Home Health Care: Final Wishes
“I’m too ornery to die; I’m going to stick around forever to make everyone else’s life miserable.” Those were the only words of wisdom I had that alluded to her last wishes. My mother was dead. I did not understand why, and the responsibility of her final internment was placed upon my shoulders.
SCIENCE, my inner voice screamed. However, my uncle’s response was “she has been poked and prodded on her entire life; we should let her rest in peace.” I did not agree. My mother suffered from rheumatoid arthritis since she was 15 and, at 52, why should her suffering go in vain? True, she suffered in life. She endured countless surgeries and disappointment because of the degeneration of her joints. Nevertheless, she could help someone, her pain would be knowledge. My mother would make a curious team of medical students’ lives completely miserable for an entire year. I felt completely confident her sense of humor would be validated. More importantly, because her condition was so extreme they might not ever forget her.
A testament to this theory came when Dr. Won Yi, D.O. recalled his first encounter with his cadaver at the University of North Texas Health Science Center.
“It was startling at first; it was so personal,” Yi said. Twice weekly, the students organized into teams for anatomy lab. “We developed an intimate, educational relationship—it was a respectful and gratuitous one.”
Yi said having a real a real human body was an extremely beneficial and educational resource. He also plans to donate himself as an anatomical gift. “It’s only right; you must give in order to receive in the name of medicine.”
I was touched to learn that at the end of the semester, the students gathered to participate in a memorial ceremony to commemorate their cadaver’s contribution to the cause.
I faced major challenges. First, I had to find a school in Texas that would drive eight hours to pick up my mother’s body from Oklahoma and bring her back to Texas (or suffer a possible haunting—she was a devout Texan). Secondly, because she died suddenly from streptococcal pneumonia, she was septic. This meant that, I needed to investigate the issue further by means of an autopsy. All of the opposition proved to weigh heavy on my already overloaded, grieving, confused heart.
So many factors were dependant of another to reach my goal. The majority of schools will not accept donations that are not pre-arranged, from out-of-state, or from an autopsy and especially one that was septic. My anxiety skyrocketed. I called upon a friend, Sarah Willis, a scientist at Baylor College of Medicine, to assist in my quest. Tirelessly she searched, and after several rejections, Parker College of Chiropractic met all the criteria for a small fee. I was elated. It was a small price to pay for the fulfillment of my mother’s final wishes, as well as my own peace of mind.
“I am so sorry for your loss,” was the initial greeting followed by sincere gratitude from Claudia Venable, director of Anatomical Services at Parker College. I had a million questions and she answered them all twice. She even allowed me to make monthly payments and notified me on what date to expect my mother’s parceled remains. The hardest part of the whole process was the day the mail man delivered the package to my door step.
In a more recent conversation with Claudia, I asked her why Parker was willing to accept my donation, while so many others were not. She replied, “Bigger institutions can be pickier, because Parker College is smaller and private, we are more willing to invest the time in more difficult donations.” For that, I am so grateful.
Once the proper forms for a donation to Parker College are completed, witnessed and notarized, they can be faxed as long as the originals follow them via mail. Those forms include; Personal Data Form, Donation Form, Next of Kin Form, and the Return of Cremated Remains Form. The executor of the donor’s estate is only required to pay for transportation expenses for the removal of body and cremation. The institution will then retrieve your loved one and they will become part of their curriculum. Upon completion, your loved one is cremated and mailed to you. This usually occurs within 12 - 18 months of donation.
My second go around with death, distress and decisions came a short 11 months after my mother’s death. I had not even received the “cremains” of my mother when my father died. One would think that having the previous anxiety of not knowing one parent’s last wishes would evoke an immediate need to know the other’s. My innate ostrich tendency meant never wanting to plan for the inevitable. Instead, I always focused on the present, living and hoping for the miracle that my father’s malignant meningioma would not fulfill its prophecy. Even when palliative (fuzzy-feel-good-word for hospice) care was introduced to his daily battle, compelling optimism remained. It was not until the night before his death I bombarded my grandmother with one long, unprecedented stream of desires. Though taken by surprise with the intensity projected, she agreed. Maybe I had known what he wanted all along; at any rate, he could no longer tell us.
Science was also the wish I had for my father; however, this time I wanted to give the gift of life. Because he was still technically “living,” I had more options in terms of donation avenues. I wanted whatever living element he had to directly benefit in the continuum of another’s life.
We were fortunate enough to have Odyssey hospice guide us in this process. Being a most helpful liaison, BioGift was contacted immediately. BioGift is an association in Oregon that assists in the placement of non-transplantable human organs, tissues, and specimens for research and education. Steven Wells, the BioGift representative was so helpful to my family. Nearly two months later, when I called him he remembered me and has made himself available for any follow up questions my family may have. “We are here to help 24 hours a day, call me with any questions,” Wells said.
After the death is confirmed, BioGift discusses the donation with the family and physician. Consent forms, Individual Death Certificate, and Cremation Authorization are completed at that time. Next the arrangements are made for the professional transportation of the donor, to the BioGift facility. Then, blood is drawn and testing for infectious disease takes place. A body can be rejected if the presence of infectious disease is the cause of death, such as HIV or hepatitis. The tissue is then entered into a nationwide database to be paired with potential medical researchers and educators. The body is then cremated and returned to the family along with certified death certificates.
There is no cost to the family for tissue and organ donation; this includes the filing of the death certificate and transportation permit. All information regarding the donor and recipient is kept confidential. We recently received a letter of gratitude from BioGift and a brief follow up that my father was able to benefit as many as 75 people from a single tissue donation.
In addition to the basic anatomical donation, there was a special plan. I, like so many, loved his “smiling eyes.” His big blues “were that of an old soul” said Dr. Kimberly Monday at his memorial service. His in particular, corneas and surrounding tissue went to Baylor College of Medicine. A questionnaire almost identical to the ones given when donating blood was required. I found this to be a long and slightly uncomfortable experience, especially within the hours of his death. It was all worth it though. This aspect helped give closure to the grieving process. There is a feeling that life continues for your loved one.
I searched my heart for the answers and did the best I could with what each of my parents gave me. I had a separate, unique and very special relationship with both of my parents. The correlating factor befitting to both would be the decision to cremate. Death is inevitable, thus universal to every living thing on this planet. Ashes to ashes and so forth…
My mother currently resides in my closet, waiting to make her final journey to the “mother land,” Ireland, to be released into the atmosphere from the tallest castle her “baby girl” can find. As for my father, my grandmother safely guards him. We, as a family, are still undecided. I do not need a monument to visit; my wish is to free his soul. I would like to return his spirit to the place in which he found the most peace, Hawaii.
Death is obviously a dark subject. We are never ready to say goodbye no matter how much preparation, or lack there of, we have. Resistance to conversation might be the unwillingness to contemplate death. Everyone is different. What is most important is that you tell your family if you want to be an organ or tissue donor or an anatomical gift; it is the best way to ensure that your wishes will be carried out.
As for myself, there is no question that I wish to be donated, and then cremated. I, like my parents, want my death, as well as my life to have meaning. Life is precious; what is more so than the gift of education and life?
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