As you may have heard if you read this blog regularly, I recently lost my sister Kate after a grave, unexpected illness.
I call her my sister because that’s what she called me. She insisted to everyone she met in her last couple of weeks on earth that I was her sister. She introduced my husband to people as her brother-in-law. On the family tree, she’s listed as my mother’s sister, but families are messy and I spent nearly as much (if not more) time with Kate’s parents as I did in my mother’s less than tender care. Our relationship was about as clear as mud to most people, but it worked for us.
I gave a eulogy at Kate’s memorial service, and it was through writing that eulogy that I came to realize just how much she had taught me through my childhood. I learned at her knee everything from how to peel potatoes to how to look innocent when I was being just a little naughty. The last month, watching her go through a tragic, horrifying experience in the ICU with multiple system organ failure, I learned a few more lessons. A few very, very important lessons:
- Make your end of life wishes known. Kate did, and because of that she had the gentle passing she wanted, surrounded by her family and friends. I am in awe of her courage, in that even though she did not want to die, she never once, not even once, went back on her often stated wish that she never be placed on a ventilator.
- Even if your wishes are known, appoint an advocate who will follow them. The attending doctor on my sister’s case actually talked her next of kin into revoking the no-intubation order and DNR momentarily (while that person was exhausted, emotionally fragile, and without adequate support). He did that willfully and with the knowledge that Kate’s well-known wishes would be violated. He did it with the false promise of “just a few days” when in reality a few days of being on a ventilator would not have changed her situation except for to extend her pain and suffering. This momentary lapse cost our entire family immeasurable pain as we tried to advocate for Kate’s wishes and still be supportive of the one making them, who didn’t deserve that burden. Kate made that decision, long before her illness, and it was unfair of him to create that Sophie’s Choice for her kin.
- Know who your next of kin is. Legally for someone in Kate’s situation, the order is spouse, adult child (eldest to youngest), parent, adult siblings (eldest to youngest). Is that really the person you want making your decisions for you? Really? What about the second or third person on that list? If not, getting a health care power of attorney might save you a lot of grief some day. Kate’s next of kin was in debate most of her stay in the ICU, and the person who finally ended up with the responsibility wouldn’t even answer the phone most of the time.
- Make a will. Even if you have nothing of real value. Some of our long estranged relatives came out of the woodwork after Kate died and started throwing around talk of lawyers and law suits. She was the most generous woman I ever met, and because of that, she died owning little more than the clothes she wore and a few mementos. The legal threats were a clear power play intended to hurt the survivors and had nothing to do with the minimal material goods my sister accumulated during her lifetime. Even her cremation and burial were paid for by the generous donations of her friends and family members. Imagine what the situation would have looked like if she had owned a house, a car, a life insurance policy…
- Live every day as if it is the only one you get, but don’t forget to plan for the future. Kate often called people up out of the blue, just to tell them she loved them. You always knew where you stood with her, and for that I can only be thankful. But she also avoided doing the things that might have extended her life – proper medical care, self-care, and follow-through. Her medications were so out of whack when she was admitted to the hospital that they almost certainly contributed to her sudden downturn, and that could have been prevented just by getting her follow-up labs on time. She suffered from a fatalism that is so very common where we come from – what will be will be, they say – but that’s not always the case. You’re more likely to be hit by a bus playing in the street. When it came to her health, she played in the street, and while I genuinely believe she had no regrets, I regret that she was taken from us so soon.
My husband and I met with a lawyer today. With any luck, we’ve just wasted $375 dollars and about an hour of our time having wills, powers of attorney, and health care powers of attorney drawn up. We included very specific instructions in relation to our son, so that his future is never compromised by those (thankfully) estranged family members attempting to claim him to get at his inheritance. Yes, I believe they really would.
So I guess that I should thank my big sister, for teaching me a few last lessons that I knew in the back of my mind, but never really took to heart until her death brought them home.