[Magdalen] RIP Sir Terry Pratchett

[sally.davies at gmail.com]

Yes indeed, and this is what is interesting to me - because you would not
die from Alzheimer's directly but from kidney failure, pneumonia,
septicaemia or whatever, as behavioural and then physiological systems
falter and shut down.

And in our health system, if a doctor is called in, vigorous treatment
would commence and in most cases a younger patient would survive until the
next thing comes along because their organs are in good shape and they have
reserves.

Patients with life limiting conditions or who have been very ill for a long
time can be officially declared "not for resuscitation" if they crash, but
I haven't yet seen a situation where a drip or an antibiotic would not be
given, and in quite a few cases its gone beyond tthat, with insertion of
feeding tubes and even use of a ventilator.

Full-on nursing care with regular observations and turning is also provided
and not uncommonly we see scans and X-rays being done, patients turned on
their tummies to help them breathe (a desperate and rarely successful
measure) as well as a crazy sequence of antibiotics. This reflects an array
of circumstances and pressures - financial, emotional, clinical, ethical,
and even societal in terms of whose life will be fought for and whose will
not.

The best practice is to have a Palliative Care team in every hospital,
working alongside the regular doctors and effecting a seamless transition
that involves patient and/or family, nursing staff and medical staff all
working together to obtain the best possible outcome. Most hospitals can do
it - no extra staff need be employed, you just have to identify the people
who really care about this and equip them to play that role. But our
medical culture i.e. "my patient, my responsibility", does not favour a
team approach even when lip service is paid to that. This is in the Private
sector; the State sector here is mostly too overwhelmed, so we have the
opposite problem, needless loss of patients who could be saved with the
correct interventions.

As you can see, I think about this a lot and find these situations very
troubling!

Sally D
On Fri, 13 Mar 2015 at 18:08 Marilyn Cepeda <mcepeda514 at gmail.com> wrote:

> Actually, one often dies from Alzheimer's and the early onset type can move
> quickly unlike the later onset which can be a 20 year process. By the time
> one is actually symptomatic and diagnosed, the changes have been going on
> in the brain a number of years. Quite often, the brain ceases to say eat
> and drink, and the person dehydrates or their brain or verbal abilities
> cause an infection to go undiagnosed etc. semantics, I suppose, but I see
> those things as directly attributable to Alzheimer's they are such standard
> parts of the course of the illness.
>
> Marilyn.....hoping for better treatments before it is my turn.
>
> On Thursday, March 12, 2015, <sally.davies at gmail.com> wrote:
>
> > Amen...at one stage I would go and buy a new Pratchett book whenever I
> felt
> > as though I needed a mood lift. I also read them when my babies were tiny
> > and keeping me awake at night.
> >
> > One does not, typically, die from Alzheimer's as such and 66 is so
> young. I
> > wonder if he didn't decide for himself that it was time he moved on "to
> > beat the rush".....Alzheimer's...Bugrit, millenium hand and shrimp!!!
> >
> > There have been times when I have really, really wanted "Pterry's"
> version
> > of the Afterlife to be true. Wherever he may be now, may he be full of
> > wonder, surprise and delight.
> >
> > Favourite Pratchett character, anyone? I'm going for Granny Weatherwax
> but
> > I also really like Tiffany Aching, and The Librarian. And Vetinari and
> > Vimes.
> >
> > I enjoyed (and was moved by) this tribute beautifully written by Sir
> > Terry's co-author Neil Gaiman
> >
> >
> > http://www.theguardian.com/books/2014/sep/24/terry-
> pratchett-angry-not-jolly-neil-gaiman
> >
> > Sally D
> >
> >
> >
> >
> >
> >
> >
> >
> >
> >
> > On Thu, 12 Mar 2015 at 18:18 Richard S. Crawford <richard at underpope.com
> > <javascript:;>>
> > wrote:
> >
> > > One of my favorite writers, whose books got me through some rough spots
> > > with my depression. I'd read one of his novels, like "Small Gods" or
> > "Night
> > > Watch", laugh, think, and wonder "How in the world did he do that?"
> > >
> > > He succumbed at the age of 66 to early-onset Alzheimers. It's good to
> > know
> > > that he's no longer in pain, but the world has lost one of its
> sharpest,
> > > quickest, and funniest minds.
> > >
> > > May he rest in peace and rise in glory!
> > >
> > > --
> > > Sláinte,
> > > Richard S. Crawford (richard at underpope.com <javascript:;>)
> > http://www.underpope.com
> > > Twitter: http://twitter.com/underpope
> > > Facebook: http://www.facebook.com/underpope
> > >
> >
>
>
> --
> Marilyn Cepeda
>