It was a nightmare Rick, his wife, and their family thought they had guarded against. But after Rick’s father in law became short of breath and an ambulance arrived, the Parker, Colo., family was dragged down into America’s maddening morass of misguided medicine when it comes to end-of-life care.

It actually started seven years ago (I’ve agreed to use Rick’s first-name only because of the sensitivity of these issues) when the older man’s heart stopped.

He was revived, but doctors informed the family of numerous complications, and he was admitted to hospice care. As is sometimes the case with hospice patients, his condition improved. He was far from 100 percent, but he was discharged from hospice.

However, because of his ongoing complications and an up-close experience with the revive-at-any-cost mentality, he and his wife filed “advance directives” with the hospital asking that “he not be resuscitated again, because of the emotional cost to him and his wife,” Rick says.

When he became short of breath a couple months ago, the family did call 911; he needed help, but didn’t appear to be in crisis. (After all, just because a patient has a “do not resuscitate” order doesn’t mean he or she shouldn’t be kept comfortable in non-life-threatening situations.) for But then, his heart stopped, and the 72-year-old man was revived no fewer than eight times in the ambulance and hospital, despite the family’s wishes.

At the hospital, anguished and stressed, when doctors provided contradictory information — first that he was brain dead, next he was “responsive” — the older man’s wife decided to wait until morning before making any decisions about discontinuing care.

In the morning, another doctor showed up and said, “I’m sorry, we made a mistake,” Rick says. The doctor acknowledged to the confused family that the older man had, indeed, been brain dead.

“I asked why did you bring him back eight times then?” Rick says. “He says, ‘No good reason.'”

Worse, the older couple had taken pains to file documentation of their express legal wishes with the same hospital, asking that the man not be resuscitated.

The medical team had even consulted the older man’s file, but either had failed to see, or worse, ignored the family’s clear advance directive.

To Rick, who used to work as an emergency medical technician, the whole painful episode — his father-in-law eventually was “allowed” to die — reminds him of people he saw in the medical world who have “almost a God complex. … There are times they get so wrapped up in what they’re doing that they don’t stop to consider the ramifications to individuals and families.”

Sadly, such situations are more common than many think, says Dr. Merle Miller, a physician with HospiceCare of Boulder and Broomfield Counties, who worked as an emergency room doc for 20 years. (Dr. Miller was not involved in the above case.)

“Paramedics tend to be driven by protocol, and if there is any doubt, they resuscitate,” Miller says. “And that can start a cascade of events.”

In her practice, “I’m not one of those people who needs a piece of paper that’s been stamped and signed,” she says. She communicates directly with family members and wishes more emergency personnel would consult their “medical backup” before plunging into something that could cause a tragic cascade.

The roots of most of our misconceptions about resuscitation go deep in American society. Entertainment and media have badly skewed our notions of success and promulgated the false impression that medicine can rescue us at every turn.

“The pendulum has gone too far toward this resuscitate mentality, and I think TV is part of the problem,” she says.

On “House,” “ER,” and other shows, resuscitation is shown as normal, and successful 75 percent of the time, according to a 1996 survey by the New England Journal of Medicine. In fact, among the chronically ill and elderly, the success rate is an underwhelming 1 to 3 percent. Overall, the rate hovers around 18 percent, with the best success rates for younger, healthy people who experience sudden heart arrhythmia in a setting where help is immediately available.

And did you know that, done right, CPR will probably snap a good number of your ribs? CPR is only done with someone who is dead or almost dead, not whenever they are having a medical emergency.

The problem, at the deepest level, is our death-denying culture. Miller, who grew up in the African nation of Congo, saw death regularly: “It was visible, and not uncommon.” In 21st century America, few people see death up close, and many of us consequently have deluded ourselves into believing that medicine can — and should — keep us living far beyond our otherwise likely sell-by date.

Physicians today run the whole gamut from being very aware of these issues and of the equally important potential trauma to the families to physicians who have had no professional education and very little experience in dealing with the outcomes of end-of-life choices. But doctors, more than anyone, also know all too well that the massive interventions they inflict on us — typically at our own, misguided request — are a “cure” worse than the “disease” of human mortality. I urge you to look up “How Doctors Die,” an essay by physician Ken Murray of the University of Southern California.

“Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone,” Murray writes. “They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen — that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR.”

Some physicians and institutions understand all this; others don’t. In other words, every situation is individual, contingent on how decisions are made.

Murray writes candidly about all that intervention we think we want.

Most doctors, he writes, have seen ” ‘futile care’ being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs.”

And guess what? Those who elect hospice and palliative care, blessedly free from such brutalities, actually live longer, statistics have found.

With yet another round of “debate” about the Affordable Care Act (Obamacare to those who diss and dismiss it), the know-nothings are bound to start spouting demagoguery about “death panels” and such nonsense.

But the truth is, much of the medicine we inflict on ourselves, particularly at the end of life, causes more pain and suffering … for both the living and the dying.

“If you go to the hospital, you are offered a whole spectrum of treatments,” Miller says. “People don’t always realize that they have any choices” — including the choice to say, “No thanks.”

Coming up next: Kim Mooney, an expert in advance directives, will discuss how to protect your family against situations like that faced by Rick’s family.

Email: claybonnyman@yahoo.com.

When I traveled to Israel in 1996, things were pretty calm. Minus a couple brief side trips to Jordan and Egypt, I was there for about a month.

Benjamin “Bibi” Netanyahu was serving his first term as Prime Minister, but was much less “conservative” than he is now. The only violence deemed front-page worthy by the media was the stabbing murder of two West Bank “settlers.”

Israel is, not surprisingly, a pretty militarized place, and that can be a strange experience. All young people must serve in the military (excepting, curiously, ultra-Orthodox Jews who have been given a pass for religious reasons), and it was not uncommon to find myself sitting next to a beautiful female member of the Israeli Defense Forces on an Egged bus, her rifle resting lightly between her knees as she slept.

And all around Jerusalem and Tel Aviv, I picked up on the pride Israelis feel in their ability to protect their tiny nation, surrounded from its founding by potential enemies. In particular I remember seeing a T-shirt with a photo of an American-made F-16 fighter and the message, “Don’t worry America — Israel is behind you!”

Intended as a winking defiant inversion of a message Israelis must tire of hearing, the shirt conveyed a certain pugnacious grit: After the triumph of the Six Day War in 1967 and the near disaster of the Yom Kippur War in 1973, many citizens of the Jewish state came to believe they could withstand any assault.

Things are more complex now, following more dubious military actions and the continued occupation of territories taken from Jordan, Egypt and Syria. To boot, Israel has taken unilateral, pre-emptive action to forestall what it saw as future threats. That’s what happened in 1981, when IDF planes bombed Saddam Hussein’s Osirak nuclear facility in Iraq and Syria’s incomplete al-Kibar nuclear installation in 2007.

In both cases, the United States government stood firmly behind the nation that receives more American foreign aid each year than any other (about $3 billion annually, or nearly one out of every six U.S. foreign aid dollars; most of it is in military aid).

Now we hear that Israel is prepared to take matters into its own hands and attack several nuclear facilities in Iran, amplified by American politicians eager to seem “tough.” Netanyahu’s government and many Americans are convinced that the big dog of the Persian Gulf (for that we can thank the ill-advised war in Iraq) is pursuing nuclear weapons.

President Obama said Monday that the United States “will always have Israel’s back.” At the same time, he has criticized all the cheap belligerence emanating from GOP presidential candidates and Israeli hawks. On Tuesday, he rightly called out the Republican war hounds for not taking war seriously enough.

“This is not a game,” the president said.

No, it’s not. But it’s all to easy for many Americans to treat it as if it is. The media is generally more than happy to aid and abet that thinking.

After listening to (but in my case, never believing) the lies we were told about the extreme dangers of Hussein’s “weapons of mass destruction,” the recent drumbeats for war against Iran have sounded distressingly familiar.

First, there is not unequivocal evidence that Iran is pursuing nuclear weapons, at least not yet. As Secretary of Defense Leon Panetta told a Senate committee hearing on Feb. 28, “I think they’re developing a nuclear capability (but) our intelligence makes clear that they haven’t made the decision to develop a nuclear weapon.”

And according to many careful military analysts, it’s far from certain that Israel could effectively carry out a mission to destroy or cripple three Iranian facilities, due to limitations in aircraft fueling, among other logistical issues.

