end of life care – watercress words by Dr Aletha

This is at least the fouth book about death I have reviewed. I didn’t plan to, but it just happened. Maybe because of what Dr. Atul Gawande wrote in his book Being Mortal, another book I reviewed.

Death may be the enemy, but it is also the natural order of things.
Atul Gawande, M.D.

In this instance, I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. The book links in this post are affiliate links which may help support this blog financially.

Dying with Ease by Jeff Spiess, M.D.

A Compassionate Guide for Making Wiser End-of-Life Decisions

In the introduction, author Dr. Jeff Spiess explains his purpose for writing this book.

my primary hope is for you, dear reader, to become more informed and at peace regarding your own dying.
Jeff Spiess, M.D.

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

His book reviews the challenges of the dying process, and guides us in making choices that make it smoother and with ease.

Let’s review the titles of each chapter with a brief description of what each contains.

1. Dying in America

Here he proposes a definition for what is a “good death”; it’s one that matches the wishes of the dying person and their family.

2. I’m Going to Die? What Can I Do?

In this chapter he explains Advance Care Planning

Advanced Directives
Durable power of attorney for healthcare
Do Not Resuscitate-DNR
Physician Orders for Life Sustaining Treatment
Artificial Nutrition and Hydration

3. Hospice

In this chapter he reviews the history of hospice care care and explains the basics of palliative (rather than curative) care

4. Suffering

Most dying persons want to minimize suffering so Dr. Spiess lists ways to do so, some of which are controversial and even illegal in some states.

Palliative sedation
Voluntary stopping eating / drinking
medical aid in dying
voluntary euthanasia

5. It’s My Life, Isn’t It?

Here he discussed autonomy , bioethics, and the legal system using past high profile cases as illustrations, those being

Karen Ann Quinlan
Brittnany Maynard
Theresa Schiavo

"To every thing there is a season" Bible verse with fall color leaves — from Ecclesiastes 3

the time of peril, what St. John of the Cross called the “dark night of the soul,” … both tests the validity of one’s faith and initiates that essential process of incarnation
page 109

6. What’s God Got to Do With It?

Here he talks about “Religion, Spirituality, and the End of Life. He finds many people turn to religion when faced with death and sometimes that is not an altogether positive experience. However, he denies being anti-religion saying,

many find religious traditions to be sources of profound comfort and meaning. …it has been so for many friends, relatives, and patients, and also because it is true for me.
page 109

He finds it essential to differentiate religion as primarily a matter of intellectual assent to doctrines and beliefs, or whether the essense of a person’s faith has become understood and embodied in their being.

7. What Does It Feel Like to Die?

In this chapter he invites the reader to do a guided exercise to encounter the inner experience of dying. Putting pen to paper you will answer a series of questions about your life. Then you review it as you finish reading the chapter. I did the exercise and found it enlightening and sobering.

8. Envisioning Your Own Death

Here he expands on the idea of Advanced Care Planning introduced in chapter 2. He adds such steps as

Know the rules (insurance coverage)
Disposition of your body
Disposition of “stuff”, making a will

woman sitting in a cemetery — photo from the Lightstock.com collection, an affiliate link

9. What’s It All About, Anyway?

Dr. Spiess concludes with a true story about a wife’s journey to finding meaning after her young husband’s unexpected death.

living well increases the likelihood of dying well
page 161

Conclusion

After the obligatory Acknowledgments this book has

Discussion Questions which seem most appropriate for personal reflection . There is one question based on each chapter.
Notes, which are chapter specific
An extensive Bibliography
An Index
Brief Author bio

Jeff Spiess, M.D.

Dr. Spiess started in medicine as an oncologist, cancer specialist, then transitioned into palliative and end-of-life care as director of a hospice. His website, https://drjeffspiess.com/, offers a complete bio, audio interviews, his blog posts, social media links, and form to join his email list.

exploring the HEART of life and death

Dr. Aletha

Lightstock-quality photos and graphics site- here.

(This is an affiliate link)

a review of Driving Miss Norma

By Tim Bauerschmidt and Ramie Liddle

When I first reviewed this book the tag line was

One Family’s Journey Saying “Yes” to Living

the most recent edition now calls it

An Inspirational Story About What Really Matters at the End of Life

And it’s both of those. When faced with death, Norma chose living. And in doing so, she and her family learned what really matters at the end. Through this book, they share what they learned with us.

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book. I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel trailer they parked in campgrounds and Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon — Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States — Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

Continue to follow Norma’s family at the web site Driving Miss Norma

sharing the HEART of living well

I hope you enjoyed this look at Norma’s book and will share this post on the social sites you meet up with friends. Please check out some of my other book reviews. Links are in the menu on the side bar (may be below if on a phone or tablet).Or just search.