UPDATE: I chose not to name my friend when I wrote this, because his passing was so fresh, and I expected the people who knew him would immediately recognize Dr. Lowell "Hap" Lutter.
Over the last two days, I watched cancer take down a long-time friend of mine, just as quickly and surely as a cheetah running down a gazelle.
Two weeks ago, we left his house, marveling that he was sick at all, and last night, I sang the last song he ever heard.
He was a doctor and a husband and a father and a sculptor and a fly fisherman. Each year he took his family to Tunisia where he performed free surgeries and had his children learn French. If you were a runner with an injury in the last quarter of the century, his was the name on everyone's lips — the man you had to see, because he understood the runner's obsessions as well as the mechanics. But he especially applied his knowledge to healing children and little people who suffered foot and ankle problems from birth. Runners, despite his prowess and prominence in the sport, were merely a sideline.
He was a modern man and husband, with a life partner who had her own distinguished life, and they raised three great kids who turned out different and well.
He never spoke ill of anyone — in my hearing, at least — and no one spoke ill of him. Although Paul Wellstone, who once consulted him over running injuries when he was still just a professor, seemed awfully disappointed that no miracle had been performed on his behalf.
Irony of ironies, the Twin Cities Marathon ran past his house this morning, making it difficult to reach the front door.
You will read his obituary in a few days, and I guarantee that it will come up short.
As a physician with an assertive spouse, he had likely received more attention than all but Saudi sultans. The cancer had been around for about four years, and it had been beaten back with radiation and chemicals, visualized into a corner, and monitored through all its feints by some of the best medical people in the state. But he had also languished in hospital wards, bumped around emergency rooms, battled with pharmacies, waited hours for an IV pole to arrive and made fruitless return trips to appointments and paperwork.
Despite this we thought that, in anything approaching a moral universe, he would get another 10 or 15 years.
And as the final hours stole upon him, it became apparent he and his family had not received an important aspect of care from the health care system.
We may have the world's best physicians and medical technology, but nothing is equal to the task of preventing impending death. It comes. It always comes.
There comes a time to set aside the talk of cell counts and the scan reports and the probabilities, and to talk about the end and how you want it to be.
And yet, it seems none of the physicians assumed this task — perhaps because it fell in the cracks between specialties, but even more likely because they did not know the details to be managed at the end.
So no one said clearly: You are about to die, and here are the steps you and your family should take now, while your faculties are sharp and time is not rushing at you. This is how to arrange for hospice. This is what happens if you die at home on a weekend. These are the conversations you and your family will want to have. Then you can spend your last time together the way you desire.
You could call this a death panel, I suppose, but I would call it the final act of care.