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Dying with dignity: An excellent podcast with Wanda Morris

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Wanda Morris of Canada’s Dying with Dignity.

Whether you are an atheist or not, this podcast is well worth listening to. Wanda Morris of Canada’s Dying with Dignity offers one of the most eloquent, fair, understanding presentations about choices in death and dying that I’ve ever heard. Seth Andrews, host of The Thinking Atheist, is a professional broadcaster and his shows are both compelling and well-produced.

The interview itself doesn’t spend much time on the religion question, but as faith so often impacts decisions about end-of-life choices, Seth and Wanda discuss it — quite fairly, in my opinion — at different points. Mostly, this is just a well-rounded, well-supported, factual conversation about the larger issues.

Listen to the podcast

Seth begins with a powerful email from Ben, an ICU nurse with 10 years of experience, which I’ve transcribed below:

“Invariably, when someone is close to or has just passed away, somebody mentions, ‘They are in heaven now’ or ‘God has another angel.’ I have had to bite my tongue death to me has because more final more important to me. And the just dismiss it is stepping stone to fantasy camp to the delusional. What frustrates me most is when patient not going make it and we have done many thing to them that violated their advance directive due to a family member stepping in and changing the course of action once the patient is no longer coherent thereby denying any possible shred of dignity in their final moments. Imagine you’re the patient. IV fluids bloat your body to an unrecognizable distortion of a person. Blood pressure medications called ‘pressers’ are administered to keep the heart pumping and the pressure up to some nasty possible side effects, not limited to kidney failure, peripheral vascular necrosis, blood clots etc. A tube is placed into your mouth past the trachea to allow a machine to breathe for them, which as you might well imagine is very uncomfortable, which usually required sedation. However if the blood pressure is too low we might have to forgo sedatives, so you might be very well aware of the discomfort permeating your being. This is God’s plan? To have you endure these and other interventions preventing your peaceful passing away? Now here’s where it gets interesting. Say your heart stops but the family wants everything to be done. What happens? A flurry of personnel rush into the room and typically the big guy begins doing chest compressions. For awhile during nursing school, as an orderly, this was my responsibility. Invariably while performing these you’ll feel a ‘pop,’ maybe several. To a person I’ve spoken to, we all feel a sickening wave of nausea when we realize we are breaking rib after rib in a universally obvious, feeble attempt to revive the already gone. … So as this round of CPR ceases and a lifeless body remains in the bed, waxy expression devoid of life, staring into nothing, the family will then start to pray or ask the staff to pray with them. I decline, and state that this is a family matter, as I leave the room to reflect upon everything that’s happened. Fast-forward a few days and there is the obituary, ‘Went home with the Lord peacefully, surrounded by family.’ I shake my head at the lie. This person died violently, surrounded by strangers, being mutilated by sharp needles and tubes with broken ribs and soiled linens, with family members thanking God for taking another soul but cursing the doctors and nurses for letting it happen. If I sound bitter it’s only because I believe we have a right to die peacefully among loved ones telling stories about you, which does happen, though not frequently enough, as opposed to the method I have just described. Despite evidence that the body is failing and faith is relied upon to bring the person back, and as my career has progressed I have learned that the evidence never lies.”

I will say that even Seth buys into some of the commonly held misconceptions about the dying process. For example, he refers several times to patients “starving to death.” In truth, that rarely happens, even when a person has declined further feeding or nutrition delivered by artificial means (which may entail all kinds of uncomfortable complications). Although it is dependent on many factors, including weight, genetics, other conditions and so on, research indicates that otherwise “healthy” people can survive 40 to 60 days (sometimes beyond) if they are properly hydrated. In practice, someone with a terminal illness never comes close to that.

And during my many years of association with hospice, it’s amazing to see how the body’s own “wisdom,” if you will, determines when a dying person wants to stop eating and drinking. In fact, watching this process when a patient has chosen not to receive further intervention (except pain and other medications to keep him or her comfortable), including artificial nutrition or hydration. As the last caller on this podcast notes, death is not always (or even mostly) “peaceful,” at least for those watching. But for the most part, the body has evolved defenses, so that when a patient stops eating and drinking, or drinking a lot less, the kidneys and liver and brain begin producing chemicals that are basically “dope”; by the time of their last breath, most patients are very unaware. Meanwhile, the maximum-intervention deaths I have witnessed have been horrific, just as the ICU nurse describes.

