#realistically. no. but in my fantasy world i nurse him back to health and we get ice cream and go to sesame place

[newagevictorianorphan]

i could be a good mother…

[autumnslance]

Character Meme: Haurchefant! (If Haurchefant has been done already, Foulques!)

I'll do both! Starting with Our Pal:

Give me a character and I’ll break them down:

HAURCHEFANT

How I feel about this character:

The truest of friends, bestest of bros, and someone who truly saw and believed in the WoL. Perhaps a bit of hero worship, but it came from a genuine place.

I didn't make much note of him at first--my very first run of Central Coerthas in ARR was frustration at Ishgardian nonsense and the experience point gap that existed at the time; I was having a rough go of things. Haurchefant doesn't even figure into any cutscene moments at that point. The patches and HW itself very quickly fixed that and made him a figure to pay attention to, when he was so genuinely pleased to see the WoL and help them out again.

All the people I ship romantically with this character:

Warrior of Light. All of us.

My non-romantic OTP for this character:

His friendship with Francel is so important to everything that makes him who he is by the time we meet him.

His interactions with his family are fascinating to think about and we only get glimpses.

I love the idea Haurchefant, Estinien, and Aymeric are all friends even before the WoL gets involved; the trio all have various things in common, and two of them at least are personable enough to make it work (and drag Estinien along while he tries to pretend to not enjoy himself).

My unpopular opinion about this character:

He's much more than hot cocoa and unrelenting cheer.

His death was one of the few well-written and presented and timed ones. The narrative elements work, much as it hurts--it's a good reason why it hurts still, actually, in a different way than other characters with clumsier demises we still get angry about.

One thing I wish would happen / had happened with this character in canon:

More interactions with the family and Francel in HW. More seeing some of his rougher side, his anger, how he deals with it to fuel his kindness and compassion.

---

FOULQUES

How I feel about this character:

A tragedy showing some of the ugliest sides of Gridania; all the city-states have their flaws but oh boy...

He deserved a second chance, and was denied it. He'd internalized the wrong lessons about strength and courage, fundamentally misunderstanding them in his search for understanding and meaning, only frustrating himself further.

He could have been better helped, but while Ywain meant well, his own blindspots in how the city-state's bigotry shaped Foulques and his situation kept the guildmaster from really knowing how to, and led to things escalating.

All the people I ship romantically with this character:

I really don't have any, though I've seen good OC/Foulques ships out there, rare though they are.

My non-romantic OTP for this character:

His rivalry and almost-friendship with the WoL came close; we tried to help.

My unpopular opinion about this character:

Given the story they present for Gridania, Foulques' tragic tale is a mirror to the Archer story, where we deal with the bigotry from another angle. Foulques is the result of what nearly happens to Leih and Silvairre, had their stories turned out a touch differently at various points. Given the presentation of Gridania, both guild stories are needed to paint the picture of how ingrained the awful view points are, to where even good people like Ywain and Luciane are stymied by the way it's shaped them.

OTOH I'm tired of fantasy stories making clumsy attempts at giving us transparent allegories for real world bigotry when the writers have similar blindspots as the characters, and often feel like they "have to" add it to stories to be "realistic" because people can't imagine a world without the same kinds of prejudices we deal with in reality--and that some people may really want or need to escape it, not see a coat of paint tossed over what some outside perspective thinks their lived experiences look like. Especially when it's as heavy-handed as it is in early Gridania.

There are other ways to create conflict that don't involve making the traditionally darker skinned groups purposefully oppressed second class citizens--and then ignoring that aspect of the story for a decade because you've made the leaders we regularly interact with entirely oblivious to and ignorant of it.

One thing I wish would happen / had happened with this character in canon:

That we had been able to help him and Ywain reach an understanding--it felt like communication was passing each other, not connecting--and actually helped him, not have him, out of so many other class NPCs, die; even villains like Doesmaga don't get the treatment Foulques did!

