It's apparently spreading through the Whitehouse like a California wildfire in an unraked national forest, and sounds like in the Senate too....at least one segment of the senate. Good thing for them it's just a hoax, one big nothing burger.
Reports are Hope tested positive Wed morning, but Trump still held an intimate fundraiser with top donors Wednesday evening knowing he had been exposed. Now, with his campaign out of money, he's put his biggest donors at high risk, and they are mostly elderly too, a high risk category.

Trump is in at least 3 high risk categories. Elderly, obese, and with heart conditions.

Two words seem to sum up the irony of the "nothing burger" president contracting and personally super spreading the virus that he's downplayed in every way since the outbreak......poetic justice.

Hey Rflagg, you asked a good question. Why, if you believe that you do here will effect your eternity, would you live according the system of this world? Jesus gives us an answer:

Matthew 6:19-21

Do not store up for yourselves treasures on earth, where moth and rust destroy, and where thieves break in and steal.

But store up for yourselves treasures in heaven, where moth and rust do not destroy, and where thieves do not break in and steal.

For where your treasure is, there your heart will be also.

Your heart condition will determine how you live. If you love God with all of your heart, you will live for Him and His Kindom, and your life will reflect that. If your heart is for the things of this world, that is what you live for. This is why the scripture warns us:

1 John 2:15-17

Do not love the world or anything in the world. If anyone loves the world, the love of the Father is not in him.

For all that is in the world--the desires of the flesh, the desires of the eyes, and the pride of life--is not from the Father but from the world.

The world is passing away along with its desires, but whoever does the will of God remains forever.

When it says do not love the world, it doesn't mean the people of the world, but the system of the world. If you live in the west you are used to seeing nominal Christians practicing a lukewarn faith. This isn't how it is in many parts of the world; there are many Christians out there with their eyes set on eternity. Many Christians here in America, as well, but they don't sound a trumpet before themselves so you don't see them.

This video, like many others, has such a mistaken view of what the scriptures say about faith; it is referring to a blind faith whereas the scripture calls us to believe based on what God has revealed to us. There is a living God who reveals the truth of His word, and everyone who is seeking Him will find Him.

Is it just me or does the guy at 4:33 look like Willem Dafoe? Kind of acts like him too lol.

I vaccinated my daughter, but let's not kid ourselves, *general practitioners* are not the end-all-be-all of medical knowledge and, collectively, they make wrong diagnoses and mistakes all the time. For instance, my family doctor prescribed Flovent to my daughter when she was less than a year old, yet the manufacturer's literature clearly states not to give it to children under a year of age. My father was prescribed a drug for a medical condition which should not be given to patients that have atrial fibrillation - he questioned his cardiologist about this and was told not to take the medication. Good thing he didn't just rely on his other doctor's infallible judgement (and yes the other doctor was aware of his heart condition.)

Most general practitioners are likely not at the forefront of medical research; I'd much rather trust the advice of a medical researcher or specialist in the field. I trust our well-tested vaccines, but that doesn't mean future vaccines might not carry unknown or unexpected risks (see Pandemrix).

I'm not sure how serious they were about not treating patients that refuse to vaccinate their children, but up here in Canada, I'm not sure that would fly. I'm not sure a GP can refuse to treat a parent because they refuse to vaccinate their child; it would be an interesting case to see argued in court. It has something to do with the way the Human Rights Code is defined: physicians must provide services without discrimination, which may be in conflict with their moral beliefs.

Canadian from Manitoba checking in here. Things like crutches, prescription medications, and ambulances are out of pocket expenses. Got something like diabetes? Expect to be spending a lot of money every month on drugs.

For life threatening emergencies or even broken bones and stitches our system works great for people, and no worries about going broke, you just go in anyways. Our federal and provincial taxation levels though are also much higher than in the US and a large percentage of that is spent directly on health care. I don't know what level of health insurance that amount would buy each Canadian, but it is important to remember that the Canadian healthcare system is NOT free.

I must say I do prefer the Canadian system to the American one. Largely on the basis of not seeing working class families being financially destroyed by life threatening and uninsured medical conditions.

I can't just say that though without pointing out that our Canadian system has it's own serious flaws. I know of people with back injuries putting them off work until they can get surgery, and that surgery being a waiting time for them measured in years. They flew down to the states to spend thousands of dollars out of pocket to get the surgery in weeks instead, and were financially ahead too over those two years since they could get back to work. Patients showing symptoms that might indicate major heart conditions or other illnesses who would get an immediate MRI or other expensive diagnostic in the states straight away will routinely wait months in Canada.

That is all just a long winded way to say the Canadian system is far from perfect and has very serious problems and flaws in it that are negatively impacting peoples health and financial well being too. It's no magic bullet.

@Yogi and SFO, smart refs, smart players, and the best place to be with a diagnosed arrhythmical heart condition when time is always of the essence in an emergency....Nothing get's a dull match going like an NDE, send him the fuck back out on the field after a rest!

