I contemplate this as my father will undergo a cardiac catheterization tomorrow in advance of an aortic valve replacement. Dad is 83, and we found him collapsed next to his bed where he lay for almost three days.
While I've written about him before, the last few days have been spent bedside in the hospital on Long Island where he is a weak old man by day, and a tortured and confused soul at night, needing to be restrained so he doesn't injure himself.
Dad's mind is pretty much intact during the day, paying close attention to the doctors and nurses, and cracking wise during the multiple examinations. He surprised the nephrologist by observing that he was Iranian.
"How do you know that?" he asked.
"Well your name is spelled with two 'Z's instead of two 'S's," my father replied.
At first my father didn't want surgery, but when his primary care physician and I explained the options, which included never returning home, going to a skilled nursing facility, or sudden death, he said, "let's give it a try."
With careful reflection, I've asked myself, how much is too much healthcare? When do we stop? When our bodies are old and no longer function the way were when we were young, is there a line in the sand we must no longer cross?
Watching my father dependent and scared, defiant and arrogant, frustrated and sometimes incoherent, I wonder what the "best" outcome should be?
I know he wants his life to end in his home, not in a nursing home. I know his mind is still functional, when he asked the nurse to write "Giants Rock, Patriots Suck" on the whiteboard in his hospital room.
I know he will be more functional with the valve replacement. The question is, how much more time should he or anyone else have, when they have spent 83 years on the planet.
Perhaps this is one health care intervention too many. What do you think?