That if he does have to be the class NPC that dies, it's a better one than getting freaked out and falling off a cliff. Or that we could have learned later that he didn't die after all, that someone found him, nursed him back to health, showed him genuine kindness, and then he coulda shown up in the HW or StB DRG quests to help us out, a changed man.

[ryanmeft]

Alpha Movie Review

I’m always in for any story that gives me a bit of obscure history, no matter how fictional. If that story is going to jump back to prehistoric days in an age when most people seem to think the world began with their birth? And involve an entire invented language for the sake of authenticity? And recreate such a forgotten age with as few concessions to romantic fantasy as possible? Well, it’s going to ring not a few of my nerd bells. If none of that interests you, the movie also has dogs.

In 20,000 BC, in an unrecognizable Europe during the ice age, a group of human hunters approach a herd of bison, slowly, on their stomachs. The bison realize their danger and charge. There is a face-off, and Keda (Kodi Smit-McPhee), son of the tribe’s chief Tau (Johannes Haukur Johannesson), is thrown off a cliff. This shot is inflicted with the curse of slow-motion, and I worried this would be a film that does not have the courage in its shots to present them unadorned. Fortunately, this is one of only two scenes with any kind of unnecessary gimmickry thrown in; most of the movie is stark and direct, as life in those times would have been. Keda survives the initial fall but loses his grip and ends up unconscious on a jutting piece of stone halfway up the sheer cliff face.

Two hundred centuries later, we can get in our cars at the top of such an imposing edifice and be at the bottom 20 minutes later, safe and sound. The film makes it seem like Keda has been thrown into another world. He has. His father and tribe have no choice but to leave him for dead. Johannesson is not in most of the film, but his reaction here is crucial, as the stoic chief, distraught, has to be prevented from suicidally climbing down after his son. Another tribesman comforts him with kindness, assuring him their sons (his had died before the movie began) will walk together in the afterlife. It is an unfortunate tendency of the modern world that we seem to believe it was only recently that people began caring for their families, and that not so long ago children were glorified crop pickers. We can’t know for sure how paleolithic man behaved, but things like caves and graves have yielded proof that social bonds were important. Keda, to this point, has not been great at hunting, and cannot bring himself to kill wounded animals, but there are no cliche villains, insisting they forget about the useless child. They are reluctant to tear Tau away from the cliff face for an entire night.

It’s that sort of heart that lets the film win you over, well before the promised canine connections come into play. On posters, the movie bills itself as an origin story of the buddy system between dogs and humans. It is, of course, likely to be largely fictional in that regard. The boy wakes, high on the cliff, and tries to climb down but ends up dangling with nowhere to go. A torrential rainstorm turns the valley into a temporary river, a regular occurrence in the days before dams, and he is swept in, waking up in an unfamiliar wilderness. Full disclosure: I’m an absolute sucker for things like this. My earliest experience with epics was a video game where the characters are separated and lost multiple times, and I liked Pixar’s The Good DInosaur much more than you did, in part because it involved a character lost somewhere in nowhere. The boy sleeps in trees to avoid predators, and eats insects and plants. It is the stuff of ordinary survival. The camera work of Martin Gschlacht rarely announces itself, letting us vanish into an ancient world rather then reminding us there is a man filming there. And then the wolves come.

Mythology has long fascinated me, and the wolf has probably been a supporting character in more myths, across more of the world, than any other animal. As I watched, my mind began to cast the story into legend. It went something like this: Once, long ago when the mammoth walked and the world was cold, a boy became lost. He was attacked by wolf, but he wounded him. Yet boy did not kill wolf. Boy nursed wolf back to health, and wolf walked with boy, who was now Man. Man and dog have been walking together since. The actual process was probably slow and took many generations of men and wolves, but that’s not as exciting. Keda and the wolf, who he names Alpha, slowly develop a bond. Director Albert Hughes (From Hell, The Book of Eli), who works from his own story, and screenwriter Daniele Sebastian Wiedenhaupt cannot resist nodding at us. Knowing smiles will result when Keda angrily throws a stick at Alpha, and Alpha picks it up. These things take time, though, and many snarls and an attack attempt or two from the wounded wolf.