Let's look at the scripture in a little more detail:

Mat 19:21 Jesus said unto him, If thou wilt be perfect, go and sell that thou hast, and give to the poor, and thou shalt have treasure in heaven: and come and follow me.

This scripture is at the tail end of a conversation Jesus had with a young rich man. The young man had inquired of the Lord how he could have eternal life. The answer Jesus gave was simple, "sell your possesions and follow me." In the rest of the scripture we see that the only requirements for salvation is a confession of Jesus as Lord and a belief that He was raised from the dead. So, why did the Lord give the additional requirement to the rich young man of selling all of his possessions? We see why in the next verse:

Matthew 19:22 But when the young man heard that saying, he went away sorrowful: for he had great possessions.

This man, even knowing that Jesus could instruct him on how to attain eternal life, could not follow after the Lord because he loved his wealth more than God. This is what Jesus said in Matthew 6:24

"No one can serve two masters, for either he will hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve God and money.

His riches were the stumbling block preventing him from following the Lord, and that is why the Lord dealt with it there. The Lord knew He was a slave to his wealth and could not bear to be parted from it, even at the expense of his eternal life. This is a reason why the Lord warned us in Matthew 16:26

For what will it profit a man if he gains the whole world and forfeits his soul? Or what shall a man give in return for his soul?

Which is to say, that if someone laid all the wealth of the world at your feet, and you traded your soul for it, you would have made an unprofitable deal. The wealth of this world is perishing and will pass away, and we along with it, but those who do the will abide with Him forever. So, let's look on to what Jesus said to His disciples after the young rich man parted:

Matthew 19:23-26 Then said Jesus unto his disciples, Verily I say unto you, That a rich man shall hardly enter into the kingdom of heaven.

And again I say unto you, It is easier for a camel to go through the eye of a needle, than for a rich man to enter into the kingdom of God.

When his disciples heard it, they were exceedingly amazed, saying, Who then can be saved?

But Jesus beheld them, and said unto them, With men this is impossible; but with God all things are possible.

You'll notice that Jesus only said it was impossible for men, but with God all things are possible. The problem with the young rich man was not his wealth but his heart condition before God. He wanted the gift more than he wanted the giver of the gift. When Jesus put his loyalties to the test, the true condition of his heart was exposed. There is nothing inherently bad about money, but there is something inherently bad about putting it before God. That is the sin of idolatry, and that is what Jesus is condemning, not money itself. Take Joseph of Arimethea for example:

Matthew 27:57-60 When it was evening, there came a rich man from Arimathea, named Joseph, who also was a disciple of Jesus.
He went to Pilate and asked for the body of Jesus. Then Pilate ordered it to be given to him.

And Joseph took the body and wrapped it in a clean linen shroud and laid it in his own new tomb, which he had cut in the rock. And he rolled a great stone to the entrance of the tomb and went away.

Joseph was a disciple of Jesus yet He did not require Joseph to sell all of his possessions. Indeed, if he had Joseph would not have been able to provide the tomb that Jesus was buried in, ultimately fulfilling the prophecy about Jesus in Isaiah 53:9.

So, to conclude, what God is most concerned about is the heart. If your love for your possesions is what is keeping you from the Lord, He may ultimately require you to sacrifice them. I think is especially difficult for the rich man to realize his need for salvation because he is so self-sufficient. He believes he is in control of his life because his money insulates him from many of the cares of this world. He does not realize that his very breath rests in the hands of the Lord. He may not confess, as Job did, that his riches are all blessings from on High, and at the disposal of the Almighty to do with them what He may.

Job 1:21 And he said, "Naked I came from my mother's womb, and naked shall I return. The LORD gave, and the LORD has taken away; blessed be the name of the LORD."

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Related

Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.

After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.

In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”

They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.

Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.

He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”

His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.

Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.

My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.

As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.

A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.

Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.

My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.

When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his trade­offs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.

Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.

Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.

I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.

It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.

Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.

The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.

And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.

Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.

The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.

In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.

In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.

When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.

When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.

If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.

On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.

Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.

The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.

This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.

Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”

Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”

By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.

Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”

Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.

Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.

(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)

In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.

Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.

Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.

My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.

On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.

After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.

A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.

The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?

I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.

The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”

She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”

Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.

A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

I sure hope the health issue that's preventing him from traveling isn't a heart condition!

>> ^marbles:


First you say there's zero evidence, but now you say it's all about "quantities and timeframes". GOOD POINT! When you administer a substance intravenously, the entire quantity is delivered into the bloodstream instantaneous. So why are comparing it to ingesting where the process is slow and little is even absorbed?


Dosage, whether intravenus or oral, is the important factor, not the delivery method.

Chemotherapy drugs, using cytotoxic chemicals, can easily kill you. People still get treated with them. Digitalis for heart conditions. Ffs, alcohol is toxic in large doses. So is salt, and you can even suffer water poisoning... (http://en.wikipedia.org/wiki/Water_intoxication)

And the list of conditions suffered by number of cases? Wow, so compelling... Do you perchance have the population norms to compare against to see if the numbers are higher for those treated with the vaccine? Any other qualifying factors that demonstrate a significant deviation from the norm? Nada.

