Real Intentions for Life

Make Peace with Yourself

Bringing Your Personality to Caregiving.


What do people like about your personality? Are you fun-loving or organized? Do you see the glass half-full or half-empty?  Do you tell it like it is or mince words? Do you like to speak on behalf of others or prefer to listen to what they say? Do you know how to act when the physician walks in the room?

While Helen was telling the ER doctor about her medical complaints, her daughter, Joan, was sitting in the corner reading her book. At one point, the doctor caught Joan glaring at her mother with a look that could kill. Her eyes conveyed that it was time for her mother to die if she was so miserable. Misery loves company. Yet your personality informs you about how miserable you want to be as a caregiver.

Like Joan, you are not required to be someone different while being a caregiver. You may have been chosen to care for your loved one by default, but why not make the best of the situation instead of being upset? You might question, “Why is this happening to me? Why am I called to be a caregiver?” This “why” suggests that you have the personality for it Your “why” is what makes you step up and be recognized as the best person for the job.

Joan was stuck between a rock and a hard place – the rock of needing to be a disciplinarian and the hard place of her mother aging. Her only option was to polish the rock through “romancing the stone.” You romance the stone through three aspects of your personality.

  1. Be receptive

You are who you are.  This stone-cold fact can be either rejected or accepted. Most caregivers believe they need to be careful about what they say and do. They might feel as though they’re walking on eggshells, trying to not upset their patients’ medical conditions. You, however, have very little to do with your patient’s illness. Your patient has a right to his or her own feelings and you have a right to have yours. Your best intention is to be yourself.

The hard facts of a loved one facing death and dying are devastating. Sometimes it feels as if little stones are being hurled at you. Other times the big boulder is rolling toward you. You may not see the rocks at first, but then they hit you like a personal assault. More than likely, you’ll become angry. You work hard to shore up your loved one and then experience rockslides.

Be receptive to softening your anger through your personality. Everyone has a soft side to his or her personality. A gentle, generous and passive part of one’s nature. When the going gets tough for your patient, you can either get tough or soften up. Most caregivers are romantics at heart.  Using this part of your personality allows you to become less angry.

  1. Be romantic

Romance opens the door to your being creative. It permits you to fall in love and be fascinated with a person, place or thing. This enthusiasm is generally short-lived, but will often stay with you for a lifetime. The love that exists in caring for another will wax and wane. The task of caregiving may last three months or three decades. You need to make the most of it if you intend to walk away from the situation feeling blessed by the experience.

Romancing the stone is like polishing a stone and making a gem out of it. Or taking a plot of land and making a garden out of it. This doesn’t happen by accident. It takes a lot of blood, sweat and tears. No one expects it to be easy, yet your personal satisfaction during the process is paramount. You need to feel a sense of accomplishment at the end of the day.

With each thrown stone of something bad happening, you can sculpt it into something good. Your “why” becomes purposeful. Your personality allows “the stone that the builder rejected to become the cornerstone.” Your personality can allow you to see the future in a positive light. That stone at your feet might be the beginning of a new foundation.

  1. Be resolved

Your being firmly determined to do something stems from your personality. Being a go-getter or laid- back is an attribute of your personality. This encircles you like a fortress. It prevents you from being influenced or susceptible to outside forces. It’s your best defense against fear.

You prevent fear from getting the best of you by not giving it attention. Your best defense is to stop worrying about what might happen. The foundation of caregiving is not to care too much. Don’t be afraid of what happens, but realize how to use your personality when the situation with your loved one takes a turn for the worse.

Resolve to have strength under fire. Use the best part of your personality to allow you to cope. Many people find humor to see them through. Others tend to dance around illness. Still others are more matter of fact. Whatever speaks to your nature is what makes you an authentic caregiver. Resolve to let your personality shine though as you care for others.

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Preventive Care Tools


It was no accident that Gwyn had to be her husband’s caregiver. She was a wellness instructor and understood the value of preventive care. The goal of wellness is to prevent illness. Gwyn had just turned 50-years-old and her husband was diagnosed with multiple myeloma. Gwyn knew the importance of creating balance in her life. But was she prepared for the upset of her husband’s illness? Was her wellness experience key to creating an advance care plan?