The movie is patient and, realistically, lacks any place for significant female roles (Natassia Malthe and Leonor Varela have small parts as, respectively, Keda’s mother Rho and a shaman, the latter of which would have been more likely in the days before civilization decided a woman was best silent). This almost guarantees it will not be a financial success in an era when there are only a few ways to effectively market a movie. Alpha bucks all of them; despite the ads making it seem like a studio project, it is an effort that real people wanted to see happen, and believed in. Those there because they love dogs may not care about the craft and detail that went in. If you’re more inclined to do so, notice the people’s clothing. It lacks serious bling, but neither is it a haphazard collection of hides and furs, thrown together. Each layer appears to serve a function. The world, which is really various Canadian and Icelandic locations with a few sets, is so empty and at times still the silence might drive modern man, used to incessant and needless noise, mad. Yet the most astounding technical feat is the creation of a fictional language. There’s not a speck of English or any other modern vocabulary in the film. Instead, the characters speak something based on the languages that eventually diversified into those of Europe and India, constructed by University of British Columbia professor Christine Schreyer. It seems like “Best Invented Language” is a bit too niche to have an Oscar category, but Schreyer’s efforts make a strong case for it. Do not expect cliche grunts and groans from an old caveman cartoon, for every sound uttered sounds like a real word that means something, and patterns are repeated just like a living language, so after a time we stop noticing we’re reading subtitles. Similarly, the characters do not jump up and down or shout as a matter of common practice. You will find no prehistoric cliches in this movie.

The acting comes down, since he is alone except for the wolf for most of the movie, to Smit-Mcphee. None of the previous roles I’ve seen him in have suggested whether he could handle such a subtle and unusual role. He can. Though he has a language to speak, this was long before the days in which men wrote sonnets and novels, and even for a sensitive lad he sticks to the basics: what he needs, where he has to go, that sort of thing. The entire absence of humor or levity among the hunters struck me as odd, since knowing anything about people suggests we’ve always liked a good laugh, but it is a minor quibble. McPhee handles Keda’s journey perfectly. He and Alpha learn to hunt, but at no point does he become someone who kills as second nature. At the end of the journey, he is still himself, but a wiser version of himself. That journey can be appreciated if you simply like dogs. It can be appreciated more if you have fondness for history and myth, and old-fashioned adventure stories.

Verdict: Highly Recommended

Note: I don’t use stars, but here are my possible verdicts. I suppose you could consider each one as adding a star.

Must-See

Highly Recommended

Recommended

Average

Not Recommended

Avoid like the Plague

 You can follow Ryan's reviews on Facebook here:

https://www.facebook.com/ryanmeftmovies/

 Or his tweets here:

https://twitter.com/RyanmEft

All images are property of the people what own the movie.

[usashirtstoday]

