Friday, October 30, 2015

THE CEPHALOPOD COFFEEHOUSE: IN THE MIDST OF LIFE BY JENNIFER WORTH

Gentle Readers . . . and Maxwell,

It's time for The Cephalopod Coffeehouse, hosted by The Armchair Squid.



The idea is simple: On the last Friday of each month, post about the best book you've finished over the past month while visiting other bloggers doing the same.  In this way, we'll all have the opportunity to share our thoughts with other enthusiastic readers.

My book for October is In the Midst of Life by Jennifer Worth. Some of you might recall that Jennifer Worth was the nurse/midwife whose memoirs became the background for the popular show we in the U.S. can see on PBS: Call the Midwife.

In the Midst of Life is Worth's final book. As a midwife, Worth assisted mothers and babies at the beginning of life. Later, as a nurse and ward sister in various hospitals, Worth assisted many patients at the end of life.





The focus of Worth's final book is one that's dear to my heart: that is, doctors and families interfere when patients approach death, instead of allowing for a natural death.

What Worth describes as "modern medicine" often prolongs life unnecessarily, and causes the dying untold suffering. She recalls her grandfather's natural death. The family did not call the doctor until her grandfather passed away--that outcome typical of the time period. He died in 1956.

How the world of medicine changed, as Worth documents in her descriptions of many cases:

A catheter was in place all the time, and this avoided incontinence of urine, which would have made the bedsores worse, but it had to be changed every few days, and kept clean, which was unpleasant and possibly embarrassing for Dr. Hyem. Unless we cleaned his mouth every two hours with glycerine, his tongue became so dry that the skin peeled off, and ribbons of grey, stringy stuff could be pulled from his throat. 

The doctors saw none of this. Junior doctors sometimes get an idea of the suffering and humiliation that patients endure, and what nurses do, but a consultant seldom does. The more senior a doctor, the less he knows of the unpleasant details. . . . 

Dr. Hyem died peacefully, five weeks after a successful resuscitation from cardiac failure.

I don't provide all of Worth's details regarding the patient's suffering, but as you can see from Worth's description, the man died, was resuscitated, and suffered horribly for several weeks, when the doctors finally allowed him to die.

I feel great sympathy for dying patients whose doctors or families won't "let go." At the nursing home, we cared for a woman who had cancer. Her pain increased daily. Her family wouldn't allow an increase in her pain medication because they didn't want her to be groggy and unable to communicate with them. She finally died one evening after an assistant brushed her filthy teeth, an act that probably dislodged bacteria that went to her heart and lungs to kill her.

I understand if you don't want to know such details. I understand if you don't want to think about it. All I can tell you is that I have a DO NOT RESUSCITATE order in place. Willy Dunne Wooters and my children have strict instructions that no unusual measures will be taken to keep me alive, and that includes--especially--no feeding tube.

In the Midst of Life earns The Janie Junebug Seal of Highest Approval. I ordered it from The Book Depository in London. You can order the book through Amazon, but they'll get it from a third-party seller. They don't have it in stock.

I wish you self-education and beneficial reading with Jennifer Worth's book. I also hope you join The Cephalopod Coffeehouse. Please visit The Armchair Squid to sign up.


Infinities of love,

Janie Junebug



47 comments:

  1. I love her books. I'm sure this one is good, too. :)

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    1. Yes. She has such a lovely, simple style--straightforward and honest.

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  2. I don't understand how we as a society can let people languish and suffer endlessly before dying. When our pets are in pain and have no quality of life left we make the loving decision to put them to sleep. Why can we not euthanize our loved ones when the time comes. I for one believe in assisted suicide. It would be my choice.
    Michele at Angels Bark

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    1. I believe in assisted suicide, but so many ethical questions come into play. Some people move from assisted suicide to eugenics.

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  3. Janie, I agree with you. Nan had a DNR, my parents will have a DNR, and I will have a DNR. We all believed that if it is our time to go, we want to go and not suffer. I remember when Nan was diagnosed with cancer in July 2012. It came back, but it was caught too late and not much could be done for her. She was 89 and although the doctors suggested chemo, she said no because even with chemo, it didn't look good. She just said, "I want to live my final six months on my terms." She did and lived in beautifully. I remember when I worked at the center, someone who knew my grandmother said: "I just don't understand why she didn't prolong her life."