Preventive care is necessary for you, as a family caregiver, to guard against burnout and heartache. It’s been said, an ounce of prevention is worth a pound of cure. Meaning – it’s better to be prepared than needing to fix problems later. Having an ounce of prevention is the necessary tool that allows you to survive caregiving and prompts you to do no harm.

In staking out a garden, flags are posted every so often in the yard to mark the spot where a new plant will either flourish or perish. The garden becomes a pin-cushion for your hopes and dreams.  By the same token, your patient may feel like a pin cushion when he experiences repeated needle sticks. Your hopes and dreams might appear as inflicting harm to your patient.

3 Preventive care tools can help caregivers do no harm:

  1. Keep it simple

A gardening project can get out of hand. You may think you’d like a lot of plants or that mowing a large lawn is not a chore. What if you had to hire someone to keep up your garden?  How expensive does this become? There is no such thing as a low-maintenance patient. Caring for your loved one is often manageable at first. Then like a vine, the growing responsibilities begin to creep into every aspect of your life.

Keeping it simple requires that you begin to think in reverse. Breathing tubes and feeding tube need a lot of maintenance. Frequent hospitalization results in burnout. Encouraging others to get better is like beating your head against the wall. It becomes self-defeating.

Tell yourself that your job is not to prevent your loved one from dying. Commit to making life easy for you and your patient. You have the choice to say, “We can either do this the easy way or the hard way.” The hard way means inflicting harm. Oftentimes, for no good reason.

  1. Appreciate your work as a labor of love

Do you tend to slave away or enjoy life? Saying, “I love what I am doing” often becomes fleeting as the years pass. A true labor of love is giving yourself permission not to do everything or achieve any results. You can just “be me” or “live in the moment” without expectation or judgement.

“Love is patient . . . Love is not easily angered.” When you become angry, you are caring too much. You have reached a boiling point. You need to turn down the heat and allow a cooler head to prevail. Losing your patience might reflect that your patient losing his battle with chronic illness. Learn how to use love to let go of fear and anger.

Allowing nature to take its course is a labor of love. There is strength in being both aggressive and passive. As a caregiver, your work is to find balance between being gung-ho and letting go. This prevents you from losing your sanity and becoming sick yourself.

  1. Treat caregiving as a gift

The value in receiving a gift is you can take it or leave it. Can you think of caregiving as not being important to you?  How can you give up being a caregiver when someone is depending on you? In this context, your loved one has become more of a parasite than a person.

Living together is a close physical association can mean that you share a symbiotic relationship. Each person gains some advantage through being together. Viewing one another as a gift, you may appreciate this relationship as a blessing and a curse. Establishing this middle ground upfront may prevent you from feeling like killing each other.

Caregiving is only a gift if you remain indifferent to it, i.e. you can take it or leave it. Remaining indifferent is the path to doing no harm. It’s a passive tool that caregivers rarely use. Guard against staking out the perfect garden. Allow enough room in the space for indifference. You’ll experience serenity as a gift when you allow nature to help fill in the gaps.


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3 Tips for a Yearly End-of-Life Assessment


When the ball drops in New York City on New Year’s Eve, will you be ready?  When the bombshell of a cancer diagnosis hits you in the ER, what will you do?  Listen to the doctor or follow an assessment and plan of your own?

Sara was a 68-year-old woman who was not feeling well and had shortness of breath. The doctor thought she might have a blood clot in her lungs. Her CT scan showed that she had lung cancer that had spread to her liver, thyroid and kidneys. She smoked for many years, but never imagined it taking a toll on her body.

Life, as Sara knew it, ended sooner than December 31.  She needed a moment for reflection and time to make an assessment. She could stay in the hospital, but had the option to go home and sleep on it. A home-base palliative care nurse was consulted and met with her in the ER.