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Syndication service later onand Mr Jack Douglas who produced Johnand Yoko Ono’s current album double fantasy who was with Johnand Yoko shortly before his tragic death here in New York last night I would be right back to run the 1975 interview with John Lennon after these announcementsand I hope that you will stay with us we back in about two minutesand seconds John Lennon in a Best Dad Bod Ever Since 1965 Vintage Father T Shirt little bit later on in the program will talk about the possibility of us having to leave the United Statesand at that time his attorney Mr Leon Wilds will join us to make certain that John or I make no mistakes in the legalities but I welcome you hereand I’m glad that you’re here as I said at the outset the back in 1964 by after the cataclysmic arrival of the Beatles here in the United Statesand the great popularity had on the Ed Sullivan programand others there were many people who did not really understand what you were doingand and they thought then that your hair was longand that you looked might. They can escalated to a vaccine invention so is very important that we resist this mashup not only is truth on our side the Constitution and the law on our side but logic and common sense is on our side and a lot more people out there that are frustrated with this mask shipping you think they just don’t know the lawn he don’t have the intimate knowledge about what’s really being done to us like we do there pushing the coalition shut the schools down and the church is why because schools and churches aware boating happens if they can shut down a bolt of the polling places guess what happens mail in voting Horowitz study of our thousand hundred UK schools show very little evidence that the virus is transmitted in school you know why because everybody has tested positive is asymptomatic the CDC and the World Health Organization already said asymptomatic people do not get the do not. Like John Snow Amy’s motivation is drivenand the nonsense in the service of keeping him sympathetic relative to Dragon Lady bad we know what kind of a guy Jamie is based on his actions so for him to say even really giving us a why only serves as a cheap twist surprising but not unexpected isn’t it after all he’s explaining his motivation with wordsand motivations are explained with words that means a defect to make telling the audience the thing makes sense with your dialogue while not supporting the thing with the characters actions is kind of the trends in the last season game of thrones Thursday one of the greatest villains not just in TV history but arguably all of literature she she didn’t have much to do battyand there did she all of tearyand stupid mistakesand wildly out of characterand unmotivated sudden trust in his evil sister serve the purpose of keeping Circe in the game optional remember I chose to help promises or assurances which feels even more insulting given that Circe closed lowing up that faces no consequences nor has a secret evil plan beyond staring on a balconyand glowering over my domain with a glass of wine which I get it that’s my usual Friday night but all she in season eight is a scene of the thing was not to be the most in the show makes Circe sympathetic but it’s like in the most condescending way possible be characters somehow just go she just got he says come when the plot says so Circe’s armies instantly crumbleand she dies a weirdly sympathetic death in Jamie’s arms who is here for some reason in a rocks fall everyone dies situation that feels more on par would like a your Disney movie is in line with someone who once said how or how this is important to look at Circe for who she is presented as a monarchand what the show built her up to be before dinner is torched King’s Landing elements multivitamin will take off the big thing hereand I mean big scene as a defining actionand Circe’s rule is are effectively blowing up the in universe equivalent of the Vatican as a means to wipe out her enemiesand flex on how many foxy gives which is zero is the scene was awesomeand yes it feels like something someone as recklessand vengeful as Circe would do when pushed to the editor Brink but prior to season for most of the plot of game of thrones is centered around the direct consequences of one guy Ned start getting his head lopped offand what pretty much everyone who wasn’t a child who ordered it even Circe felt was a massive dick move meanwhile postseason six Circe not only blew up one of the largest buildings in West Rosen wiped out a decent chunk of the faithand its leader but also decimated one of the most powerful wealthyand well liked familiesand mistress with a lot of loyal Bannermanand apart from a few stray remarks from other characters you sister this major act of mass violence just kind we just move on it nobody cares there are no consequences for this she is crownedand life goes on the only person opposing her is Dragon lady who would have invaded no matter who is on the throne so let’s break this down why in God’s name when they set up Circe finally exacting revenge on the faceless masses that through literal feces on her during the walk of shameand weeding out religious extremism with impunity only to conveniently forget the internal logic of much smaller scale political issues like that starts execution causing massive upheaval dimension again wasting someone likely entities talent’s well here is why because of how season eightand this one act necessitates that yes Circe would be considered an unparalleled top tier Megatron grade tyrant she couldn’t have wiped out all of the faith militant or even most of them let alone the countless followers of the seven in West Rose who would feel understandably very pissedand personally attacked by this maneuver is also to say nothing of all people who saw her as 100 illegitimate or believe that her children were inbred pastors or who would want revenge on her for what she did the house Tyrell to the dumb dumb throated juicy situation which in theory could have led to some of the best acting from one of the most talented players but the problem here is that it would have revealed her as a tyrant leading to a situation where literally anyone with a claim to the throne would be looked upon by the people attend landing as a liberator which leads us to the person who at least far as everyone knows has the best claim to the throneand wouldn’t you know it has already defined herself as a liberator so Dragon lady shows up writing some dragons like okay hi I’m here to liberate y’all on the breaker of chains love me please it’s fair to say that DD created a situation where I actually does a pretty great for the small book of Kings Landingand the vast vast majority of the nobles who already support herand pretty much everyone who is in the iron Bank of bravos to whom the Lancers a lot of money can count on the back support our students to go should they wrote a situation where there’s no way Circe would be able to maintain power after her move with the septic without being a complete totalitarian who stomps out dissent before it even manifests she created a situation where she had no choiceand she is a personality to relish that sort of thing like oh God yes revenge please I live for thisand I remember the face of every peasant who flung shit at meand I will pull each of their fingernails out myselfand on a related note you really expect me to think alike Circe’s good I like be upset that the nurses murdering that the innocence of Kings Landing after what they did to her she should be like go girl so the only way to deal with the fallout of Circe’s actions while still barreling full steam ahead to this predetermined ending is to ignore them altogether the show must maintain that the people of Kings Landingand help greater West Rose are never affected by their monarchand that they don’t care that social trends do not apply to the rabble or the common folk even though that was a huge chunk of the Kings Landing plot for seasons six that yes the machinations of the powerful do have effectand politically savvy nobles like Marjorie Tyrell have sound methodsand this development in later seasons especially with Circe kill me because what set game of thrones apart for the first few seasons was how it was so conscious of the house that intrigues a magical or otherwise have realistic consequences that affect not only the lives of the major characters but also the culture of the world itself like in season seven during the latrine attack dinners recklessly burns all that food from the reach that surely should have some consequences right may be set up a touch of the old starvation but like the destruction of the set they wrote a situation that should have had consequences but didn’t that the existence of a gun create a situation where it makes perfect sense not only for the people of West rest to reject an heiress for her own sense of entitlement to make her descent into power up session makes sense only based on the situation but also based on the character that we know unfortunately that is not the situation at the Chapel Road facility with the nearest nurse came to power effectively from nothing not only because of an important nameand some dragons but because people believed in her once so it was like the service provider leaving with whom I know a lot of people problematic writing or no sacrifice a lot because they believed what she believed this isand then she went some more crimesand you didn’t even see it coming because she pretty don’t you feel stupid

