failed to prepare for the outcome that’s vastly more
probable. The trouble is that we’ve built our medical
systemandculturearoundthelongtail.We’vecreateda
multitrillion-dollar edifice for dispensing the medical
equivalent of lottery tickets—and have only the
rudiments ofa system to prepare patients forthenear
certaintythat thosetickets willnotwin. Hopeisnot a
plan, but hope is our plan.
FORSARA,THEREwouldbenomiraculousrecovery,and
whentheendapproached,neithershenorherfamilywas
prepared.“Ialwayswantedtorespectherrequesttodie
peacefully athome,”Richlater told me.“ButIdidn’t
believe we could make it happen. I didn’t know how.”
OnthemorningofFriday,February22,threedaysbefore
shewastostarthernewroundofchemo,Richawoketo
findhiswifesittinguprightbesidehim,pitchedforward
onherarms,eyeswide,strugglingforair.Shewasgray,
breathingfast,herbodyheavingwitheachopen-mouthed
gasp. She looked as if she were drowning. He tried
turninguptheoxygeninhernasaltubing,butshegotno
better.
“Ican’tdothis,”shesaid,pausingbetweeneachword.
“I’m scared.”
Hehadnoemergencykitintherefrigerator.Nohospice
nursetocall.Andhowwashetoknowwhetherthisnew
development was fixable?
We’llgotothehospital,hetoldher.Whenheaskedif
theyshoulddrive,sheshookherhead,sohecalled 911
andtoldhermother,Dawn,whowasinthenextroom,
what was going on. A few minutes later, firemen