Stiffer Spines

By DON ROLLINS

He calls me two weeks to the day before the cancer will finish its grizzly work. How to tell his wife of fifty-one years that he’s ready to die? Even looking forward to it? He’s had a good run. But no more heroic interventions and no religious platitudes. Just a little hospice morphine, maybe a quick bedside bash with friends — something worthy of an old liberal warhorse (his term) — and her familiar hand to hold when the time comes. But how to tell her?

For the last quarter-century I’ve been helping folks prepare for the journey into ultimate mystery. Along the way I’ve had my heart broken, my spirit lifted and my eyes opened. Turns out you can’t hang with the dying without grieving, laughing and learning a thing or two.

One of the things I’ve learned is that a good many of us have no idea how to talk about the details of dying. We don’t have a clue and we don’t have a plan. And we and our loved ones are the worse for it.

As of Jan. 1, talking about the dying process was supposed to get a little easier; at least for the 65-and-over crowd. Supposed to, being the operative phrase. If you’ve been following the sad saga on this one, you know that the Administration had proposed, authorized and nearly implemented a health care provision allowing physicians to bill for annual end-of-life discussions with Medicare patients (with particular emphasis on advance directives). Just a once-a-year, doctor-patient reminder that nobody lives forever. This was a good idea. This was common sense brought to the examination room.

But just days into the new regs’ application, exam room common sense took a predictable, fatal hit from conservative religious activists, corporate medicine and the scores of lobbyists that do their bidding. On the one hand, the culture-of-lifers knew that the provision would be a boon to individual conscience and thus a blow to unyielding religious doctrine – never a good thing if you’re in the business of imposing moral uniformity. On the other, Big Medicine knew that fewer medical interventions and shorter duration of care would put a serious crimp in the revenue stream: reducing unwanted, overly aggressive and often ineffective measures may be very good for the country but it’s very bad for the profit margin.

So the pious and the profiteers mounted a mighty, concerted, Orwellian “death panel” campaign to nix common sense. And the Administration that we, of the grassroots left helped bring to power, caved.

Disappointing as this episode may be, we should not discount the Obama administration’s (Lyndon) Johnsonian instinct for initiating plans that advance the American greater good. (Witness universal health care and ending Don’t Ask, Don’t Tell — two monumental achievements.) But they caved early on tax reform. And now they’ve caved early on an issue with more import than many may imagine.

The Obama policymakers don’t need better ideas. All they need are stiffer spines.

Rev. Don Rollins is a Unitarian Universalist minister in Spartanburg, S.C. Email donaldlrollins@gmail.com.

From The Progressive Populist, February 1, 2011