A love letter to humanity
Relationships, religion and respect – these things are important when a loved one dies, writes Anna Loren.
Tiara was a bright, 20-year-old commerce student when she had a seizure that stopped her heart. When the paramedics arrived to shock her back to life, her skin was blue. At south Auckland’s Middlemore Hospital, she was found to be so brain-damaged that she could not speak or move voluntarily. Her family prayed for a miracle. It was Dr David Galler’s unenviable task to explain that the girl they loved was never coming back. The shift was gradual. Her little sister, especially, was hard to convince. But as Tiara slipped away, the family began to share stories of her childhood and the jokes and pranks that shaped her life. When she passed, her aunt took comfort in knowing it was on ‘‘the ninth day of the novena’’ – a Christian prayer ritual. In his 25 years as an intensive care specialist, Galler has seen a lot of patients, like Tiara, die. His memoir, Things That Matter: Stories of Life and Death, tells some of their tales. It begins with his father being felled by a heart attack, and ends with his mother – who survived Auschwitz as a child – succumbing to cancer. In between there are aneurysms, and staph infections, and the devastating, all-consuming complications of obesityrelated diabetes. Some patients have had the odds stacked against them since day one. Some are too young for their deaths to make any sense. It sounds like a hard read, and in a way it is. But more than that it is a love letter to humanity, and to families, and to life.
In the intensive care unit, the things that matter most to people are amplified. Like Tiara’s aunt, many people turn to religion to help them come to terms with catastrophic events.
Galler himself is not religious, but he understands that impulse. ‘‘I actually think it’s quite a nice thing,’’ he says. ‘‘It’s a shame we don’t think about that more often.’’
Relationships become more significant when faced with the prospect of death. So, too, does treating people with respect ‘‘and actually standing up for them when things aren’t right’’.
Wouldn’t it be magic, he says, if we did that not just in a foxhole, but throughout our entire lives? ‘‘I think if we had that a little higher up in our thinking we would be a lot better off.’’
He tells of a man named Carlos, a cyclist who was critically injured when he was hit by a truck. He spent an excruciating three months in hospital, fighting infections and setbacks, and a further 15 years re-learning how to walk unaided.
But Carlos believes himself a better man now than he would ever have become without the accident.
The support of others can fuel that resilience, Galler says. People without material wealth – in particular, low-income Maori and Pacific families – often adapt to loss or suffering more smoothly than the well-off, because of their strong family and community ties.
‘‘It’s kind of nice to see that, because it again reminds you of what is important.’’
The principles of how we think about end-of-life care – how we age, where we live – actually those principles need to be embedded in the way we think through the entirety of our whole life.
Things That Matter was inspired by Dr Atul Gawande, an American surgeon and researcher, whose latest book, Being Mortal, wrestles with the complexities and dilemmas around end-of-life care. It was written ‘‘for ordinary people – certainly not doctors’’.
Galler’s hope is that readers are empowered to seek more control over their lives and their medical care. To ask the big questions: How are we going to die? And what do we want out of life while we’re here?
‘‘All those preferences that people have, we talk about them at the end of life, but the idea of people having preferences goes back right through the whole system,’’ he says.
‘‘The principles of how we think
David Galler
about end-of-life care – how we age, where we live – actually those principles need to be embedded in the way we think through the entirety of our whole life.’’
He also wants to inspire reflection on what matters in a wider sense – not just to themselves or their families, but to society as a whole. It’s a conversation, he says, that we desperately need to have.
To Galler, it is unacceptable that people are sleeping in garages. It is unacceptable that people are getting ‘‘poorer and poorer and fatter and fatter’’.
The health system, he says, cannot fix all the world’s failings; certain conditions must be improved if huge swathes of our society are ever to have a chance.