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A Piece of My Mind
January 5, 2005

The Octogenarian’s Plan

JAMA. 2005;293(1):15-16. doi:10.1001/jama.293.1.15

She had a plan to end her life, but she needed a little help from me. She was 87.

Mrs Smyth was in her late 70s when I first met her; she had breast cancer metastatic to bone. She would live for years with a large lytic lesion at C2, a Christopher Reeve type of problem had it ever collapsed. Mrs Smyth knew this and made it very clear to me that if she ever stopped breathing, she wanted no “so-called resuscitation.”

Mrs Smyth had little sympathy for the infirm or for the dead. She hated nursing homes, not able to accept what Alzheimer disease had done to so many of her bridge partners. One of her pet peeves was the way some women talked about their deceased husbands. Mrs Smyth would parody: “‘Oh, I know how happy George is up there, golfing every day,’” and then comment, “How stupid! What can they be thinking?”

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