When My Time Comes

Book Review by AZELO supporter Rudy Van Puymbroeck

when-my-time-comes

When your time comes, you will be grateful that you’ve read Diane Rehm’s When My Time Comes. The book collects her conversations with twenty-two remarkable people about end of life care (physicians, patients or their kin, public officials, religious ministers, and advocacy leaders). Not all of them support Medical Aid In Dying (MAID). There is also a fine lecture by Dr. David Grube (National Medical Director, Compassion & Choices) to medical students, and Diane’s follow-up with the students.

Six conversations involve doctors and their patients or surviving spouses. They can be exceptionally revealing. For example, in one case the conversation takes place twelve months after the patient was diagnosed with pancreatic cancer. The physician who had agreed to assist her with MAID asks the patient: “Were you harmed by living longer?” (California law requires a prognosis of six months or less, which would be met in a typical case of pancreatic cancer.) The patient answers: “Not at all. I think having the option made me more open to trying treatment, even though I knew it might be very unpleasant. I’ll try this, I’ll try that, and see how it goes. And if I can’t take it, I have a place to go.”

There are many revelatory moments like that in the book. Take the case of Brittany Maynard, who famously moved from California (where medical aid in dying was not available at the time) to Oregon after her diagnosis with the most aggressive form of brain cancer. Dan Diaz, her widower, in a loving description of his wife’s ordeal, puts it in proper perspective: “It’s not that Brittany was choosing between living and dying. The living part was not on the table. The only thing Brittany was choosing between was two different ways of dying.”

Palliative care physician Dr. Stephanie Marquet finds that people interested in medical aid in dying tend to have “some guiding sense of self.” So, it’s incumbent on each of us to make sure that our desires are known. The book ends with a conversation between Diane Rehm and her eighteen-year old grandson, during which she dictates her end-of-life wishes into his iPhone. Read it. It’s a master class.

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Rudy Van Puymbroeck is a supporter of and contributor to AZELO who lives in Phoenix.

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