Consider these tips for a yearly and end-of-life assessment:

  1. Count your blessings before taking on hardships.

Sara’s husband immediately broke down with the news of her metastatic lung cancer. If there was any doubt of her finding Prince Charming, it was tearfully obvious. She had a fulfilling career as a teacher and raised two successful children. Given the stress of the situation, Sara had remarkable strength.

With counting your blessings, you take note of your accomplishments. Comfort and joy emerge from realizing that you achieved a lot of your goals. Unfinished business often seems unnecessary and like a hardship. We generally do what matters to us and this is what others tend to remember about us. “All’s well that ends well” when you die with a sense of thanksgiving rather than focusing on the loss.

  1. Create closure before opening the window of opportunity

Just as 2016 draws to a close, your life is certain to end. Will there be a series of celebrations or the feeling of “Bah Humbug.” Denial will keep you from creating closure, certainty allows for acceptance. The serenity to accept the things you cannot change allows you to sleep in heavenly peace.

Sara had to think about how her sisters were going to react to her cancer diagnosis. She felt they were going to insist that she receive chemotherapy. Would they also offer to suffer its side effects? Did Sara wish to die miserably to make her sisters happy?

Closure involves giving others reassurance. It’s a reminder that “when a door closes, a window opens” to a brand new world.

  1. Try out the new normal before making a final decision

Out with the old and in with the new is the message of “Auld Lang Syne.” If 2017 was your last year, would you spend it differently or make other plans for the New Year? Do you have a contingency plan when you can no longer say, “at least I have my health?” Will you focus on your well-being?

Most people view Sara’s situation as the worst thing that could happen. Others might see it as a new lease on life. Sara can now live for the moment and without expectations. Can the end of life truly be carefree? We are often encourage to “try it – you might like it.” Decide how you might reach for the stars without being limited by others’ expectations.

Before another year comes to a close, make a yearly end-of-year assessment of what truly matters to you. Then create your own advance care plan.


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How to Draw the Red Line in the ER


Self-determination often escapes patients while not feeling well and being hoisted onto a stretcher:

Ms. Lacy was 86-years-old and barely weighed 80 pounds. She had an anxious look in her eyes while having difficulty breathing. Her lung cancer was resistant to chemotherapy and had gradually destroyed her sense of well-being for 2 years. Her oncologist had recommended three more treatments before stopping. Ms. Lacy seemed agreeable to this plan of action and ongoing misery.

While fate had determined her lot in life, had she considered drawing a red line to receiving unnecessary medical intervention? Was this red line preset, left to her doctor’s discretion or arbitrarily established in the ER? Patients dealing with life-threatening conditions are often angry or anxious, triggering a chaotic response. They rarely maintain control of these situations.

Three simple guidelines can help patients draw a red upon admission to the ER:

  1. Establish where you are and where you are going.

Ms. Lacy’s medical condition had progressed beyond any hope of survival, making further medical intervention futile.  She knew the end was near, but seemed to be distracted by the promise of more treatment. In the meantime, she was experiencing a nervous breakdown. She was used to playing by the rules and having her doctors determine her plan of action. Ms. Lacy had never considered the prospect of a carefree existence. Breaking the rules was difficult for her to imagine.

Ms. Lacy’s arrival in the ER was a commencement exercise. A clear demarcation between the past and the future. It was time for her to take an inventory of her life and reset her priorities. Instead of minding follow-up appointments with her oncologist, she could tend to some personal files that she had been neglecting to organize. She was encouraged to create another type of nesting phase in anticipation of much-needed relaxation and enjoyment during her final days.

  1. Choose between evidence-based and common-sense medicine.

Did Ms. Lacy prefer the doctor listen to her medical history or focus more results from lab studies and x-rays? Self-determination requires forethought, while being exploited appears to be an afterthought. The tourniquet had been placed on Ms. Lacy’s arm to draw blood as per protocol, yet the need to pursue abnormal lab findings at the end of life rarely makes sense.

