The TLA was common in the military : the three letter abbreviation (TLA) overly populated the literature and vernacular. NFF, DNF and TBD are some I can instantly recall. We even extended the list to include such veritable organisations such as the NAAFI. These abbreviations also are common place in the civilian world and, no doubt, in many areas of professional life. Whereas NFF or No Fault Found was disappointing when, as aircrew, I would notify the engineers of a particular fault but they were unable to find it; or due to weather conditions precluding safe flying DNF or Did Not Fly was also saddening, especially if the destination was exciting or hot (or both); or TBD or To Be Detailed, awaiting further instructions; I have come up against one TLA which was deeply disturbing, for the right reasons. That is DNR.
As we all get older, we notice that we lose some of our capabilities. Some might claim our capabilities actually change, we may even develop new capabilities. Our physical capability to adapt to the ever so changing modern world also changes. If I recall the changes in the computer technology available to homeowners in my (short) lifetime, it is staggering. How could you ever fill a solitary 40MB hard drive? Seriously! I have also noticed that TVs are now unable to be controlled by even simple controllers but require a plethora of buttons; often we require 2 or even 3 controllers to be able to remain seated and affect the TV, radio (do we even have need of one now if it is streamed through our PC or smart TV?) and lighting/heating (I’ll add here that I use the wall switch). The expression ‘there is an app for that’ echoes in our ears to sustain our capabilities. Sadly our age progresses at a steady rate and one day we are unable to cope with such adaptions to our life.
Every change brings new insurmountable hurdles.
To see someone whom I dearly love struggle with the most basic operations: of making a cup of tea, operating a toaster, a TV, a HiFi, and now life itself has been heart breaking. Every change brings new insurmountable hurdles. We created speed dials on his large button mobile phone, and then devised a large colour page of very simple instructions so he could keep in contact with 5 people, yes just 5 people. But that was far too complicated: which button do I press to make the call or stop the call?
Recently the family had the heart wrenching call from the hospital : “please come quickly“. Following rapid critical medical intervention he returned to us but suffered injury in the process, and at a cost to his health. It was suggested by a skilled professional within the family that we consider asking the question “would you feel it was appropriate for a DNR to be placed on his records?” A ‘Do Not Resuscitate’ instruction which would go on all his records: for the GP, the paramedics and the hospital. We initiated the conversation with the youthful junior doctor. I make this latter comment in no way to denigrate their ability: they were supervising 6! wards over the Bank Holiday weekend; therefore, their ability was first class. They were so pleased that we had asked such a question. For many family members it would seem that the consideration is that this may mean the removal of life support systems, whereas the focus is entirely on the future quality of life for the patient. To intervene one again, causing further injury in the process (it would be inevitable given the necessary medical protocol), could bring the patient back to us but again at what cost to them? It is not about the family but entirely with regard to the patient.
These 3 letters DNR have haunted me, in some ways, ever since. What does it mean as a Christian? Are we playing ‘God’? Through medical excellence we have been able to extend our lives from the given mantra in my school days of ‘3 score and ten’ to now that 1 in 10 of newly born’s will reach the age of 100.
I heard a Radio 4 Thought for the Day on the days leading up to the recent incident at the hospital. The minister spoke of the apparent need to keep our bodies going as we get older. The gyms around the country are full of lithe somewhat aging bodies who are pumping iron, or pounding the treadmill whilst watching the latest soap on the overhead TVs. The minister continued to articulate that in the far east the concept of the older member of the family was to go and take time out to gain enlightenment. What form was this new knowledge? To understand who they were : to be and not to do. Perhaps as we grow in that understanding we can determine where we are and become content with ourselves. We may be able to understand that God is in the beginning and at the end of our lives. This journey is one that we walk with God and, as a Christian, I believe that we continue to walk with God after our death. But do we give ourselves time when we can contemplate such thinking to ponder how all this fits together?
As I hear my loved one try to bring together 4 or 5 decades of memories together, like disparate jigsaw’s floating around in cerebral space, juggling with various inputs and struggling to make any sense, and hear that frustration, that anger at times, there appears little we can do to calm that raging intense mind. To hold their hand, suggesting lines of thought which might help, to say words of comfort which may merely placate those times we can be there – I, for one, hope that those thoughts linger on with them. The nursing staff are extraordinary in their patience and care as well. But inside, the mental turmoil of our loved ones must be intense. To add to that the pain and anguish of physical limitations must only add to their struggles. It is NOT turning off their life but permitting a departure point which does not leave them hurting, scrabbling around for solutions which may not be present.
Some might say that we should pray for their recovery. Yes I do believe in healing, but it refers, in my opinion, not only to bodily healing but to a holistic healing of mind, body and spirit. I have been praying so much for that healing recently: the healing from pain in their mind, in their body. Please tell me that isn’t wrong? Where is love here if we don’t seek to end that pain? I so desperately seek quality of life for this cherished loved person.
You are giving them that option, for your loved one.
I would encourage families who are walking with loved ones who are struggling in mind and body to consider approaching their doctor regarding DNR. The medical staff at the end will make that decision whether it would be viable to resuscitate. You are giving them that option, for your loved one.
Our loved one is still there: settled and comfortable for the time being. And I pray, walking with God.