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[yes-dal456]

Efforts To Prolong My Husband's Life Cost Him An Easy Death

For the past seven months, I’ve carried around my husband’s advance medical directive in my purse. During this time, I’ve shown this lawyer-prepared and notarized document to dozens of doctors, nurses, ambulance crews, surgeons, dialysis center teams, hospital emergency room workers and administrators, intake staff, nurse practitioners, nursing home staff, medical transportation drivers, and others. I’m an expert in summarizing its contents, and my 11-second elevator pitch goes like this: Do not resuscitate. No heroic measures. A gentle and peaceful death, pain-free and with dignity. Please.

After my husband was diagnosed with end-stage renal failure, we talked about how he didn’t want to be a burden to his family, how much he hated hospitals and getting poked and prodded by doctors. We talked about how his 81 years had been full of love and laughter, being a great dad and loving his work. He noted how even his much-beloved Cubbies had finally delivered him a World Series title, and he joked that he could “now die a happy man.” 

Death, we agreed, was a natural consequence of life and not something to be feared. And so we prepared the legal documents that were intended to give him control over the end of his life.

A fat lot of good it did us. On Jan. 4, my husband died, and I threw his advance medical directive into the fireplace. It worked better as a fire starter than it did as it was originally intended.

We simply had no clue that dying and medicine, as it is commonly practiced, exist at cross purposes. And in my husband’s case, the engine of life-prolonging medicine decisively won.

End-of-life care is a pot of gold in our modern medical system. Spending on Medicare beneficiaries in their last year of life accounts for about 25 percent of all Medicare spending. In 2011, Medicare spending was almost $554 billion ― 28 percent of which was spent during patients’ last six months of life, according to Kaiser Health News.