After being given the option to defer another needle stick, Ms. Lacy was beginning to appreciate the benefits of drawing her red line. The concern about mission creep at the end of life –whereby patients receive unintended care/consequences – might be traced back to the very moment that the invasive needle slithers under the skin. This procedure crosses the red line between using common sense and relying on evidence-based medicine.

  1. Change your mind and begin to feel fulfilled

There is always room for improvement, but not perfection. Ms. Lacy was lead to believe that if her lung cancer did not improve, she was a failure or a goner. Life happens and cancer occurs as a natural part of living. No one is perfect, yet Ms. Lacy was led to believe that she would be good if her cancer was cured. However, there was nothing truly wrong with her. She was actually being given the opportunity to feel fulfilled in life.  She also deserved to be given reassurance, like receiving a badge of honor.

With drawing a red line to further treatment, the mission was directed toward calming her anxiety and alleviating suffering. She was offered medication to help her relax, which she accepted. Almost immediately, life no longer seemed miserable. With her husband and daughter at bedside, Ms. Lacy expressed overall gratitude for her good fortune. She was able to regain control of the situation by taking a different perspective of thanksgiving. By not crossing the red line in the ER, Ms. Lacy was able to retreat and say to herself, “Mission Accomplished!”

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Survival of the Fittest Does Not Apply After 85


John was an 88-year-old ranch owner who struck gold when he sold his homestead in Wyoming. His “golden years” in Arizona were spent struggling with back pain and caring for his 80-year-old niece with dementia. He ran out of pain medication and presented to the ER for another “handout” of hydrocodone. He admitted that life was taking its toll and he was beside himself from aging. Was it time to stop doing for others and start allowing others to do for him? Might it be time to disavow “survival of the fittest” for the chance to ease his suffering?

It seemed survival of the fittest had cost him dearly. He proudly told the physician that he had $300,000 in the bank and told the nurse that he had sold his ranch for 10 million. He had recently spent $15,000 for both himself and his niece to have a get-well-quick remedy of electromagnetic alignment in a Mexican clinic. In addition, he was not sure if the “male booster” that he was receiving monthly through the mail was doing him any good at his stage of life. Nevertheless, it was being sent by the powers that be for free. The physician suggested that he check his monthly credit card statement for this “free” product.

Survival of the fittest might default to having money to burn, expending large amounts of treasure and energy on the losing prospect of anti-aging. Physicians need to continually remind patients and family members that it is not necessary to prove anything after the age of 85 – survival of the fittest does not apply and is not grounds for advocacy. The “golden years” are meant to be as carefree as the school-aged years. These age groups similarly assume some responsibility, but do require a guardian. Care provided to persons near the beginning and end of life needs to be mindful, conservative and less damaging over the long run.

Survival of the fittest is reflected in the headline article from Medscape – Letting Go: No Reduction in Aggressive Care for Advanced Cancer.  Ronald Chen, MD from the University of North Carolina at Chapel Hill conducted a study that involved 28,371 patients with metastatic cancer who died from 2007 to 2014. His findings indicated, “Despite being ‘widely recognized to be harmful to patients and their families,’ aggressive care is still administered to the majority (75%) of [these] patients.’ Moreover, the article states, “This included about two-thirds of patients who were admitted to the hospital or the emergency room in the last 30 days.”

While some may question both the definition of advanced cancer and whether age is a state of mind, it might be best to define advanced cancer as occurring in people over the age of 85 that cannot be conservatively managed as an outpatient. Naturally, survival of the fittest is called into question anytime these patients arrive in the ED.  The certain reality is that these patients are no longer surviving and are in fact dying. How physicians treat patients at this juncture is to either restore confidence in their being fit for graduation or advocate indignation through their being fit to be tied in an ICU bed.



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Driving Miss Norma – Off the Beaten Trail

ob_299a50_norma-90-ans-12513876-968590956565841The Number #1 regret of the dying is not having the courage to live a life true to oneself, but instead living a life based on the expectations of others.

