As I was saying, each year I toast to my grandfather with a porter.

I don’t toast to him in sadness, but always in celebration. He lived a good life. And most importantly, he went out on his terms.

One of the things I take solace in with his death is that my mother and aunt knew exactly what he wanted before he died, and they were able to give it to him. A final trip to the beach, a few final days surrounded by everyone he loved and he was perfectly happy.

With Tuesday marking National Health Care Decisions Day, I sat down with my mom to fill out an advance directives form.

An advance directive is a set of wishes regarding medical treatment made to ensure that those wishes are carried out if the person is ever unable to communicate them to a doctor.

For those who don’t know, my mom, aside from being a certified kick-ass mother, works at Frederick Memorial Hospital, and she has spearheaded an effort that has gained national recognition to ensure as many patients as possible have an advance directive.

She often uses my grandfather as an example for why these documents can be so helpful. But there’s data behind it too.

The advance directive is part of a movement in the health care community for families to have what is being dubbed “the conversation,” a family-style conversation about what their wishes may be if they’re ever in a position where they can’t communicate for themselves.

Studies have shown that depression rates six months after losing a loved are lower for families who had this conversation, largely because they know they acted on their family member’s best interests.

And this conversation is becoming less taboo. In 2015, only 1 percent of patients at FMH filled out an advance directive. In four years, the hospital has increased that number to 47 percent — 20 percentage points above the national average. The number of families having the talk are even higher. But it’s still a conversation not everyone is comfortable with.

Growing up in a family with a mom and stepdad both in health care, these types of conversations may not have been commonplace, but we certainly had them. Nothing was taboo to talk about in my family — and that included death.

So having the conversation of what I want to happen medically if I’m ever knocking on death’s door was easy. But it’s surprising for me to see how many people don’t want to broach the topic of their own death or the death of their loved ones. My girlfriend, for instance, can’t stomach the conversation about her parents’ death, and she’s convinced herself they’re going to live forever.

I’m a little more pragmatic about death. It’s going to happen to all of us, so we might as well go out how we want. But until filling out my advance directive, I hadn’t thought much about my own.

I hadn’t thought about where I’d want to die, or how hard I’d want people to fight to try to keep me alive.

So, in the interest of openness and hoping to make conversations about death a little less taboo, I decided to share my wishes for when I die.

I’ve selected my two best buddies, Ethan and Sean, to be my primary agent and act on my behalf if I can’t communicate. They are under strict instructions to follow my strict instructions. I could’ve picked my girlfriend, or my mom, but it doesn’t seem fair to burden my girlfriend with that decision and my mom probably won’t be alive by the time I die. I know this because I promised Becky I’d outlive her, and she promised me that we’d spend at least 60 years together. So given that my mom is (ahem) years old, if you add 60 to that, the chances of her being around to execute my advance directive are slim.

When I envision my death, I don’t imagine any specific place, but I guess Camden Yards might be a nice place to go out. I do envision people, though. I’d like my friends and family to be there. Just because dying alone seems, well, lonely.

I’ll digress for a second to say that one of the questions on the advance directive asked what my wishes would be if death were imminent and I were pregnant. I want to tell the world that if I’m about to die and I’m pregnant, please call the Frederick News-Post and give them the scoop. Also, all checks should be made payable to the Allen Etzler Foundation, which will be used to create the Allen Etzler School for the Gifted.

It’s hard filling out what your medical wishes might be when you’re just 27. I still feel like I have a lot of life left to live, and therefore, I might be more willing to have doctors take a few steps to keep me alive.

But the one thing I’ve never wanted to be in my life is a burden. So I don’t want my death to burden anyone else. I don’t even want to be a burden to the doctor charged with looking out for me.

So for nearly every answer, I requested that doctors allow a natural death to occur. Even at 27, I don’t want extraordinary measures taken to keep me alive. I’m not interested in sacrificing my quality of life just for a couple extra weeks, months or years of being miserable. If I can’t communicate or get around or enjoy food, I’m not sure life is worth living.

