Psyched Out

This is just such a horrible accidental death. She probably just hit her head on her ski. Natasha Richardson was a brilliant actress and fine human being, and her death at such a young age leaving two sons to grow up without her is tragic.

I'm going to riff on some themes from not-good articles, so if anyone doesn't want to read that or might be triggered regarding brain death or emergency medicine please be warned. I'm distressed over coverage because of personal experience with my brother Mike's brain death in the 1980's, and I understand how these public articles and discussions can feel to read. :(

I had an absolutely identical accident in junior high, and the back of the ski gave me a concussion and dislocated 2 of my neck's vertabrae. I had an identical lack of symptoms, and my girl scout leaders were identically advised to take me to the ER and identically refused. For good reason - millions of falls like this happen every year, and only one person dies. It's tragic, but it was an ACCIDENT and nobody did anything wrong. This seems lost on many journalists and commenters - I feel like we've culturally completely lost the acceptance that some things are not in anybody's control, and sometimes there's just no cause to blame anybody. Nobody, least of all Natasha Richardson herself, could have prevented her death.

I hate the health moralism in many of the articles I've seen, "This goes to show she should have been wearing a helmet." or "This shows she should have gone to the hospital with no symptoms." or "it must be malpractice - see what socialized healthcare does." Also, the laughable American neurosurgeon saying "this is why we keep people with possible head injuries 24 hours for observation."

First, I can GUARANTEE that if she had shown up immediately in any US ER, she would've been told to take ibuprofen and discharged immediately with advice to come back if she started to stumble around or slur speech, NOT "kept 24 hours for observation." Her only prayer would have been a typical long wait, but once symptoms appear there's just so little time before brain surgery is futile that she still might not have lived. Most of the surgeons quoted even said so.

Starting when I was 21, my family had to watch my brain dead brother Mike linger for years with no hope of recovery because, "you can't sue us for 'saving his life' but you can for stopping treatment so we won't." (Direct quote from a hospital administrator to my grieving parents, may he burn in hell. But only for a bit, I'm a universalist agnostic, after all.)

Mike and I both had severe asthma, and after watching a movie on a "vegetable" swore a pact to kill each other if it ever happened to us, which frankly was not unlikely given our medical histories. We were maybe 13 and 12. And I didn't follow through on my promise to him, from a blend of cowardice and the knowledge that if I killed him as requested, my parents would just be agonized all over again.

And I can never forgive myself for breaking that promise.

I know intellectually today that I promised when I was too young to understand fully the promise made, and that we didn't regard anyone else's feelings when we made the pact, and even that because Mike was brain dead (presumably unaware) and my parents were not I probably made the "best" choice for everyone else involved.

And none of it changes the magnitude of my betrayal of the person I loved most in the whole world.

Because watching what happens to your brother when bean counters keep the dead artificially alive is disgusting and enraging to a degree that I'm not sure I can express. My funny, loving, cynical, brilliant and occasionally cruel little brother Mike's corpse was mutilated for years by people who swear to preserve health and life (albeit reluctantly by most of them). He was overdosed on antifebrile medications to force his brain stem to regulate body temperature, and steroids to keep him breathing so he couldn't die of an asthma attack. They bloated his body unrecognizably. Because he was brain dead he wasn't "eligible" for physical therapy and his muscles withered and contracted, contorting his limbs. He was often racked with coughing because of opportunistic viruses. I was really outraged when they gave my already dead brother TB treatment that some inner city kid it would actually save desperately needed and would never get because his parents were poor. A recurrence of TB and pneumonia at once finally allowed Mike the peace denied him for six years after his original death. He'd died again and been resuscitated at least 10 times in the interval, all against my parents' wishes.

At least we have laws now that allow families like Natasha Richardson's to stop medical interventions that keep a brain dead beloved family member from dying peacefully. The immediate grief and pain are no less, but I wouldn't wish the prolonged version on any mother's 12 and 13 year old sons. Truly there are things worse than death, but kids shouldn't have to know it.

If you don't have an advanced directive, I urge you to write one and give it to everyone in your family.