Driving Miss Norma is a popular Facebook page, a truly inspiring passage about an endearing 90-year-old woman who “hit the road” last summer after being diagnosed with uterine cancer. Off the Beaten Trail is the soul-searching journey of 18-year-old Jake Heilbrunn, due out this summer. Their remarkable stories brilliantly tie into the message of Wishes To Die For, demonstrating how one is never too old or too young to experience profound personal freedom.

Jake set out to be happy with the life he intended to live – proving to himself that he had the capacity to succeed – off the beaten trail – through traversing countries in Central America. Buying a one-way ticket to Guatemala, he created his own reality TV version of Survivor. He taught English, not through speaking Spanish, but through playing soccer with his students. His sense of adventure and adaptation were key to having the courage to change the things he could while continuing to be true to himself.

Miss Norma stated, “I never intended to live my final days in a nursing home.” Most patients attract what they fear through a self-fulfilling prophesy. Miss Norma engaged self-determination by stating, “You get so old that you have to do what you want.” Most patients with a terminal diagnosis still expect others to tell them what to do. Norma found herself sitting in the doctor’s office, listening and humoring her physician as he presented options for surgery, radiation and chemotherapy. She was prepared and eager to sign herself out AMA, maintaining her wits to have a higher purpose in life than to spend her remaining time as a patient.

From the redwood forest to the Gulf Stream waters, driving Miss Norma off the beaten trail has captured the hearts of “we the people” with images of America’s splendor and what it truly means to be fiercely independent. Being the home of the brave, America’s finest are people who have a dream and inspire others to make their own wishes come true. Americans do not take lightly to being beaten up – nor should they accept the end-of-life abuse so often perpetrated by the current healthcare system. Many more Americans like Norma and Jake need to share their inspiring stories and spread the self-empowering message inherent to Wishes To Die For.

Breaking down the barriers of fear by having wishes to die for is a means for people to succeed in life and achieve victory in the end. Wishes arise from the heart and are directive, allowing people to live on their own terms and pave their own paths. Curiously, a grandmother named Norma and a grandson named Jake share one grand-perspective of personal fulfillment. Their ageless passion and profound enlightenment provide prime examples of why all people need to read Wishes To Die For and begin to cultivate the desire and ability to surely follow their own hearts.

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#How Lives Matter


Oftentimes, I encounter patients who are angry when they enter the emergency department because other doctors have not given them proper attention or helped them feel better. I might say to myself, “Who are you being that your health and well-being do not seemingly matter to these doctors?” My impression of these patients is that they portray an air of self-destruction. Doctors are more inclined to help those who help themselves. Victims protest the situation, disrupt the department and are quickly dismissed. Victors resign to their ailments, persist in understanding and gain insight. Lives seem to matter through profound wisdom, self-confidence and personal integrity.

In general, humanity recognizes that all lives matter, while many special interest groups tend to be selective and divisive. The feeling of discrimination works both ways when one person points a finger at another through righteous cause and militant separatism. This naturally creates more of a competitive society that can easily erupt in violence. I care for dying patients who generally feel like their lives no longer matter and accept worthless medical treatment as a consequence. Death does not discriminate, yet many people choose to become victimized by its selection process.  These incidents sadden me, yet inspire me to question how dying lives matter.

I resolve that lives matter through impressions left on others that reflect self-validation. These individuals tend to seek the middle ground from which to reach agreement and affinity while confronting oppressive situations. Beauty is in the eyes of the beholder who might envision the bigger picture, personified through the following attributes of good patients:

Reasonability/Mindfulness Service/Volunteerism
Receptivity/Engagement Cooperation//Connection
Courteousness/Attention Introspection/Soulfulness
Appreciation/Enlightenment Mutual Respect/Dignity
Patience/Understanding Empowerment/Self-Confidence


Lives matter through personal well-being rather than on attacks against the healthcare system. The inaugural words of John F. Kennedy proposed, “Ask not what your country can do for you, ask what you can do for your country.” This provocation shifts the focus from how people are treated to how lives matter. Demonstrations that combat the ills in society are most effective when they appear as acts of kindness and mercy rather than incidents of bad behavior.