What you are doing is not scientific, and it's not presenting evidence. You've attempted to handpick the pieces of evidence you think support your position then tack them together in a casual correlation with zero underpinning. Even if you were right (and nothing you've presented actually says you are), your haphazard cherrypicking approach and unsubstantiated conclusions discredit your own position.

>> ^drk421:

>> ^Boise_Lib:
The capacitors aren't the problem as stated above. The CRT itself is a very large capacitor (stores charge) and can knock you on your ass for a long time after the tv is unplugged.
Also, she's weird.

Yeah, my old boss got shocked by the CRT discharge and his arm swung against the side of the wall and he got cut really bad. It has about the same effect has getting shocked by an ignition coil from a car. I had a similar situation while working on a tube amplifier (around 600V).
High voltage DC will basically burn you really bad (provided it has enough current), but unless you have heart condition it probably won't kill you. It will defibrillate you and wake you up though.
High voltage low frequency AC (between 30 and 1000hz) is deadly starting at around 45 volts. As you get into the higher frequency AC voltages it has less affect on your heart, and thus less likely to kill you.


I saw a chart once in physics class that showed the lethality vs. frequency of AC. The peak was at 50 Hz--right where Europe put their power supply.

I got bit by 277VAC 50Hz once--burned a 1/2 inch hole 1/4 inch deep in my arm.
(I wish we had the metric system in the old USA)

>> ^Boise_Lib:

The capacitors aren't the problem as stated above. The CRT itself is a very large capacitor (stores charge) and can knock you on your ass for a long time after the tv is unplugged.
Also, she's weird.


Yeah, my old boss got shocked by the CRT discharge and his arm swung against the side of the wall and he got cut really bad. It has about the same effect has getting shocked by an ignition coil from a car. I had a similar situation while working on a tube amplifier (around 600V).

High voltage DC will basically burn you really bad (provided it has enough current), but unless you have heart condition it probably won't kill you. It will defibrillate you and wake you up though.

High voltage low frequency AC (between 30 and 1000hz) is deadly starting at around 45 volts. As you get into the higher frequency AC voltages it has less affect on your heart, and thus less likely to kill you.

Made perfect sense to me:

"You're suicidal and have a potential heart condition. But its alright, we're here to help you, we're going to exacerbate your heart condition and endanger your life by tasering you, thereby assisting your suicide. Stop resisting the will to live. You'll die quicker if you give in and let your heart stop. Stop resisting..."

I'm not saying I approve of the tazer, but that kid needed to be taught a lesson.

Also, would you rather have him tackled to the ground forcefully? That also carries the risk of serious injury. And if you say tazers can cause death, well, if the kid had a susceptable heart condition, he wouldn't have been running around the field like an idiot in the first place.

>> ^marinara:

as much as i hate police violence, a taser aint gonna hurt a young boy at all. Probably still needs to be whipped after you taser him.


I don't know what makes you so sure that Tasers won't hurt a young boy. Over 351 people in the U.S. alone have died after being shocked by Tasers. Now I know that other factors could have contributed to those deaths in some cases (drug overdoses, heart conditions, etc.), but that doesn't mean that Tasers are in no way dangerous to young children.

Tasers are supposed to be used as an alternative to firearms, i.e., only when a situation calls for potentially lethal force. Unless that kid had a deadly weapon, there is no way that he should have even been tasered in the first place. Two grown men couldn't subdue an unarmed 10 yr old boy without using a Taser? If that's the case, then they shouldn't be cops in the first place.

QM: I asked a question about which country had superior health care to the USA's. It wasn't properly answered, and I don't expect it to be in a VS post.

Let me answer, from personal experience.

I have mentioned on the sift a number of times about my son who has a host of congenital heart defects. Here in Melbourne Australia we have some of the best heart surgeons in the world, we have access to them, he has had a number of operations and is doing great now. We've spent months in total in hospitals getting fantastic care, and have not been out of pocket once other than the cost of medicine, which is heavily subsidized such that a month worth of medicine (which he has daily) would come to around $12 or so.

There is a large community on the web of parents of children with heart conditions, and those in the US are always mentioning how MUCH money they have to spend to have these procedures done on their children. Fundraisers have to take place, houses have to be remortgaged etc.

It's NOT right to be in a position where you NEED life saving procedures and yet have to wait until you can find the money.

THAT is what is wrong with the US system, and THAT is what will ALWAYS put it below other countries like Australia, the UK etc. where we get access to still world class services and yet do not end up in financial difficulty because of it.

If you think that a system which limits access to life saving procedures to those with access to lots of money is right, well, good on you, you're either very rich, plan to never get sick, or have some unwavering belief that your health insurance will never turn down a claim.