Wednesday, August 15, 2012

Tattoos, Hospice Nurses & Competing Wolves


I’m just discovering the blog at hospicediary.org, written by Amy Getter, a hospice nurse in Seattle. I was drawn to it by her Twitter exchange with physician Alex Smith following his blog post at GeriPal.org.
Smith writes about people getting DNR chest tattoos -- to make as unmistakable as possible their wishes against resuscitation measures. The advance directive could not be clearer, it would seem, or more certain to accompany the person, than when indelibly imprinted upon one’s chest.

In response, Getter tweeted: “I know a woman who attempted suicide and wrote no code on her chest, she was resuscitated anyway when found. Who decides?” 

“Who decides?” is a timely question, in light of recent consideration in JAMA and elsewhere of whether CPR, so rarely successful and so often brutal, should cease to be automatic.

Hospice nurses have a unique perspective into contemporary quandaries in end of life care, and so I was glad to discover her blog. Getter blogs insightfully and compassionately about the realities of caring for the dying at hospicediary.org.

I was rewarded with this gem:

An old Cherokee, teaching his grandson about life, said: "A fight is going on inside me, It is a terrible fight and it is between two wolves. One is evil -- he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority and ego. The other is good -- he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion and faith. The same fight is going on inside you and inside every other person too.”

The grandson asked in reply: “Which of the two wolves will win?"

The grandfather answered: "The one you feed."



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