As I promised yesterday, today deals with a similar but, in many ways, worse scenario.  Assume that you have had extensive end of life discussions with your spouse.  Your spouse agrees to honor your wishes not to be placed on a ventilator and knows when to invoke your DNR orders.  Also imagine that you have not discussed any of this with your children.

Afterall, discussing end of life issues with your children would be awkward and upset them.  Right?  WRONG!

Your 26-year daughter, Amanda, and your spouse come to see me the week after you are buried.

Spouse – “Doc, Amanda won’t talk to me.  She thinks I killed her mother.  I tried to explain to her . . .”

Amanda – “You did kill her.  Had you let the docs intubate her and breath for her she might be alive today.  I can’t stand being in the same room with you.  I thought you loved her.”

Spouse (crying) – “If you won’t listen to me, listen to Dr. Segal.”

Doc – “I know losing your mom came as a surprise.  Covid-19 hit her hard.  Her cancer treatments were also taking a toll on her.  Your mother, father and I had multiple, lengthy conversations about your mother’s wishes.  She did not want to be intubated under any circumstances, She signed DNR papers at her last office visit.  That was before Covid-19.”

Doc – “She also did not want to discuss any of this with you or your brother.”

Amanda – “My brother is furious.  He wouldn’t come today.  He can’t understand why you and dad did not fight harder to prolong mom’s life.  To give her a chance to beat the virus.”

Doc – “Your father and I honored your mother’s wishes.  Your father didn’t want to but had promised her he would not keep her alive mechanically.  She was very sick.  The cancer treatments were horrible.  She told me the only reason she didn’t go on hospice is that you and your brother were not ready to let her go.  The Covid-19 pneumonia made everything 10 times worse.  Your father did what she wanted.  He did not kill your mother.  He loved her enough to let her go.”

Unfortunately, the above conversation is not fictional.  I’ve heard it too many times in the past.  It is far better to have end of life conversations with your children (if they are mature enough) than to leave it to the surviving spouse.

The father depicted above just lost his wife.  He came close to losing his children.  Had they not openly discussed their feelings, the belief that he took away the only chance their mother had to survive Covid-19 would have destroyed their family.

Make sure your children know what you want if catastrophe strikes you.  Every few years, reaffirm your beliefs and wishes.  Should your spouse or children ever have to take you off of life support they will know what you want. They will be able to console each other and give the acceptance and loving support each survivor will need. 

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