And that would mean the U.S. would be forced to enter the fray.

Such a move would almost certainly catalyze further anti-American fury across the Muslim world, set Hezbollah and Hamas aflame on the borders of Israel, kill thousands of Iranian civilians and create chaos on the region — probably the world. What’s more, it could even make it more likely that the Iranians would develop nuclear weapons.

“Should Israel rush to war, Iran might follow Hussein’s example (after the Osirak attack) and rebuild its nuclear program in a way that is harder to detect and more costly to stop,” wrote Colin H. Kahl of the Center for a New American Security in The Washington Post on March 2.

Let’s say Iran does wind up with a nuclear weapon or two. As North Korea has learned, that’s pretty good protection against an attack, which might make it easier to build more nukes.

Netanyahu continually raises the specter of another Jewish holocaust at the hands of a nuclear-armed Iran. And, he suggests, failing to attack preemptively would be the equivalent of appeasing Hitler, Neville Chamberlain-style.

But is Iran truly “insane” enough to attack Israel, the only nuclear-armed nation in the Middle East, with an estimated 200 warheads poised for delivery? To read the Western press, yes, the Persians are all mad, mad I tell you, bent on Israel’s destruction even at the cost of their own annihilation. As someone rather vividly put it to me, if Iran launched prospective nuke(s) at Israel, “It would immediately become the world’s largest ash tray.”

Americans are tired of war, according to most polls. Even so, 48 percent polled by Rasmussen in February said the U.S. should join any effort by Israel to attack Iranian nuclear facilities.

Yet that’s more than the 43 percent of Israeli Jews — compared to 42 percent of all Israelis — who think their nation should attack so long as America joins in. (A solid 32 percent say they don’t think Israel should attack at all.)

Could it be that Israelis, who have tasted the bloody fruits of war, take it more seriously than Americans? We were rightfully aghast at the deaths of some 3,000 people on Sept. 11, 2001. Why is it that so many of us don’t seem to feel that same horror when tens of thousands, or hundreds of thousands, are killed in other nations — sometimes at our hands?

All “those who are … beating the drums of war should explain clearly to the American people what the costs and benefits would be,” Obama said last week.

And if we do take such stock, is it too much to ask that we consider the potential death and suffering of people other than ourselves into those costs?

E-mail: claybonnyman@yahoo.com

Ever loved a dog or cat? My guess is that most people in the United States have.

So imagine this:

Take that beloved pet and place her in a confined space in which she cannot stand up or turn around. Artificially inseminate her, and when she whelps, move her — beat her, if necessary, because she won’t want to go — into a “gestation crate” where her pups will have a small space to nurse.

She, meanwhile, will be pressed to the ground by metal bars, forced to eat in that position and urinate and defecate onto hard concrete floors. She’ll probably develop sores. Because of that, and because she lives in a massive indoor facility with hundreds of other animals just like her, she’ll need to be injected with huge amounts of antibiotics and other pharmaceuticals.

Her offspring will be taken from her unnaturally soon, so she can start cycling again and produce more puppies. Her boredom will be so excruciating that she and many of the animals around her will literally go insane, smashing their faces and breaking teeth against bars, bloodying their mouths while chewing on anything nearby.

You can well imagine that after three or four years of such an existence — she’ll never have seen the sun or experienced a kind touch — she’ll be no good as a mother and she’ll be shipped off for slaughter.

You surely realize, by now, that I’m talking not about your cat or dog, but an animal of equal intelligence and social needs: pigs. (But for the record, this more or less goes on in puppy mills, too; if you want to adopt a rescued mill dog, check out milldogrescue.org.)

This is how more than 99 percent of hogs are raised in the United States, in so-called “concentrated animal feeding operations,” or CAFOs in meat-washed industry argot. All factory farming is repugnant, but because of the combination of their intelligence, sociability and the brutal conditions that bring us our daily bacon, pigs are by far the most tortured.

(By the way, the agricultural industry doesn’t want you to know how it raises hogs or other meat species. In Iowa, Minnesota, Kansas, Montana and other states, there are now laws banning the filming of these death houses, pushed by agri-giant Monsanto. Out of sight, out of mind)

Pigs are amazing — and clean — animals. The only reason they roll in the mud is because they have no natural cooling systems. They are, by some measures, smarter than cats and dogs, able to perform certain complex tasks as quickly as chimpanzees.