 

 

The real divide in America: Big vs. the rest of us

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Like you (presumably) I’m beyond disgusted with our mindlessly dysfunctional, money-driven politics. Just thinking about it literally makes most Americans unhappy: “People appear to dislike politics and politicians so much,” Princeton University economist Angus Deaton said of one study, “that prompting them to think about them has a very large downward effect on their assessment of their own lives.”Matt-Taibbi

And I may have crossed a personal Rubicon from disgust to anger in the last month.

First, though I am one of those privileged Americans who have never gone without health insurance, a recent encounter with the system left me fuming. The United States surely has the most maddening, inefficient, creativity- and innovation-crushing system in the world. It’s as if mischievous gremlins got together and said, “Hey, let’s invent the worst health-care system imaginable!”

But at least I had a choice. The Affordable Care Act is better than what we had before, but mostly for millions of previously uninsured and “uninsurable” Americans who now have coverage. But I’m not sure it’s a great improvement for anyone else, including friends of modest means who now pay more for less.

Second, I just finished reading Matt Taibbi’s “The Divide: American Injustice in the Age of the Wealth Gap,” a deeply reported, infuriating piece of advocacy journalism that exposes just how far from justice we’ve strayed.

The book peers into the upper reaches of the system, where bank fraudsters who launder money for drug cartels and terrorists on their way to imploding the economy not only get off scot-free, but also are rewarded with billions in government bailouts that allow them to keep their obscene, unearned wealth.

At the bottom, Taibbi finds hapless, helpless people such as undocumented immigrants and minorities who are nabbed repeatedly for minor infractions — possessing a joint or just standing on a sidewalk — and welfare recipients ensnared in the pitiless web of cruel, soul-killing government bureaucracy.

In between lie the tattered remains of “justice,” where judges often are in cahoots with government prosecutors, feckless “regulators” and quota-obsessed cops, and the goal is usually to win a quick, phony plea — lie, basically — and extract fines that will fund more unnecessary arrests, and never mind the truth.

“A guy goes to jail for a joint while an HSBC (bank) executive walks for washing hundreds of millions for drug dealers,” writes Taibbi, whose stories in Rolling Stone about the financial collapse are illuminating and infuriating. “Some guy in backwoods Arkansas gets arrested for forging a check for $450 to bail his girlfriend out of jail but nobody gets arrested for systematically forging hundreds of thousands of signatures on foreclosure documents.”

Thanks to Taibbi, I no longer think America’s divide is between Republican and Democrat or rich and poor. It’s about Big vs. the rest of us. Big Bureaucracy, in government and business alike, Big Justice, Big Law Enforcement motivated more by the promise of government largesse than protecting citizens, Big Tech (hint: Facebook, Amazon and Google are not your friends), Big Security, Big Ag, Big Debt, a Big, Fat Self-perpetuating Military-Industrial Complex, and more.

“The system eats up rich people, too, because it is not concerned with protecting individuals, even the rich ones,” Taibbi writes. “This is a machine that loves and protects money but somehow hates all people.”

“The Divide” exposes the rot at the core of both major political parties, which have fallen into a poisonous, black-or-white infinity loop. I have long believed that government is the only thing standing against a GOP-style Hobbesian nightmare; I still do. But as Taibbi makes clear, Big Government now harms the most vulnerable as often as it helps.

Most Republicans now embrace such lunatic notions as “money equals speech” and corporations have the same rights as individuals, not because it serves them, but because that’s what Big GOP tells them. They march, zombie-like, to the tune of big money in politics and business alike, endlessly chanting, “government is the problem;” (yes, but only partly).

Mainstream Democrats, meanwhile, love government so long as their team is in charge, even, apparently, continual erosion of civil liberties, a president who kills American citizens with a pen stroke and the Borg-like assimilation of power — “Resistance is futile” — by ossified, self-perpetuating bureaucracies. As the occasionally lucid George Will has observed, many seem to believe that “whatever the government’s size is at any moment, it is the bare minimum necessary to forestall intolerable suffering.”