I spent most of my adult years in Missouri, the Show Me State.  Don’t tell me how lives matter, show me how lives matter. I consciously wrote Wishes To Die For as the show me guide to how Advance Care Directives become spiritual proclamations for dying lives matter and deserve to be treated with compassion and dignity. My book essentially channels the examination of good conscience through the heart’s desire to attain peace and harmony.  True introspection of how lives matter occurs when spirituality intercedes with humanity, resulting in a reconcilable justice that is both self-serving and self-evident.

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Whereas a terminal condition in its broadest definition leads to death, I underscore and accept that the experience of living will naturally progress to a time to die and my life will end. As defined in the practice of medicine, a terminal condition is an incurable and irreversible illness that leads to death. While treatable medical conditions exist within incurable illness and might be treated for a long period of time in order to prolong life, I would respectfully decline any intervention that might prevent terminal illness from ending my life, particularly while mentally incompetent or unconscious.

Incurable and irreversible illness include: end-stage heart, lung, kidney, and liver disease; diabetes, overwhelming infection, HIV-related illness, most forms of cancer and neurological illness such as stroke, ALS, Alzheimer’s and Parkinson’s disease.  The hallmark of this WILL TO DIE emphasizes my desire to die naturally and gives respect to incurable illness actually assisting in my death. Moreover, I define a terminal condition as being an insufferable and irreversible existence whereby I am unable to live semi-independently following a three-month period of treatment or rehabilitation.

Potentially enduring a terminal condition and incurable illness will justify the personal resolve to have my life end. In lieu of prolonging the time to die, my apparent demise would free me to decline ongoing life-sustaining care in conjunction with the survival rule of threes: thirty minutes of CPR if initiated, three hours on life support if declared brain dead, three days in an intensive care unit, three weeks of hospitalization or three months residing in a long-term care facility.  If my recovery lapses while in an unconscious or semiconscious state, I am not to be transferred to a higher level of care.

My living will recognizes that personal dignity and sanctity of life is to be respected, secured with the blessings of free choice, self-determination and the realization that death is an inherent, inevitable and inalienable birthright.  As such, I choose to honor the significance and responsibility of being able to decide and declare autonomously whether the quality of my life remains worth living. This WILL TO DIE provides the necessary documentation that advocates my intention to die of natural causes when a terminal condition is present and quality of life becomes mired in total dependency.  This WILL TO DIE intends to enshrine my humanity in the midst of a terminal condition.

Any living will is drawn from mindful conviction and heartfelt wishes. My three wishes are give me liberty or give me death, respect my dignity by advocating certainty and show me the mercy. Illness and dying may cause my mind to waver as my body deteriorates. While dying, I may be vulnerable to righteous claims, coercion and tactics that undermine my WILL TO DIE. As a conscientious objector to having life sustained indefinitely, I respectfully wish to silence and absolve those who may feel legally obliged to inform or persuade me with offers of life support. My WILL TO DIE abides in the truth that there is a time to live and a time to die, given by my own terms as outlined.

My end-of-life plan allows me to envision transcending peacefully from this life while lying in the solemn state of levitation.  I wish to leave this world unattached to any machines, tubes, lines, infusions or fluids; a simple saline lock will suffice in order to administer sedation. For those who honor my time to die through nurturing and lifting my mind, body and spirit, I commend a similar blessing to their lives and deaths. My WILL TO DIE ultimately provides a prayer for peace and a more universal appeal to encourage others to have their own “wishes to die for” during a time to die.


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gotcha-1Life lessons include choose your own battles, fight the good fight and never allow others to fight your own battles. As an emergency physician, I often care for patients who are beside themselves rather than on top of their medical conditions. Patients’ capacity to make wise decisions is generally dependent on how well they understand the disease process in addition to potential risk factors, informed consent, family expectations and their ability to handle stress. Attempting to combat these divergent forces reasonably and wisely requires preparation and the experience gained from a few hard knocks. Oftentimes, making wise healthcare decisions is delegated to the person with the medical degree.

