Monday 8 August 2011

8-8-11: A Good Death

8-8-11: A Good Death: "

Audio for this segment will be available by the end of the day.


Dudley Clendinen is an award-winning author and journalist who lives here in Baltimore. A former reporter and editorial writer for The New York Times, he found out in November, at age 66, that he has amyotrophic lateral sclerosis, or ALS, more popularly known as Lou Gehrig’s disease.


There is no known cure for ALS, and once a person is diagnosed, they usually live between 1.5 to 3 years.


Over the past few months, Dudley has been speaking with Tom Hall about living with ALS. In this conversation, they’re joined by Lora Clawson, a nurse-practitioner who works with Dudley at Johns Hopkins’s ALS Clinic. She’s also an assistant professor of neurology at the Johns Hopkins School of Medicine.


Dudley says he’s been feeling sadder recently. “I think it’s probably in relation to the physical changes, as if my body was sad. Independent of the way my mind feels, or my heart feels, it’s as if the disease and the body have a set of feelings of it’s own.”


Tom asks Lora about how she helps terminally ill deal with saddness–and even depression. “We have frank, open, untimed conversations to talk about feelings, and to really try to determine the nature of the depression, and whether it’s short-term or long-term. Are there good things? Does he look forward to things when he wakes up in the morning? Does he have plans of things that he perhaps has been not able to do, to seeing friends or go places, to try to help muster the energy to accomplish those things that are important that he may not have gotten to.”


Lora also talks about how she discusses the notion of a good death with terminally ill patients. “We start out with discussions of advance directives. Have they thought about their life, and how their life might end? We also talk about what their perceptions or misconceptions are of interventions such as feeding tubes, BiPAP, non-invasive ventilation, as well as trechostomoy and long-term ventilation….we try to de-mystify what would be a good death, and how they’d like it orchestrated.”



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