The well-intentioned ACA is the foul spawn of Big Bureaucracy, Big Pharma, Big Hospitals, Big Education, Big Tech and on and on, a lousy, inefficient system that rewards those players at the expense of everyone else, Tea Partiers and liberals alike. Courtesy of Big Politicians who must feed at the Trough of Big Bribery in their unending quest for re-election.

But I’m convinced that if average Americans could just agree to disagree on those big, unresolvable questions the Bigs love to distract us with — personal morals, religion, militarism, Facebook, celebrity superbodies — people on both right and left could join forces against Big Everything to demand change.

Maybe I’m dreaming. But Taibbi has shown us the enemy, and it’s not us. It’s Big.

Email: claybonnyman@gmail.com

First published in the Daily Camera on July 20, 2014

A stone, a leaf, an unfound door — Who deserves to be remembered as a great writer?

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The angel statue in Oakland Cemetery, Hendersonville, N.C., that partially inspired Thomas Wolfe’s novel, “Look Homeward, Angel.”

I had a couple of outstanding high-school teachers who introduced me to the idea of literature.

Susan Helle and Richard Holm introduced me to great American fiction of the 19th and 20th centuries — Melville, O’Connor, Faulkner — and more contemporary works by authors such as John Knowles, Graham Greene and Herman Hesse. “Mr. Holm” also drew me into the worlds of such geniuses as Shakespeare, Conrad and Dostoevsky and the poetry of Arlington, Eliot, Frost and more.

Until that point, I’d been a fan of science-fiction and other adventurous works of fiction, though my fantasy tastes were fairly narrow and discerning, mostly Tolkien and Le Guin. I also had read, on my own, everything from Solzhenitsyn (no, really!) to Agatha Christie.

I still read in all those genres — which, contrary to the comforting myths of snobbery, entail everything from schlock to literary masterpieces — as well as a great deal of nonfiction and “literary” fiction.

Recently I re-read “Look Homeward, Angel.” I found the book windy, sometimes tedious and sometimes fascinating, its characters lacking in richness and realism — and shot through with remarkably poetic flourishes. Though I did not notice it as a younger reader, I now see how much Wolfe influenced the even-more-poetic Ray Bradbury (as even he admitted). Wolfe_Thomas_Look_HomewardAngel-1

“If I had 40,000 years, I would give all but the ninety last to silence. I should grow to the earth like a hill or a rock. Unweave the fabric of nights and days; unwind my life back to my birth; subtract me into nakedness again, and build me back with all the sums I have not counted. Or let me look upon the living face of darkness; let me hear the terrible sentence of your voice.”

Wolfe was so poetic that after his death, his great editor Maxwell Perkins took some of his passages and published them as poetry. But despite his stylistic richness, I can see why Wolfe may not hold up for modern audiences.

Wolfe, along with Hemingway, Steinbeck and eventually, Faulkner, captured my fancy as an literary icon in youth. Yet today, so many of the 20th-century writers I assumed would remain “essential” for my lifetime and beyond are all but forgotten or unheard of, especially by the young.

Steinbeck is still read even in high school, but more for his documentary approach to history (meaning, “The Grapes of Wrath”) than as a literary artist.

People still talk about Hemingway, but more as a celebrity than a writer, though his influence — like the Beatles, or Robert Heinlein in science-fiction — is undeniable, whether you are a fan or not; I find that his short fiction is considerably more accomplished and ingenious than any of his novel-length works (read “Big Two-Hearted River,” “Hills Like White Elephants” or “A Clean, Well-Lighted Place” and you’ll see what I mean).

Faulkner goes largely unread by the young, though he seems, to me, to be the lone 20th-century writer who may prove enduring on not just the American, but the world stage. He is a true genius, though a writer who requires a certain amount of exegesis to truly appreciate (those coming to him blind may find themselves wildly offended by what appears on the surface, for example in terms of racism, without ever understanding how he is subtly eviscerating such afflictions).

Meanwhile, the likes of Wolfe, Dos Passos, Flannery O’Connor Greene and Hesse are all but gone.

That’s sad, because so many of these writers — oddly, of the above examples, I’d put Wolfe near the bottom of the list — are so worth reading. They are universalists whose works transcend setting and time.

And who will be remembered among today’s American 50 years from now? Seriously. Opaque, challenging and difficult (and often rewarding) writers such as Pynchon, DeLillo, Toni Morrison? Or will, as happened with Dickens, writers like Stephen King somehow manage to be elevated and analyzed as literature rather than pop fiction, under whose label they were published?