So, now you guys know my wishes. You also have strict instructions to ensure that Ethan and Sean stick to my strict instructions if I’m ever near death.

You also have strict instructions to at least begin broaching this conversation. It’s an important one to have. I’ve seen families tear themselves apart from the inside over the death of a loved one. It doesn’t need to be that way. It might not ever be easy. Planning for my own death is kind of weird. Thinking of my family members dying makes me cry. But it’s better than not knowing what someone wants until it’s too late to ask.

I miss my grandfather — and my other grandparents who have since died — every day. But our family stuck together through of all of those deaths. And knowing what people wanted when they died is a big reason why.

Follow Allen Etzler on Twitter: @AllenWEtzler

Allen Etzler is a city editor at the Frederick News-Post. He can be reached at aetzler@newspost.com.

(4) comments

sue1955

BTW, Allen, you were very smart to not to put your girlfriend on your advanced directive. Folks, never ever put someone who you are not married to (but in a romantic relationship and even a fiance/fiancee) to decide medical issues on your behalf. If the relationship ends (no matter how you think that it is "forever"), it may not. I will spare you readers more detail.

sue1955

Allen, you are well meaning. It's good, too, that death is not a taboo subject with your family and that you are thinking ahead.

But be aware that an Advance Directive is not going to be honored by a hospital depending upon the patient's age and their medical condition that brings them to the hospital in the first place. The hospital is going to try to keep one alive. For example; if you as a young man are in a castastrophic vehicle accident and the hospital has to put you on a ventilator in ICU to save your life, your buddies cannot just say "well, Allen does not want to be kept alive by extraordinary means" and the hospital takes you off the machines and lets you die. Your next of kin comes into the situation, also, not your buddies, regardless of whether or not they are included in your advanced directive.

You are glib in your article and, at 27, your thinking may be typical. When you are young and healthy with your whole life in front of you, your viewpoints are different than what can happen in the years to come. As the hospital representative in Baltimore told me when I had to approve various possible procedures/surgeries for my critically ill daughter, one has "to be careful what you wish for." She said that a young adult who has an advance directive who chooses "not extraordinary means to keep alive" is essentially not applicable for any critically ill patient (as I already stated above). Allen, this is not a cavalier black-or-white issue.

I'll try to keep the following brief. Last month, the unthinkable happened. My daughter (in her thirties and never a smoker, but has had pneumonia a few times) developed a very serious respiratory problem in the last year and a half. I found her unconscious in early March and had to call the ambulance. During her hospital stay, she got much worse and put into ICU after a few days on a ventilator. She had to be air-lifted to another hospital where she remains. (Names withheld because I don't want to be
"moderated out"). She was very close to death. She is just coming around after a tracheostomy was performed over a week ago. If it weren't for the extraordinary top-notch care by a group of phenomenal professionals (at the Baltimore hospital) who are absolutely on top of things, she would not be alive. Her age is on her side, of course, as opposed to somebody older (as the hospital says). I have been told, too, that she has a long way to go. I thank God, too, for my friends and family who have been praying for her and continue to do so.

Dwasserba

27 seems young, but I can name two instances in the last year when people died beyond-unexpectedly, one from an aneurysm, another from a blot clot after surgery considered so minor, we didn't know it had happened. It is not a good time for families to disagree over what the person would want, while trying to deal with their own biases that they had not considered before. We did this at the time our lawyer drew up our Will in 2006. And in the event that you are indeed "trapped in your own body yet lucidly overhearing your family discuss your fate" (I may have given this some aforethought), learn fingerspelling. If you have just 5 working fingers you can join the conversation! Also good in case of debilitating stroke.

sue1955

Deb, your post was not up when I wrote my comments. Good points of yours. Unfortunately, my daughter cannot manage to do what you state about in terms of "fingerspelling." Even when a patient is in a coma and can hear what people are saying, they are restrained (arms) so they cannot remove life support (especially the ventilator). Of course, I realize that you are saying - IF they have just 5 working fingers..." Also, the patient is very weak upon being on life support for weeks and may not be able to maneuver their fingers at all (as is the case with my daughter). I appreciate your input.

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