"I want to die."

"I want to die." No, not me. It's the man in room 456. He was my very first patient on fieldwork. He has a terrible pneumonia, which is complicating his prior existing conditions of chronic obstructive pulmonary disease (COPD), congestive heart failure, and very painful spinal compression fractures. For those of you who've been reading this blog since the beginning, he's the one with the sailor Jerry tattoos. Every morning for my 1st three days of fieldwork, I "wiped and diaped" this man. I postponed writing about this to preserve his dignity, but now I feel it adds to the understanding of why he feels ready to die. I can't imagine living in diapers in a world of pain.

"Honey, I'm the picture of health," his humor has kept him going and kept us going as well. But as the jokes fade and the moans and groins grow, I do not feel this friend will be with us much longer. I actually thought he had died last week... he was sent out acute and appeared in one of my dreams. So I thought, that's nice that he died and came to visit me in my sleep. But low and behold, a week later he was wheeled back in on a gurney. Now he's telling me "he's ready to go." And I wonder... is that the pain speaking or is that a 75 year old man in diapers who's been losing function and independence for years? The look in his eyes tells me the later, but who am I to make that call?

It was simpler 100 years ago, without a million drugs on the market to secure and prolong life. We didn't have to ask ourselves the questions that we have to ask today. The choice was not made by doctors, family, or therapists, but by the individuals body, mind, and will to survive. Today that part seems to play a smaller role. Yet, I suppose it doesn't have to if people would only realize that. Realize that there is choice, even at the end of life.

So, Mr. P, what'll it be?