"I just don't want him to suffer anymore..."
Almost always when I walk into a patient’s hospital room, the first thing I do is turn off the TV. Sometimes, I'll turn off the roommate’s TV, too. (Every room has two, you know.) Have you ever tried to maintain interest in someone’s diarrhea when right behind your head there’s a John Wayne marathon on AMC ?
Well, for whatever reason, today I left it on as I walked up to the bed in critical care. And sure enough, like the TV-zombie child of the 70’s that I am, I was soon fighting desperately to concentrate on my patient’s kidney failure instead of the breaking news on the Today Show: “NYC studio offers naked yoga.” That’s right, naked yoga. Fig leaves? Shame? Those are so Garden-of-Eden. Here in America, we gonna let it all hang out.
Suddenly, it became clearer than ever before that all a man needs to understand America is Isaiah 5...
20 Woe to those who call evil good, and good evil;
Who substitute darkness for light and light for darkness;
Who substitute bitter for sweet and sweet for bitter!
21 Woe to those who are wise in their own eyes
And clever in their own sight!
22 Woe to those who are heroes in drinking wine
And valiant men in mixing strong drink,
23 Who justify the wicked for a bribe,
And take away the rights of the ones who are in the right!
24 Therefore, as a tongue of fire consumes stubble
And dry grass collapses into the flame,
So their root will become like rot and their blossom blow away as dust;
For they have rejected the law of the LORD of hosts
And despised the word of the Holy One of Israel.
Patients want TV’s in their rooms for the very reason I turn them off.
All of America, especially healthcare, has joined forces to call evil “good” and good “evil.” You simply can’t think soberly about life, let alone the relationship between sin and suffering, while all 60 channels, 24 hours a day tell you if it makes you happy, it can’t be that bad. But of course no one, except maybe an occasional nurse’s aid or housekeeper, (certainly not chaplains, doctors, hospital attorneys, or administrators) wants to get mixed up in Godly sorrow, deathbed conversions, or the Holy Spirit’s conviction of sin, righteousness, and judgment.
Is that constant pain making you think about how you’ve treated your wife for the last 40 years? Just turn on CSI and you’ll soon feel better about yourself. Thinking about how you wouldn’t have gotten cirrhosis if you had honored your mother and father? Hey look, Brittany Spears has a new boyfriend! Wondering if your pneumonia has anything to do with your greed or failure to discipline your children? You can worry about that after the Breaking Bad season finale.
I disciplined my eyes to look away from the anchor-babe calling evil “good” and good “evil”, demonstrating the exercises she would do if she were in a naked yoga class. Instead, I finished tending my patient. But before I made it back to the nurses station, Isaiah 5 washed over me again with the overwhelming reality that I live and work in a world that’s completely upside down, blind beyond all natural hope, busy validating every form of wickedness, and doggedly opposed to righteousness.
Take, for example, the recent uproar over the method used to execute a convicted rapist and murderer in Ohio. It turns out drug companies have gotten squeamish about their wares being used in state executions. Accordingly, some now refuse to sell their drugs for death penalty purposes, forcing Ohio authorities to turn to an alternative two-drug combination that reportedly has never been used in executions. Departing from the tried-and-true methods was too risky, opponents claim, and predictably resulted in the convict suffering unduly.
There’s just one problem with this argument. The cocktail is actually so well-tested it’s ubiquitous. The effectiveness of this combo is so universally accepted as to be standard of care, despite the contrary thunderings from Mt. Harvard. I will grant that the combination may be new to the criminal justice arena, but in hospitals, nursing homes, and hospice houses across the land, keeping these drugs on hand approaches the inviolability of paying the cable bill.
You see, this is the combination of drugs -- opioids and benzodiazepenes – that doctors use on a daily basis—many to kill their patients, but all to treat the very symptoms Dennis McGuire supposedly unjustly suffered from: air hunger and agony. In fact, every doctor I know (who treats dying patients) uses those very drugs in dying patients to alleviate “air hunger” and “agonal respirations”, largely for the sake of the on-looking family members “who just don’t want him to suffer anymore.”
Avoidance of suffering is the only good we know. It doesn’t matter if we’ll have to call evil “good," just so long as there’s no perceivable suffering.
A young friend studying to be a pastor recently asked me if the first goal of medicine wasn’t to preserve life. “No,” I had to answer. "Nowadays, it’s to eradicate suffering.” Everything else takes a backseat and the ends justify the means.
Did the dilaudid deaden the patient’s conscience during his last few hours left to repent?
Just so long as he didn’t feel any pain.
Did the valium take away his chance to say “I’m sorry”?
Just so long as he was comfortable.
Did the morphine drip make him die a day sooner than he would have otherwise?
I just didn’t want him to suffer any more.
We doctors are heroes and valiant men in mixing strong drink, and yes, these drugs do often hasten death (i.e. kill) by suppressing respiratory drive and other functions. Everybody knows it and many exploit it. I wish the ethicists and Christian Medical and Dental Society could successfully assuage my conscience when they bring out the principle of double effect, reassuring me there’s no moral problem as long as the intent is not to hasten death, but rather to treat pain and suffering. But I can’t seem to forget the look on that veteran oncology nurse’s face as we talked outside the room of a man taking far longer to die than any of us expected. Giving perfect voice to the universal wisdom of the medical world, she insisted, “You need to order some Ativan so we can get this over with.”
We can quibble over the doses they used in Ohio and how to perfect the process in the future, but here is the real point of irony, the most tragic revelation about our culture: we celebrate the use of two drugs to kill our parents, grandparents, and patients while we march, protest, blog, and sue when the same two drugs are used by God’s ordained authority to kill a man who raped and killed a 22-year old woman and her 30-week-old unborn baby. We applaud ourselves when we use morphine to shorten our mother’s dying process from three days to six hours, but we tear our clothes in outrage and take to the streets when it takes 25 minutes to serve justice to a rapist and murderer.
You say, “But don’t you see, Dr. Spaetti? In the one case you’re alleviating suffering while in the latter case you’re cruelly inflicting it.” With the same two drugs? Seriously? Oh, how wise we are in our own eyes!
The truth is, our god is anesthesia – anesthesia of the body and particularly of the conscience. Any level of sober awareness is too much for us. How else can we explain the complete conquering of our nation over the last 20 years by prescription pain killers and sedatives? I would venture that not one family in America has escaped the devastation of their dominion.
We want to avoid even the slightest itch, and if it means we have to reject every last law of the Lord of Hosts, we’ll do it. As our society smothers its last traces of its Biblical heritage, despising the word of the Holy One of Israel, we lose all memory that our very salvation was purchased through suffering, that Jesus tasted death so we wouldn’t have to bear it for eternity, and that we should rejoice to “share the sufferings of Christ” (1 Peter 4:13), “filling up what is lacking in Christ’s afflictions” (Colossians 1:24).