    I miss Nan terribly and while I do still wish she was here, remembering how she was before she died - out of breath, couldn't really walk without getting out of breath (she had lung cancer) - by the end her spirit wasn't there... not the way I knew her. I wouldn't wish that on anyone. While I do miss her, I still have her spirit and the memories within me.

    I think it truly is a touchy subject because no one really wants to think about this; no one wants to think of their loved ones dying. This is a great review and I will have to check this book out. Thanks, Janie!

    Love,
    Jessica

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    1. Thank you for sharing Nan's story with us, Jessica.

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  4. Hi, Janie! Jennifer Worth's book In The Midst of Life addresses an important topic. As a healthcare professional in a hospital setting, Mrs. Shady can testify about families that refuse to let go and insist on heroic end of life measures that are designed for their emotional comfort and not the welfare of the patient. Thank you for reviewing this enlightening book that deals with a sensitive subject.

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    1. The woman whose death I recounted had been sitting with her family not more than an hour before she died. She was in so much pain.

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  5. I started this series with the middle book, and moved heaven and earth to get the other two. As I started out in the forties, this theme of death is more familiar to me. How we die changed dramatically over my lifetime. When our doctor realized my father would be dying at home, my mother was asked to sign a release, which she, of course, refused to do.
    The series is a history of what was with stories of how many things yet should be.

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    1. I was pleased to discover The Book Depository. I love the TV show, but it's not as good as it was at first. I'm disappointed, too, by some of the details altered on the show, such as Chummy climbing the ship's ladder alone to take care of "the ship's woman," who didn't know she was pregnant.

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  6. When it's time to go, it's time to go. I don't want any unnatural means to be kept alive, either.

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    1. Exactly. It can be difficult for nurses to follow DNR orders because they are the ones who sit with the patients while they die.

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  7. After an operation 27 years ago (I...just...won't...let...it...go), I was told I couldn't go home until I "made water." Since a lot of action took place "down there" during the surgery which made the plumbing all swollen (temporarily, sadly), I wasn't able to pee. Then, the nurses threatened to put a catheter in if I couldn't "go."
    Within minutes, I was pissing like a racehorse.

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    1. Oh, men and catheters! A man's catheter must be removed in a certain way, or the removal is quite painful. I remember a nurse who pulled out a man's catheter. Just yanked it out. I suspect it was retribution because he was a difficult patient--no excuse!

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  8. My wife loves "Call the Midwife." It wasn't my cup of tea.

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    1. Trixie has started drinking quite a bit. Maybe it can be your glass of whiskey.

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  9. I'm going to tell my nurse daughter about this one. She is very much all for letting people go instead of prolonging what is probably not a good life. It's done for the family and not for the person dying.

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    1. Absolutely. I'm glad to know your daughter is a nurse. Working in healthcare can be quite rewarding.

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  10. I'm with you, Janie. I've discussed this exact thing with my family as well. No resuscitation, or artificial/ unusual measures to keep me alive. I've come to terms with the fact that I will die, and when I do, I want to go out on my own terms. What scares me is that one doesn't just die. That sometimes you might have to suffer for years, before death claims you. My family of course disagreed. They insisted on doing the exact opposite of my wishes (shaking my head).

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    1. People who don't respect the need to die should work with a multitude of suffering patients.

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  11. Not sure I want to read this book but I agree with everything you said.
    I also have a DNR already to go plus also the paper (?) that says that only one doctor is need for a sign off. Some states you need two, so you can get the one doctor who what to do everything in his power to keep you alive.
    After seeing my Watson die so peacefully with great dignity surrounded by all of us who adored him, that is what I want. It was great to have the vet come to our home and treat him with love and understanding.

    cheers, parsnip

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    1. What a good vet. My dogs have died in the vet's office. Dying at home is so much better.

