by Kevin J. Haselhorst, MD
Where do I begin? First, in answer to many of your questions as to why I have not reviewed a book in a while? —and thanks for your readership and interest in this site—I can say that a combination of too many professional engagements combined with too many personal issues related to health and relocation have conspired to eliminate for a while my ability to write. But rest assured, the readings have continued and now that I am back there will be more reviews coming. I start with a GREAT book.
Wishes To Die For is a tough read. Let me begin by saying I like tough reads. Really, why bother otherwise? Second, I like Dr. Haselhorst; I believe he is a good, caring Doctor; in fact, I would like to have him as my Doctor. The only problem with all of this is that I do not know Dr. Haselhorst; I don’t live in AZ where he practices; therefore, it is highly unlikely Dr. Haselhorst will ever be my doctor. So be it and my loss I am sure.
But let’s move on…The subtitle, A Caregiver’s Guide to Advance Care Directives, requires a definition. Advance Health Care Directives are legal documents that specify your wishes about how the health care profession, your family, your non-family caregivers, and even complete strangers are to provide for your end-of-life care when you are unable to make and express these decisions yourself. These documents help control how you will leave this life. They are DAMN important and, sadly, seldom done well if at all.
Enter Dr. Haselhorst with his thoughtful, very hard to read and “appreciate,” but well worthwhile, book, which we highly recommend with the caveat that this is NOT a 20-minute read; it is not a “How-to,” checklist type book for Advance Care Directives. Those books and pamphlets are ubiquitous and are available on-line, at your bookstore or, god-forbid, at your lawyer’s office. And if you pick one up and go to the trouble to check the boxes and file it where you can find it, the chances of it being meaningful to you in your competent years is almost nil; the chances it will be used to allow you to exit this life as you wish when you are no longer competent to make such decisions is almost nil and, even worse, the chances it will be meaningful for those involved in your end-of-life care and decisions is, regrettably, also nil. BUT, if you take the time to read, consider and use Dr. Haselhorst’s book, the good news is that you can change your future—you can change today how you think about death and dying, for you and those you love and for those you don’t even know—yet. And you can change your today and your competent tomorrows for the MUCH better.
Years ago, I taught two classes that made a seminal difference for me, if no other, in how I consider and approach death and dying today and each day I live. One was a course on Stephen Covey’s marvelous work “Seven Habits of Highly Effective People.” A timeless classic of expression if not original thought if there ever was one. The second class, poignant for me because I prepared and taught it at a time when my own brother and I were estranged and yet I was handling his own end of life issues, was one on Death and Dying, for which I pulled in lots of outside resources sprinkled with a few original thoughts. I remember starting off the latter course with the simple yet to some revolting and unacceptable statement that “To best understand and appreciate the meaning of life, one MUST first understand and accept the fact and meaning of their death.” I still believe that is true—until one has faced, literally an/or mentally, the concept and reality of their own death, life is shortchanged and forever less than it could be. And that includes the final stage of life when many if not most will be incompetent to give any thought or direction to such heady subjects. Too many Westerners I believe act daily as if there is this impermeable veil between them and death. It is something, like pilots thinking they will never crash because they have the “right stuff” and, therefore, it is something they just don’t have to deal with. What a tragedy for the individual and all those who will be involved in end of care issues for that person.
Dr. Haselhorst’s book lays bare that myth and lie of healthy, appropriate ignorance of end-of-life issues, through personal and professional story after story, which together paint an indelible picture as to why we should all look at death now and plan for that inevitable eventuality of incompetence when we are robbed of reason and voice in a way that will benefit human kind generally and specifically. Please take heed readers and begin the journey that will make all the different for you and others.
Stephen Covey’s, God rest his soul, seminal book of Seven Habits details seven habits of highly effective people he studied through the ages. In order, they and their application to Dr. Haselhorsts’ work are 1) Be Proactive—take charge and act on understanding your vision of who you are and how you want to exit this life and to be remembered—whatever you do, don’t default end of life issues to others; 2) Begin your thinking and planning for today with the end in mind—our death; think about life and death holistically and clearly and express how you want your end days to go; 3) Put first things first—order your life—micro and macro--based on priorities and principles and let these wishes be known, and, if you are fortunate through continuing efforts, accepted by those in your circle if influence and who ultimately may have power over you 4) Think win-win—life is best lived as a cooperative venture not a competitive one so work with people you live and interact with to make a great Advance Directive that will be good for all; 5) Seek first to understood and then (if ever) to be understood-- understand who you are, what you are becoming and how you want the end to go for you and those around you; male this an iterative process that can be constructive for all involved; 6) Synergize—work with others to create something better than you could do a lone; 7) Sharpen the saw—don’t stand pat or static. Life is an ever-changing evolution and we should constantly do things to help us recognize, accept, and rise to meet new crises at whatever stage of our life as they arise and accordingly change our Directives as circumstances dictate. Literally these habits are consistent with and inform what Dr. Haselhorst is advocating we do earlier in life so that we better control the end of life—for ourselves and others.
Ignoring end-of-life issues and leaving them to others is an avoidable tragedy for you and others and Dr. Haselhorsts, through vignette after vignette, both personal and professional, lays bare the myth and lie that end-of-life issues will take care of themselves better if we do nothing than if we tackle the hard thoughts and choices he advocates. His sharing paints a picture of why we should look at death and dying now and plan for the inevitable eventuality of incompetence when we become robbed of reason and voice in a way that will ensure death will diminish us and people involved in our final days in very unnecessary ways. Please take heed my readers that there is a very different and more edifying way to journey toward your final stage of life and it will make all the difference for your and others who will be there for that journey voluntarily or otherwise.
Dr. Haselhorst’s book is not for everybody for sure. It is not even for most unfortunately. But if you are one of the few who likes hard issues, even and particularly when they apply directly to you at whatever stage of life you find yourself, buy the book, read the book, study the book, and apply the book to write a product—an Advance Care Directive driven by your honest thoughts and wishes re the end of your life and how you want it to go. Doing so will make a seminal difference in your life and in the lives of those loved ones or strangers who will be, for better or worse, a part of your end-of life days, weeks, months or, god forbid, years.
Thank you, Dr., Haselhorst, for your service to healthcare and the millions of individuals who receive it daily. Thank you for sharing some incredible personal stories of your family and who you are and how you got to this still evolving point in your life. Thank you for your wisdom and for sharing that for all to see. Anyone will be blessed and benefitted by buying (available at Amazon.com), reading, studying, and applying lessons found in the book. No checklist here—just a well thought out and incredible personal and professional road map for a journey we are all taking and will one day finish at the same place—the only question is how and whether it will finish in a way consistent with how we have lived and, more importantly, how we want to exit this life.
Good bye for now and may you have beneficial reading ahead. See you again soon. Best!