So. Still think bacon is funny? Hip? A bold symbol of independence?

Still think it’s cute to chuck bacon at Bolder Boulder runners?

Maybe you’d like to slip on your hip “Push Button, Receive Bacon” T-shirt?

Think Homer Simpson’s dimwitted devotion to the delicious cured meat is a riot?

For reasons that I can only guess at — and I will — bacon has become hip and clever. A kind of tag that says, “Screw you, health Nazis! I love my bacon.”

I’ve seen clever posters of roses made of bacon. T-shirts that read, “This girl ? bacon!” And, my favorite — it’s just so darned rebellious — a bumper sticker saying, “I’d Kill a Kitten for Bacon.”

So what is it with all this bacon “humor” ?

Sure, it tastes good. It’s been a long time since I’ve had any (though the fake stuff is surprisingly good), but I remember. No wonder, with all that yummy fat and salt.

Clearly part of it is in reaction to the increasing pressure to eat a more healthy diet that’s lower on the food chain, a recipe for a healthier planet. Americans are rugged individuals, you know, and don’t like to be told what to do. So often we respond with juvenile “nyaa, nyaahs” to prove that nobody’s the boss of us.

And, I’m thinking, at least a few people are overcompensating for a sense of inner guilt. I think most of us — maybe not in Paducah or Tulsa, but surely in Boulder — actually know how harsh and horrible 99 percent of pig farms are.

And, I suppose, some people truly don’t give a damn about suffering.

Whatever the roots of this greasy bit of zeitgeist, just remember that every time anyone buys bacon, they’re voting “yes” for the torture described above. Unless, that is, they make the effort to buy humanely raised pork (or, of course, become a vegetarian or vegan; more on that below).

But lucky us. In Boulder County, we have a growing number of truly local farms that are rejecting the nasty, unhealthy, violent factory-farm model and raising “dirt hogs” — animals that get to have real lives before slaughter.

At Cure Organic Farm on Valmont Road in Boulder, Anne and Paul Cure raise a number of different species the old way, including hogs. In other words, the animals live on pasture supplemented by grain and produce culled from other parts of the farm. They are rotated to new pastures every two or three weeks, depending on the condition of the grass (yes, hogs are a grazing species; drive by Black Cat chef Eric Skokan’s farm on 75th Street near Valmont and you’ll see plenty of piggies, heads down in the grass).

The animals at Cure are allowed to develop natural social hierarchies, and they are never vaccinated or immunized.

“We like to have them in a natural habitat, where they can range, root up ground, turn up the soil,” says Anne Cure. “We let the social dynamic be as natural as it can be.”

When the time comes for young pigs to go to slaughter, they are sent to a small, USDA-approved, family-run processing plant in Evans, Colo., Innovative Foods.

Cure finds it curious that so many people who visit the farm are uncomfortable with the idea that the animals die. Yes, these are meat eaters.

“The switch hasn’t happened yet in their minds, of really wanting to know how food is produced. They’re still in the dark, thinking it just comes in a package,” Cure says.

(Having killed pigs, cattle, sheep and poultry myself, I’ve long thought that all meat eaters should be required to do this at least once, to dispel all that denial.)

But locally, as more and more traditional producers crop up, Cure sees a lot of people waking up.

“I applaud those community members who have gotten to the place of really wanting to know, of caring enough to seek out producers who do it in a natural way,” she says.

Now, back to that vegetarian/vegan thing.

Yes, sure, that’s a great choice if you are concerned with the cruelty of factory farming. But I’ve argued for a long time that the likelihood of America going veg is approximately nil. Given that reality, I urge carnivores to be willing to spend a little more to support the people who are farming in a more ethical way. That’s the only way we’ll ever be able to change the hideous, hellish practices that bring us all that hilarious, hip bacon. (I always get yelled at by people who tell me “free range” is terrible, too; maybe, but it’s better, and that’s progress.)

Bacon isn’t funny or cool. It’s cruel. It’s brutal.

But it doesn’t have to be.

E-mail: claybonnyman@yahoo.com.