But when it comes to death and dying, this spending isn’t always in the genuine best interest of the patient. As Forbes reported, a study published in the Archives of Internal Medicine asked if a better quality of death occurs when end-of-life medical spending rises. The short answer: Quite the opposite happens. The study, which considered factors like adequate management of pain and symptoms, found that the less money that’s spent in this time period on medical interventions, the better the death experience was for the patient and their family.

Despite studies like these, many health care practitioners have a view that extending life ― at any cost ― is preferable to death. They are trained to perform every possible diagnostic test, and treat every symptom with whatever is in their arsenal. Some experts in palliative care go so far as to say the U.S. has a “death-defying” culture. Slogans like “conquer cancer,” “cheat death” and “beat the disease” shape our expectations. Education in palliative care is offered in nearly all U.S. medical schools, but it is most often a brief portion of a course with a larger focus. The average total instruction on death and dying for would-be doctors is a mere 17 hours in the four-year curriculum, according to one study. 

But this avoidance doesn’t change one undeniable truth: We all will die. 

In the last 24 hours of his life, my husband ― lucid and alert ― had the following done to him: An IV was stuck in his jugular vein when another vein couldn’t be found. He was rushed by ambulance to the emergency room, where he spent seven hours before being admitted to the ICU. He was treated for bedsores on his back, his behind and his legs ― all developed in a nursing home with a staff that failed to turn him over to prevent them. His arm oozed fluids through cracks in his skin that soaked his shirt and stunned our children. He had blood drawn repeatedly through veins that nurses struggled to tap ― more try-and-fail needle jabs than I could bear to witness. He was denied food and water for at least 24 hours as a procedural precaution.

And the coup de grace: Once admitted to the ICU, he was rushed into a five-hour emergency surgery that left him with a colostomy bag and on a ventilator. His heart stopped for about a minute during the “pretty eventful” surgery, said the doctor who called me at 3:30 a.m. to tell me that my husband was in recovery and stable.

But my husband never woke up. He remained sedated until his heart beat for the final time at 10:38 a.m. ― seven hours and tens of thousands of dollars later.

I am bereft. I am grieving. And I am working hard to understand why medical teams feel they must chase life so relentlessly.

Nobody wants to use the “D” word.

Medical good intentions notwithstanding, prolonging death is not the same as extending life. Death isn’t the boogeyman; turning the dying process into a torturous experience is. And yet the medical establishment just can’t seem to help itself when it comes to dying.

Nobody wants to use the “D” word. When my husband and I met with the “compassionate care” team in his nursing home days before his death, I was corrected when I called it a “hospice” meeting. Besides, I was told, hospice is the “treatment plan” you choose when your “health care goal” is to accept that you will not recover and you merely want to be kept comfortable and emotionally supported. I rolled my eyes.

“We know that your insurance won’t pay for your nursing home anymore,” the compassionate care team nurse told him, “but we don’t want that to be a factor in any decisions you make.”

Really? Why the hell not? I bit my tongue before asking who exactly she thought would pay for his medical care, since insurance had denied his claim. She was giving him permission to bankrupt his family, robbing his children of their college funds and his wife of her retirement ― and for what quality of life? Our current medical system operates under the assumption that we should thwart death, no matter the consequences. So don’t let money be a factor in any decisions you make, she told him. 

Prolonging death is not the same as extending life. Death isn’t the boogeyman; turning the dying process into a torturous experience is.

When they asked my husband what his health goals were, he ― who spent three days a week hooked up to a kidney dialysis machine, had a failing heart despite seven bypasses and was unable to walk, dress himself, or get out of bed without three people helping ―  told them he wanted to go home. It’s a goal the whole family prayed for. But without 24/7 home health care assistance, that was about as realistic a health goal as me saying I was going to run the Boston Marathon tomorrow. Still, the compassionate care team wrote it down, as if it were a legitimate option. 

