Kelowna health forum addresses uncomfortable topic of death and dying
What's your chocolate ice cream?
The question, posed by Dr. Carole Robinson, initially seemed out of place when asked during a health forum—focused on death and dying—at UBCO Saturday.
Robinson began her speech by reminding the crowd that children tend to fight.
"When you get sick, that invites (children) to fight. They're anxious, they're stressed and each thinks they know you best," said Robinson.
"I'm going to ask you to think about, in advance, what your wishes are and to give direction to your children. It will help them not fight."
She told a story about Dr. Susan Block, co-director of the Harvard Centre for Palliative Care.
Years ago, Block's father was admitted to a San Francisco hospital. He had symptoms that were diagnosed as being related to a tumour that was growing on his spinal cord in his neck.
The night before her father's surgery, Block tried to avoid talking about the operation. She left the hospital that evening after the two had a more general conversation about family and friends.
"She'd been named his proxy decision-maker. What that means is she had been designated the person who would speak for him, if he couldn't speak for himself.
"She got halfway across the Bay Bridge and she realized that she didn't know what her dad wanted."
Block turned around and went back to the hospital.
Robinson explained it was uncomfortable for Block to go back, and when she did she had an "agonizing conversation with her dad."
She asked him questions about what was most important to him to be alive, what he was willing to tolerate to be alive and what level of being alive was important to him.
"The answer he gave her knocked her socks off.
"He said, 'As long as I can eat chocolate ice cream and I can watch football on TV, I'm willing to endure a lot of pain for a good shot at that."
Robinson said Block had never seen her father watch football, despite the fact they had a close a relationship.
"It teaches us we can't assume to know what is most important, even for the people we love dearly."
Block's father made it through the surgery, but he was bleeding into his spinal cord and more surgery was required to save him.
His future looked grim, but rather than make up her own mind, Block asked the doctors whether her dad would be able to eat chocolate ice cream and watch football if he survived.
The answer was yes, so she gave them the green light.
Her father had a difficult recovery, but he went on to live 10 more years. During that time he wrote two books and 12 scholarly articles, and watched plenty of football while eating chocolate ice cream.
Robinson said Block didn't have to make the decision, because her father did; therefore, she didn't have to live with any guilt.
"If you do nothing other than this one thing when you leave this room, I want you to figure out what your chocolate ice cream is. Then I would like you to start a conversation with your family—give them direction, it will strengthen the bonds, disrupt the fighting and relieve the burden."
Saturday's forum was the fifth in a health series that has been offered by Kelowna-Lake Country MLA Norm Letnick since last year.
He said the topic of death and dying is one of interest to him, noting he's had experience trying to comfort close friends who knew their days were numbered.
"Maybe by sharing some questions and answers, we can be better prepared for when, eventually, we all die," said Letnick.
Letnick was joined by Robinson and Drs. Barbara Pesut, Hal Siden and Kelowna lawyer Ross Langford.
Pesut spoke about what death looks like.
"Conversations about death and dying are very difficult, but necessary," said Pesut.
She talked about ways people can have "a good death."
The first was impeccable symptom management.
"It's not uncommon to have difficult symptoms at the end of life: Pain, breathlessness, nausea and vomiting. Our goal is to try and anticipate what those symptoms might be and manage them as much as possible."
Pesut said it's also important to give the dying individual plenty of support, as much control and choice as possible, dignity and privacy, and final wishes.