While National Healthcare Decisions Day prompts people to combat healthcare battles by declaring personal wishes, surprisingly few people realize what wishes are most important to them. In most battles few people will surrender when their lives are at stake. This quandary allows patients to become gullible to false hope, high expectations and wishful thinking rather than making wise healthcare decisions. When patients allow others to fight their battles, I often hear family members assert, “He wants everything done.” Cognizant of Christ’s words of compassion, I am reminded to forgive them; for they know not what they do. Oddly, compassion tends to be geared towards perpetrators of undying intervention rather than those dying.

Most combat fear with passion, enlisting a type of competitive edge through attaining grace under fire. Passion and grace are central elements inherent to both living well and making wise healthcare decisions. These armaments are necessary to engage battles and determine exit strategies. Passion and grace exemplify personal empowerment and contribute to patient empowerment. This enterprise emboldens patients to make reasonable wishes, allowing them to maintain control over their life and death, dignity and destiny. Reasonable wishes are both heartfelt and wise. To adjudicate and guide the process of making wise healthcare decisions, I wrote a book of heart-centric wishes titled WISHES TO DIE FOR.

As wisdom and grace often come with age, many people tend to wait until later in life to make very tough decisions regarding their end-of- life care. I mostly witness elderly people become set in their ways and fearful of death. By having their wishes ingrained as convictions in the prime of life, people are more empowered to make meaningful healthcare decisions at the end of life. WISHES TO DIE FOR expands upon doing less in Advance Care Directives, but more importantly it encourages people to lead purposeful lives, reflected in their making wise healthcare decisions.

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20150124_1120321-e1423066604853-1836x1200-300x196Perhaps a trip to Cartegena and Bogota, Colombia is not the wisest use of time while preparing to launch my book, WISHES TO DIE FOR. However, I was dying to take this trip when Mark, a travel agent friend, invited me to accompany him and share his travel perks. Why have wishes to travel if there is no intention to follow through and make good on them? Why have wishes at all? Similar to life’s journey, might wishes be more about the experience than the destination? One purpose of wishful thinking is the wonder of mindless joy. Joy brings amusement and contentment to life, similar to the inherent ecstasy of Disneyland’s Thunder Mountain that quickens the spirit and quiets the mind.

As long as I can remember, I wished to be a doctor. I could list any number of reasons why I became a doctor, but I would be hard pressed to consider this career path leading to mindless joy. Typically, there are crazy moments with heightened vigilance intrinsic to Emergency Medicine. However, I often sense mindless joy while quietly walking through hospital corridors, acknowledging that my spirit has purpose and reward. The purpose of my life becomes magnified as patients‘ eyes light up when I walk into their rooms.  I claimed the reward of mindless joy as restitution for the trials and tribulations of life by unrolling my yoga mat at the Colombian beach of Playa Blanca. Following through on wishes ultimately lifts my spirit.

Wishes potentially overcome fear. In actuality, writing a book about wishes has helped me overcome the fear of speaking candidly. I am living proof that fear and uncertainty are trumped by passion and self-determination; i.e. wishes to die for.  Maintaining a purposeful wish throughout my writing was validated by Mark’s story about how his father died. Ten years ago, the diagnosis of a brain tumor sent shock waves through the entire family as his father lay hospitalized and defenseless. Despite a hopeless prognosis, wishful thinking prompted the family to receive false hope. Nonetheless, after surgery, chemotherapy and the out-of-pocket expense of $126,000, his father died two month later.

Restitution works in opposition to making good on life’s purpose when wishes are simply mindless and lack aspiration for joy. The spirited passion in WISHES TO DIE FOR is to not readily bury a person, but for others to honor and connect the moment of destitution with empowerment. Fulfilling any purpose is an accomplishment, but the reward of mindless joy needs to accompany it. Now that the purpose of writing WISHES TO DIE FOR is complete, what is my reward? “I’m going to Disneyland!” By pursuing more travel opportunities and abiding with others in restitution and mindless joy, I seek to make good on future wishes and accomplishments.

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