A few days later, his doctors said he needed an emergency five-hour colon surgery to rid his body of sepsis. Buoyed by a false sense of hope about going home, he uttered the words that are music to the medical establishment’s ears: “I want to live.” 

I get it. I really do. You can’t blame a guy for changing his mind. And certainly his words trumped a document prepared months earlier. Decisions made in the abstract may not feel so spot-on in real time.

But I also know that my husband was prodded to that point by a medical system that charts death as a failure ― when in fact, a good death should be considered an inalienable right.

As Atul Gawande wrote of one of his patients in Being Mortal: Medicine and What Matters in the End, my husband “pursu[ed] little more than a fantasy at the risk of a prolonged and terrible death — which was precisely what he got.”

I don’t blame my husband one iota. I love him. I love that he wanted to come home to us. He was brave and honest and true to the end. What he wasn’t was protected from a medical team trained to push him into life-prolonging surgeries and procedures, even when those actions would prolong pain and prevent a gentle death. And he certainly wasn’t protected by the worthless piece of paper I had put so much stock in.

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[imreviewblog]

Efforts To Prolong My Husband's Life Cost Him An Easy Death

For the past seven months, I’ve carried around my husband’s advance medical directive in my purse. During this time, I’ve shown this lawyer-prepared and notarized document to dozens of doctors, nurses, ambulance crews, surgeons, dialysis center teams, hospital emergency room workers and administrators, intake staff, nurse practitioners, nursing home staff, medical transportation drivers, and others. I’m an expert in summarizing its contents, and my 11-second elevator pitch goes like this: Do not resuscitate. No heroic measures. A gentle and peaceful death, pain-free and with dignity. Please.

After my husband was diagnosed with end-stage renal failure, we talked about how he didn’t want to be a burden to his family, how much he hated hospitals and getting poked and prodded by doctors. We talked about how his 81 years had been full of love and laughter, being a great dad and loving his work. He noted how even his much-beloved Cubbies had finally delivered him a World Series title, and he joked that he could “now die a happy man.” 

Death, we agreed, was a natural consequence of life and not something to be feared. And so we prepared the legal documents that were intended to give him control over the end of his life.

A fat lot of good it did us. On Jan. 4, my husband died, and I threw his advance medical directive into the fireplace. It worked better as a fire starter than it did as it was originally intended.

We simply had no clue that dying and medicine, as it is commonly practiced, exist at cross purposes. And in my husband’s case, the engine of life-prolonging medicine decisively won.

End-of-life care is a pot of gold in our modern medical system. Spending on Medicare beneficiaries in their last year of life accounts for about 25 percent of all Medicare spending. In 2011, Medicare spending was almost $554 billion ― 28 percent of which was spent during patients’ last six months of life, according to Kaiser Health News.

But when it comes to death and dying, this spending isn’t always in the genuine best interest of the patient. As Forbes reported, a study published in the Archives of Internal Medicine asked if a better quality of death occurs when end-of-life medical spending rises. The short answer: Quite the opposite happens. The study, which considered factors like adequate management of pain and symptoms, found that the less money that’s spent in this time period on medical interventions, the better the death experience was for the patient and their family.

Despite studies like these, many health care practitioners have a view that extending life ― at any cost ― is preferable to death. They are trained to perform every possible diagnostic test, and treat every symptom with whatever is in their arsenal. Some experts in palliative care go so far as to say the U.S. has a “death-defying” culture. Slogans like “conquer cancer,” “cheat death” and “beat the disease” shape our expectations. Education in palliative care is offered in nearly all U.S. medical schools, but it is most often a brief portion of a course with a larger focus. The average total instruction on death and dying for would-be doctors is a mere 17 hours in the four-year curriculum, according to one study. 

But this avoidance doesn’t change one undeniable truth: We all will die. 

