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My Body, My Choices

OPINION -- November 6, 2012 – I hope to choose the time of my death. Having been born in 1934, I accept the reality of death. I did not choose blood clots in my urine. I did not choose stage 3 bladder cancer in April 2011. With help from my physician friends and family, I did choose to have the Radical Cystectomy surgery; I did choose the surgeon (from among four I interviewed) and the anesthesiologist.
November 6, 2012

OPINION -- November 6, 2012 – I hope to choose the time of my death. Having been born in 1934, I accept the reality of death.

I did not choose blood clots in my urine. I did not choose stage 3 bladder cancer in April 2011. With help from my physician friends and family, I did choose to have the Radical Cystectomy surgery; I did choose the surgeon (from among four I interviewed) and the anesthesiologist.

I now have a greater focus on the importance of making informed choices before any more major medical interventions. It’s my body and to the extent possible, I will decide which treatments I receive. If I cannot speak for myself, my healthcare advocate is to follow my advance directive. Physicians, much as I respect them, will not choose for me.

Last year, my primary care physician of 22 years fired me. I fired my urologist. I chose four new physicians, Kelly Scott, primary care physician; Doug Masson, urologist; Robert Block, interventional radiologist and Angela Kalisiak, palliative care.

I have chosen each one because of their competence AND willingness to talk with me as a partner in decision making. I see them working with me, presenting both diagnoses and recommendations along with “the good, bad and ugly,” and then carrying out my choices.

I have chosen not to have chemotherapy. I forego most screening tests. I have chosen to have no more major surgery. Although my cancer has a 60 to 70 percent probability of recurring, currently there is no evidence of cancer.

I have updated and expanded the advance directive using the Compassion and Choices form. I have filled out and registered a Physician Order for Life-Sustaining Treatment, also known as a POLST. Both forms are posted on my refrigerator door and copies are with family members, physicians and my church.

For me, QUALITY OF LIFE IS ESSENTIAL. My six components for high quality of life are:

  • A short bucket list … currently nothing is in it

  • Getting around on my own (on my feet without help)

  • Making my own decisions (not living with Alzheimer’s)

  • Taking care of myself (no one else changing my diapers)

  • Choosing the time of my death

  • Planning for family preparation of my body, a home funeral without embalming and then cremation.

John R. Wish is a 78 year old retired professor of business and economics living in southeast Portland.

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