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  12. Thanks for sharing this one Janie! It's never easy to let go of a beloved person, but it's fair to let them go when they need to. When my father became ill I was made his PoA, for medical and legal matters. He was afraid my mom would be too stressed to manage the care questions, and to do what he wanted done. He was adamant that he would not be put on a ventilator, and though we hoped he'd recover from the pneumonia that ravaged him, it did not happen. He had other co-morbidities, and had been an asbestos worker, so he knew that when his lungs went that would be it. It was hard, but he died with dignity, surrounded by his closest family members as we sang him to sleep, and prayed. He was in the ICU, where he had been sent before we learned that he would never be eligible for the transplant we hoped he'd get. When we learned he was terminal, it was days until the end. And they were good days, days of saying goodbye, and sharing love. We still miss him, but I know he was happy in the way he left this world. I can only wish for such a graceful end.

    Best to you!
    V:)

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    1. God bless your sweet heart. You gave your dad the send off he deserved.

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  13. My wife has been watching that show. I didn't know it was based on a book. She has really enjoyed it. I think maybe I should be watching it with her.

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    1. If you watch the show, you should start with the first episode and watch every season. It's better that way. Maybe you can get Jennifer Worth's first book for Amanda for Christmas. The title is Call the Midwife!

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    2. That is actually a great idea. I will look into that.

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  14. We watched the show for a while. Good stuff.

    After reading Being Mortal this summer, I've given a lot of thought to end of life considerations. My own philosophy is very much in line with yours.

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    1. Whatever you believe, it's good to have an end-of-life plan.

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    2. Absolutely. I've recently had The Talk with my parents. I expect it will be an important, ongoing discussion.

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  15. After what Errol wen through with overly optimistic doctors at UCLA, I decided to do a Living Trust, which includes my final wishes and instructions, as specific as possible. And I assigned a trusted friend to oversee these things. I'm sure these things are not perfect either, but definitely better than leaving no instructions at all.

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    1. I've seen nurses ignore DNRs, but they didn't do so intentionally. In an emergency, they want to act immediately. It's difficult to stop and check the patient's chart for a DNR when the seconds tick by.

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  16. I can't bear the thought of reading about end-of-life decisions. I know it's something I should think about, but since my husband had cancer and then recovered, I don't want to think about either of us dying for a long, long time. The possibility of losing him was so traumatic for me that I refused to believe that he wouldn't get well--and he did! It's been four years now. I know that one day we'll have to talk about those things, but right now I'm too busy enjoying life and being grateful for his continued good health.

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    1. I'm grateful he's still with you. That must have been so difficult.

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  17. My mother died December 28th last year. The doctor told her her kidneys were failing and offered her a place in a hospice, but she wanted to die at home cared for by myself and my sister in law. As a retired nurse she knew exactly what she was doing and refused all food and water, only rinsing out her mouth and spitting it out. She seemed to be saying "alright, I'm 86 years old, time to go, let's get on with it".

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    1. She was a wise woman, and you and your sister-in-law are good people.

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  18. What a review! It reminds me of a Radio Lab episode that explores how modern medicine is changing the concept of death and when it occurs. Certainly the claim could be made that blurring the distinction between life and death obscures the dignity of dying....

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    1. So many people are resuscitated only to live in hell.

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  19. I read call the midwife and loved it so will have to check this one out thanks I didn't know she had another book

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    1. She also wrote Farewell To The East End.

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  20. My mother-in-law was a nurse, and the last thing she wanted to do was die in a hospital. When she got cancer and got toward the end, she went on hospice. It was the kind of death she would have wanted, did want but wasn't quite cognizant of it when it happened, with my wife, my daughter, and my wife's sister around her singing when she left.

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    1. When I worked in the nursing home, we all said that anyone who has worked in a nursing home will never agree to be checked into one.

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  21. I worked at a nursing home and I would hope to God never to be put in one. It's sad that modern medicine so often tries to prolong a life that should not be prolonged. It's also hard to think about things we hope won't ever happen.

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    1. I would much rather die than go to a nursing home.

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  22. Someone told me about Call the Midwife and I watched two or three episodes. I really enjoyed them. I would be interested in reading this book as well. I'm an Anglophile anyway.

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    1. Call the Midwife is on Netflix streaming, if you have it. I love Jennifer Worth's books. I'm an Anglophile, too. I've never been there, and I'll probably never get there, but I can dream.

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    2. Here in the U.K we are looking forward to a Christmas day Call the Midwife special on t.v. followed in the New Year by a new series, Can't wait.

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