In the last 24 hours of his life, my husband ― lucid and alert ― had the following done to him: An IV was stuck in his jugular vein when another vein couldn’t be found. He was rushed by ambulance to the emergency room, where he spent seven hours before being admitted to the ICU. He was treated for bedsores on his back, his behind and his legs ― all developed in a nursing home with a staff that failed to turn him over to prevent them. His arm oozed fluids through cracks in his skin that soaked his shirt and stunned our children. He had blood drawn repeatedly through veins that nurses struggled to tap ― more try-and-fail needle jabs than I could bear to witness. He was denied food and water for at least 24 hours as a procedural precaution.

And the coup de grace: Once admitted to the ICU, he was rushed into a five-hour emergency surgery that left him with a colostomy bag and on a ventilator. His heart stopped for about a minute during the “pretty eventful” surgery, said the doctor who called me at 3:30 a.m. to tell me that my husband was in recovery and stable.

But my husband never woke up. He remained sedated until his heart beat for the final time at 10:38 a.m. ― seven hours and tens of thousands of dollars later.

I am bereft. I am grieving. And I am working hard to understand why medical teams feel they must chase life so relentlessly.

Nobody wants to use the “D” word.

Medical good intentions notwithstanding, prolonging death is not the same as extending life. Death isn’t the boogeyman; turning the dying process into a torturous experience is. And yet the medical establishment just can’t seem to help itself when it comes to dying.

Nobody wants to use the “D” word. When my husband and I met with the “compassionate care” team in his nursing home days before his death, I was corrected when I called it a “hospice” meeting. Besides, I was told, hospice is the “treatment plan” you choose when your “health care goal” is to accept that you will not recover and you merely want to be kept comfortable and emotionally supported. I rolled my eyes.

“We know that your insurance won’t pay for your nursing home anymore,” the compassionate care team nurse told him, “but we don’t want that to be a factor in any decisions you make.”

Really? Why the hell not? I bit my tongue before asking who exactly she thought would pay for his medical care, since insurance had denied his claim. She was giving him permission to bankrupt his family, robbing his children of their college funds and his wife of her retirement ― and for what quality of life? Our current medical system operates under the assumption that we should thwart death, no matter the consequences. So don’t let money be a factor in any decisions you make, she told him. 

Prolonging death is not the same as extending life. Death isn’t the boogeyman; turning the dying process into a torturous experience is.

When they asked my husband what his health goals were, he ― who spent three days a week hooked up to a kidney dialysis machine, had a failing heart despite seven bypasses and was unable to walk, dress himself, or get out of bed without three people helping ―  told them he wanted to go home. It’s a goal the whole family prayed for. But without 24/7 home health care assistance, that was about as realistic a health goal as me saying I was going to run the Boston Marathon tomorrow. Still, the compassionate care team wrote it down, as if it were a legitimate option. 

A few days later, his doctors said he needed an emergency five-hour colon surgery to rid his body of sepsis. Buoyed by a false sense of hope about going home, he uttered the words that are music to the medical establishment’s ears: “I want to live.” 

I get it. I really do. You can’t blame a guy for changing his mind. And certainly his words trumped a document prepared months earlier. Decisions made in the abstract may not feel so spot-on in real time.

But I also know that my husband was prodded to that point by a medical system that charts death as a failure ― when in fact, a good death should be considered an inalienable right.

As Atul Gawande wrote of one of his patients in Being Mortal: Medicine and What Matters in the End, my husband “pursu[ed] little more than a fantasy at the risk of a prolonged and terrible death — which was precisely what he got.”

I don’t blame my husband one iota. I love him. I love that he wanted to come home to us. He was brave and honest and true to the end. What he wasn’t was protected from a medical team trained to push him into life-prolonging surgeries and procedures, even when those actions would prolong pain and prevent a gentle death. And he certainly wasn’t protected by the worthless piece of paper I had put so much stock in.

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from Healthy Living - The Huffington Post http://huff.to/2kncykp