Comorbidities

bucket-listA person enters hospice based on a primary diagnosis. Multiplying cancer cells will lead to the death. Or, the heart grows weaker. Maybe lungs are compromised. Dementia can demolish normalcy.

However, as we get older, as we get sicker, as we become more vulnerable, there’s typically more than one illness eroding the sturdy walls of our vitality. When a hospice team first reviews a patient’s history, her or his comorbidities are discussed along with the primary disease. In other words, we are alert to the many life-limiting conditions that assault fragile flesh and brittle bones. As a non-medical participant in the care of a patient, the number (and numbing names) of the comorbidities that can afflict someone often flabbergasts me.

Let’s say Patient A, a lovely 60-something teacher, is dying from breast cancer. But she also has . . . diabetes, hypertension, AAA, CVA and DJD and more.

Let’s say Patient B, a once feisty 80-something, struggles with congestive heart failure. But he also has . . . Alzheimer’s, CBBG, Hypothyroidism, Acute MI and COPD and more.

So many things can harm or kill us. (Can harm or kill . . . me.)

Though I’ve looked up most of the tongue-twisting, oft-acronymized words mentioned during patient care meetings, I’d likely fail a pop quiz that involved recalling and comprehending the illnesses that can undermine quality of life. The list’s lengthy and, frankly, it . . . is . . . morbid! At least morbid when that word is defined as “an unpleasant subject.” Once my wife and I had a water leak that eventually caused mold problems in our kitchen. Experts prattled on about seen and unseen molds lurking in our home—all with unpronounceable names and horrific consequences—and it sure seemed overwhelming and “unpleasant.” It’s the same with the comorbidities stalking our bodies.

When a hospice nurse, voice like a gentle evening breeze, delivers the litany of calamities wrecking a particular patient’s body, the opportunistic ways of death confront me . . . and my fears about mortality confront me. There’s no end to the ailments that could assault, infiltrate and ruin likeable me. It’s bad enough the world “out there” has so many distracted drivers, evil generals with standing armies and junk that falls from the sky! With the legion of “in there” illnesses, I might as well never get out of bed.

But am I fascinated by the wrong list?

Why do we—why do I—avoid other lists, like those that include the honest words to say to loved ones? There are also bucket lists . . . though here I don’t mean parachuting from an airplane or traveling to Paris. Instead, what about the often-ignored bucket list of strolling around the neighborhood with eyes open, really seeing the world at your feet? Or the cup of coffee with a friend on a pleasant spring morning. Or watching children play.

There’s much that’s “unpleasant” in the world. We all know that. But if I dread the worst lists, the ones that contribute to death, let me even more embrace the best lists that enhance life and love, companionship and relationships.

A thousand illnesses with acronyms and bad intentions may darken our days, but one shared “thank you” or “I love you” can create the brightest of moments.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

Image of bucket from here.

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