Honestly, the candidates today are considerably thinner than the 20th century American lit, and I’m not sure any of the above are truly universal enough to warrant elevation to true, enduring classics.

It occurs to me that more than anything, this may simply reflect contemporary culture, in which popular music, film and videos reign supreme, and there is so much fiction published — after thorough meddling by agents and editors to ensure marketability; today Maxwell Perkins would have been fired for being so stupid as to think he could cultivate and nurture a writer of great potential like Wolfe — that this might simply herald the end of the age of literature.

History Flight to bury Marine recovered on Tarawa in November 2013

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Marine Corps Pfc. Randolph Allen, whose remains were recovered after more than 70 years beneath the sands of Tarawa by a History Flight team, will be buried at Arlington National Cemetery on July 28. Former Pennsylvania Gov. Tom Ridge will preside.

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Archaeologist Drew Buchner supervises a History Flight recovery team in April 2013. Photo by Clay Bonnyman Evans.

Allen, a member of F Company, 2nd Battalion, 2nd Marine Division, was killed on Nov. 20, 1943, the first-day of a brutal, bloody 76-hour battle to take a heavily fortified Japanese airfield on the island of Betio.

More than 1,000 Marines and U.S. Navy sailors were killed during the battle, along with more than 5,000 Japanese Marines — rikusentai — and their Korean laborers. The bodies were hastily buried due to rapid decay in tropical conditions, but the location of hundreds of graves were lost in the subsequent efforts to rebuild the airstrip and construct an American base on Betio.

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The author, holding a Marine helmet recovered on Tarawa by a History Flight crew in April 2013.

A U.S. Army Graves Registration mission in 1946 recovered more than 500 bodies and repatriated them to the United States. In 1949, the military officially declared all the rest — including that of my grandfather and Medal of Honor recipient 1st Lt. Alexander Bonnyman Jr. — “non-recoverable.”

However, History Flight, Inc., a Florida-based nonprofit founded by Mark Noah, has since 2007 worked tirelessly, through its own recovery teams and advising and assisting the Joint POW/MIA Accounting Command, to recover the more than 500 Marines still buried on the islet. To date, the group’s efforts have resulted in the recovery and thorough documentation of more than 30 intact sets of such “non-recoverable” American remains, which have been turned over to the U.S. Defense POW/MIA Accounting Agency at Joint Base Pearl Harbor-Hickam in Honolulu, Hawaii.

 

Tarawa news: Government of Kiribati buys land in Fiji against rising tides

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Laurence Caramel
The Guardian Weekly

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On Kiribati, an abandoned house that is affected by seawater during high tides. Photograph: David Gray/Reuters

The people of Kiribati, a group of islands in the Pacific ocean particularly exposed to climate change, now own a possible refuge elsewhere. President Anote Tong has recently finalised the purchase of 20 sq km on Vanua Levu, one of the Fiji islands, about 2,000km away.

“We would hope not to put everyone on [this] one piece of land, but if it became absolutely necessary, yes, we could do it,” Tong told the Associated Press. Kiribati has a population of about 110,000 scattered over 33 small, low-lying islands extending over a total area of 3.5m sq km.

The island of Betio, on Tarawa Atoll — the most overpopulated part of the island nation — was the site of the bloody 1943 battle in which U.S. Marines ejected the Japanese to take an airfield as part of the “island hopping” campaign. The remains of some 400 Marines are still buried in lost graves on one-square-mile Betio.

In 2009 the Maldives were the first to raise the possibility of purchasing land in another country in anticipation of being gradually submerged. At the time the government looked at options in India and Sri Lanka.

Now Kiribati has taken action. “Kiribati is just the first on a list which could get longer as time passes,” says Ronald Jumeau, Seychelles ambassador at the United Nations, who took part in the international negotiations on climate change in Bonn last month.

In March the Intergovernmental Panel on Climate Change published the volume on adaptation of its fifth assessment report, confirming in starker terms forecasts first outlined by scientists in 1990. Within a few decades, small islands in the Pacific and Indian oceans risk being extensively or even completely submerged. In places the sea level is rising by 1.2cm a year, four times faster than the global average.

Read more

 

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