Finish Strong – a Book Review

Book Review:

Finish Strong: Putting Your Priorities First at Life’s End

by Barbara Coombs Lee

“Dr. Blue in the ER stat! over the hospital PA. Crash carts flying. Twelve people in white coats crowded around the bed. Patient turning blue. Horse-sized needles pumping adrenalin directly into the chest cavity. Monitors. Chest pounding. Occasional broken ribs. Defibrillators shocking the sides of the patient. Total chaos. What fun, really, for the young medical professionals. We were all on the front lines of battling death. Almost like being in a real war.

For six years I worked as an admitting clerk in the Kaiser Hospital ER in San Francisco. I vividly remember these scenes. According to Barbara Coombs Lee in her 2019 exceptional book, Finish Strong, stories like this are all too common in today’s “overtreatment conveyor belt” medicine. Coombs Lee is a nurse and attorney who is the former president of Compassion and Choices, the nation’s leading organization working to make “medical aid in dying” the law of the land. Today it is legal in ten states, including California.

         This book is a plea for all of us to take control of our ending, and help our loved ones to do the same. Consider our options. Know our rights. Question medical authorities.

         If you are in the “Boomer” cohort, like me, you have seen lots of death. We have all witnessed loved ones dying prolonged, horrible deaths due to cancer, stroke, dementia, Alzheimer’s, Parkinson’s, the list goes on and on. So often I’ve heard people say, “I don’t want to be a burden.” And then, with the help of the medical establishment, they drag on for months if not years. I have heard relatives whisper in my ear, “I don’t want to see her die, but Jesus, let’s get on with it.”

       Follow the money – In the debate of prolonged hospice or palliative care, the issue that needs to be exposed is “Who’s making money in all of this?” Let’s say I die quietly at home with family and friends around me. Very few people make money.

         Now, let’s say I have a dragged-out six to twelve month “heroic battle” with_____________ ( fill in the blank). In and out of the hospital. Hospice care. Lots of bills coming in; visiting nurses; ambulance; in-home hospital equipment; hospital; geriatric nurse practitioner; doctors; pharmacy.

         Now, of course some of this is covered by insurance or Medicare – but much isn’t. So the family finances are slowly drained away to keep me alive. There is no cure. Death is inevitable and coming. I am unresponsive and can’t recognize loved ones. Lots of pain. There is a port in my chest for direct application of meds. I might even graduate to intubation. What a mess. Quality of life = zero. Chance for recovery = slim to none. Why are we doing all this? Fear of death. Fear of the unknown. And let’s keep in mind – a lot of people are making a shitton of money.  

         Finish Strong gives us options to the standard way of death. How to die peacefully at home surrounded my loved ones rather than with a team of well-meaning strangers kicking your ass with tubes and electric shocks and chemicals. Like electric cars, medical aid in dying is coming. More and more states are getting on board. Seventy three percent of the population believe we should have this choice. In state after state, the movement is always opposed by the Catholic church and other religious denominations, and also guaranteed:  the republicans in state legislatures.

       RANT – I know that name calling and mocking other’s beliefs is not mature, and is certainly not the way to change minds. To find more reasonable arguments about all this, consult and New York Times editorial pages.

         It always amazes me how the far right conservatives fight these ideas. I thought republicans hated “big gubment” interference in our personal lives. But when it comes to abortion and medical aid in dying, they are all up and in our faces. Here’s an idea… if  you hate abortion… don’t have one. If you hate the idea of dying on your own terms and would rather suffer in excruciating pain while being beat up by strangers in emergency rooms, be my guest, but please don’t try to stop me from controlling my own exit.

Religion – What galls me most in these discussions is to hear one of these wing nuts, “God has a plan. Only god can take a life.” Sorry, Bob, those ideas went out with Nietzsche Sartre, Camus, and Kierkegaard in the last century. If you think there is a white-bearded man up in the sky watching over you and making these decisions, you are delusional. Get your stupid religion out of my legislature and off my deathbed.

Finally, check out Finish Strong. You’ll find it invaluable in helping you and perhaps others in your life have more choice about how they exit this mortal coil. Barbara Coombs Lee has done us all a great service.

3 thoughts on “Finish Strong – a Book Review

  1. Bill says:

    Thanks much. Trying to get the book asap. Of late the reaper seems suddenly to be clearing the closets with grim speed.

  2. Barbara Coombs Lee says:

    Thank you for the kind endorsement, Rick. Finish Strong is here to help people live fully and chart their own end-of-life course. Thanks for helping to put it in people’s hands where hopefully, it can prevent untold suffering.

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