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2011.03.18 09:09

"Letting Go"

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“Letting Go”
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Annals of Medicine by Atul Gawande (August 2. 2010)
What should medicine do when it can’t save your life?



Wolran Kim, Feb.2011
Read & Respond                                



I had to hear suffering and labored breathing sounds of humans who became infinitely smaller—like crawling ants on giant earth—face of death, throughout reading the whole essay as homework. I became devout, fearful, and desolate drawing in my mind my near future as I faced death, even though my poor reading must rely on a computer pop-up dictionary. Because this story are not a novel or a film, and I have to act some day on the stage of death. This vivid description is from a doctor who must have watched over thousand deaths. I wonder why people who faced with terminal illness, even in a vegetative state, wanted to save their life and breathe again. The person, who has not seen deadly illness yet, only can be completely rational and beautiful. Old people say the years getting faster and faster. This is a proof of stronger attachment to life consequently getting older. Our lives will be so different in appearance if there are designated in the order of death by aging.

One of my sister's fathers-in-laws in care facilities in Korea, also had been received dialysis three times a week for a few years. Whenever I call her, her voice is drenched in anxiety. “He is getting healthier everyday with full of vigor and appetite.” He is 85 years old. Dr. Atul Gawande said that twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes foe care in their last couple of months which is of little apparent benefit. Stretching surprising. This does not seems the only one case which ignorance of human's greed ahead of common sense of a system of the society. The beautiful fictional protagonists in the movie always leave to beautiful beaches or mountain villa as soon as close calls. Otherwise, not in the real life, and I cannot guarantee for me either. Dr. Marcoux also mentioned watching the families who unable to accept the death of love ones and bringing vain toil for the last moment of patient. "I'd be the same way if I were in their shoes."

Susan Block, an expert in end of-life discussions, surprised when her farther—a professor emeritus—said he wants to live more if he could eat chocolate and ice cream, and watch football on TV. In the face of death, knowledge, wealth, and fame, all of these are disappear and only remains same desire for lingering attachment of life. According to a survey, last wishes of terminally ill patients are being without pain, with family and a clear mind, and would not be a burden to others. But it is hard to give up all hope unless people know the last minute surely or somebody acts as a substitute God. We desire the last time is not today, but it will be just tomorrow which never come as today. Who can wipe the earth away as that easily just like after kids play with the soil? Who can leave willingly without looking back these vivid scenes of life?

"Is she dying?" When the family of patients who is sixty's, lost her kidney, and have to live with dialysis the rest of her life, asked, Dr. Gawande said, he didn't know how to answer the question. He wasn't even sure what the word "dying" meant anymore. He tells that modern medicine changing the meaning of mortality and cast new issue to human being: "how to die." A high-tech medical science extended our life expectancy distinctly, and medical journals also predicted our hope to hundred fifty years old. "Ninety-nine per cent understand they're dying, but one hundred per cent hope they're not," Sara Creed, hospice said. In the realities, terminal patients rely on health care facilities and wish miracles in dying body, rather than ask help to hospice who is helping prepare to die. According to the survey 4,493 terminal patients, patients who received hospice care was delayed their time of death. One famous general said at war, "You'll die if you try to live, and you'll live if you want to die." You live longer only when you stop trying to live longer. The desire takes away the peace of mind and devastate. Hospice has tried to offer a new ideal for how we die.

"People die only once. They have no experience to draw upon." This is the reason that I cannot think shameful to terminal patients who relying on 911 cardiopulmonary resuscitation like Sara. How can I sure I'll die just like Sleeping Beauty in flower tube? But death is not our enemy we fight to win. The game is done long, long time ago; since we were born. The matter is the time. I think the greatest gift from God is that he never tells us when our last day is. So Spinoza said he will plant an apple tree today even though the Earth falls tomorrow. Should not we have a dauntless attitude at least the end of close calls of death, even if we cannot live whole life time for beautiful death? We must be resolute in front of enemy who conquered us already. We should give back our fate as a created thing to the Creator with a serene state of mind.


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