spirit, forever at loggerheads as they vie for top billing and adoration among their sycophants.  We also unashamedly believe in the Easter Bunny, wood nymphs and wee elves.   We believe such things realizing, as we do, that the more outlandish whatever we can get ourselves to believe, the more praiseworthy it makes us out to be in His eyes.  For example, any schmuck can believe that 2 + 2 = 4, but it requires saintliness of the highest order to marshall the faith required to believe 2 + 2 equals 4.3.  We say, "Let those who are able go for it!" 

3. We believe in the deity of our Lord Jesus Christ, in His virgin birth*, in His sinless life, in His magic tricks, in His vicarious and atoning death through His slowly, thickly-oozing (but eventually coagulating) blood, in His sensational, much-talked-about expulsion from the grave with a loud POP, in His ascension to the right hand of the Father, in his iridescent acne, and in His personal return in power and glow ree. 

4. We believe that for the salvation of lost and sinful people, regeneration by the Holy Spirit is absolutely essential, for we are lowly turds who can do nary a thing on our own.

5. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a god-like life, even to where he/she learns to transmute water into wine, although this last could require some practice.

6. We believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life, and they that are lost unto the resurrection of damnation (wherein those unfortunates will be flame-roasted unto the point of emitting polychromatic hues--in perpetuam).

7. We believe in the spiritual unity of believers in our Lord Jesus Christ.  And remember, the more we can persuade to believe these impossible things the more secure we'll feel, since there's comfort in numbers, and it's hardly likely so many people could be wrong.

___________________

* Yahweh impregnated Mary, who of course, gave birth to Jesus; however, Jesus and Yahweh are indisputably one.  Therefore, in truth, Jesus impregnated his own mother.  Although we regretfully realize what this logically makes him (a crude street term that will go unmentioned) we must nevertheless somehow learn to look past this unsavory conclusion and accept The Mystery.  Amen.