A Plan To Die

Do you have a plan for death? Are you comfortable thinking about death? If not, you might want to skip this one.

Birth and death are natural concepts but they create different emotions because of cultural biases. This post is to help you start thinking about death because it can not only be one expensive fucking endeavor but it can also be one hell of a shitty experience. 

Medical Perspective

As medical professionals we have lived fairly intentional lives so it’s common for us to have an opinion on not just living but dying. For all the shit our patients talk about us, they come to us not only to live a healthy lifestyle but also to die with dignity. 

The least I can do for myself is to make sure that I die in peace and don’t have my funds depleted while occupying an extra night’s stay in death hotel – ward D. 

Making Money on Death

There is a lot of money to be made on the birth of a child. IVF, prenatal care, C-sections, and follow-up care. Then there are routine pediatric visits and specialty care for various diseases.

Death is a very lucrative process in the US healthcare. Hospital systems rely on chemo, radiation, surgery, and inpatient management to offset their losses in the emergency rooms. Then there are nursing homes, rehab units, ICU stays, and the follow-up care.

Cancer Survivability

Some of the hardest data to interpret is survivability data for cancers – I’m curious why. I’m a physician and I can’t make sense of it. Opinions vary from oncologist to oncologist and the field is rapidly changing. 

With this level of uncertainty for the consumer, it’s good to have a plan should you suffer a major illness, shortening your lifespan.

• How much would you be willing to spend on healthcare?
• How many office visits will you suffer through?
• How much productivity will you lose?
• How many extra months of survival are you willing to pay for?
• If your family and friends won’t let you die, do you have a backup plan
• If the hospital or legal system won’t let you die, what’s your recourse?

Death in the US

You can die at home, you can die in the hospital, or you can die in a nursing home. You think that’s your decision to make, but it’s not. You have to fight for that one, too. 

It would be impossible for me to address each and every statistic on death but I can talk about my own personal stance on death and hopefully it will spark your internal dialogue as well.

I don’t think that most people in the US die a dignified death. It’s not that they don’t want to. And it’s not that their family members don’t want them to. But we just don’t have those kinds of conversations when we’re alive. It falls by the wayside and because of all the fear and taboo surrounding death, life-preserving measures become the standard.

Add to that the legal risk surrounding death and everyone who is involved in your end-of-life care will do anything possible so that you don’t die under their care.

A Plan To Die

One of the worst things we do to animals is raise them for food. There are humane ways of doing it but the sake of money, we don’t. That kind of suffering is unimaginable. 

It’s not just animals but humans are made to suffer by the worst perpetrators, their loved ones – the family members. 

It wasn’t until I went through medicine when I realized what total bullshit most of the socially assigned designations are – mother, father, wife, husband. You aren’t someone’s loving parent if you take that child through years of surgeries and chemo and radiation and tube feedings and IV sticks just to drag out their death. 

And though the little ones are often at the mercy of misguided parents, us adults have hope, we have options. I can die any fucking way I want and nobody can tell me otherwise. 

Humane Death

A humane death isn’t a right, it’s something you have to fight for. Because of all the lawsuits against hospitals and doctors, the standard is to keep your vegetable ass alive for as long as possible until your imminent death can be proven beyond a reasonable doubt. 

I don’t know about you but watching those sad, lonely, demented folks in the ICU, that look of violation and rape on their face every morning when the lights came on and their diapers changed, their feeding tubes cleaned, and their wounds managed; I don’t have the heart to do that to another human being. I barely had the strength in residency to watch family members doing that to their ‘loved ones’.

I’ve suffered enough in medicine to know that I need to live my life as intentionally as possible. So why can’t I die intentionally as well? Death doesn’t have to be ugly – ask the palliative doctors who make that process a breeze for the terminally ill. 

Advanced Directive

In order to do the death thing legally and as humanely as possible, you need an Advanced Directive. You don’t need a lawyer, you don’t need a notary, you just need a couple of witnesses. Sign the document and you are done. 

The Advanced Directive is sometimes called a living will or healthcare power of attorney. It’s the main document you need to take control of your death, just like you did with your life. 

Furthermore, you need to assign a person to carry out this advanced directive, the executor or health care representative. You need to give copies to that person and select even an alternative person, just in case. 

You should also give copies to your physician and anyone else you can think of who will know about your dying process. 

POLST

A POLST is a little different from an advanced directive. The latter is always needed, but the former, a Physician Order for Life Sustaining Treatment, is an extra layer of directives which can help guide your care. 

Think of the POLST as a guidelines for which emergency medical services you will want done to you and which you don’t. 

Painless Ways To Die

The things I do for you guys – let’s talk about dying painlessly. This one took a lot of research because every online question which asked about painless dying was replied to with “no, don’t kill yourself, there is hope, be brave”.

The key to going painlessly is to have someone oversee your death though I doubt you’ll find anyone brave enough or selfless enough to help you through the process.

If you just do one method then the chance of failure is high. The human body is resilient as fuck when it comes to death. I recommend combining multiple methods.

A good combination would be the following. Ideally all given together. It’s one hell of a cocktail.

• fentanyl or morphine
• Valium or Xanax
• Benadryl
• nitrous oxide or carbon monoxide
• insulin
• potassium
• Zofran

I know some of you have given this much more thought than I have, so share in the comment section. Especially the anesthesiologists, they are like masters at this topic.

The Peaceful Pill Handbook

The Final Exit

Speaking of dying, don’t forget to write your will. Feel free to leave a section in there for me as well.