Living Through the Coronavirus (COVID-19) Pandemic (# 5) 

This Pandemic should prompt everyone, and especially older people, to think about how they want to die and how they want their financial assets and liabilities handled after they are gone from this world. I already have reviewed my will, trust documents and health care directive and decided that no changes were necessary other than updating contact information for my health care agents.[1]

I also recently have discovered another important document that an individual should review and decide whether it is appropriate for him or her or anyone in their family to fill out and sign before that individual ever goes into a hospital emergency room.

That document is the POLST or Provider Orders for Life-Sustaining Treatment, which was created “to advance care planning for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty.”[2]  The Minnesota form has the following sections with boxes to check the appropriate treatment:[3]

A. CARDIOPULMONARY RESUSCITATION (CPR) Patient has no pulse and is not breathing.

  • Attempt Resuscitation / CPR (Note: selecting this requires selecting “Full Treatment” in Section B).
  • Do Not Attempt Resuscitation / DNR (Allow Natural Death). When not in cardiopulmonary arrest, follow orders in B.

B. MEDICAL TREATMENTS Patient has pulse and/or is breathing.

  • Full Treatment. Use intubation, advanced airway interventions, and mechanical ventilation as indicated. Transfer to hospital and/or intensive care unit if indicated. All patients will receive comfort-focused treatments. TREATMENT PLAN: Full treatment including life support measures in the intensive care unit.
  • Selective Treatment. Use medical treatment, antibiotics, IV fluids and cardiac monitor as indicated. No intubation, advanced airway interventions, or mechanical ventilation. May consider less invasive airway support (e.g. CPAP, BiPAP). Transfer to hospital if indicated. Generally avoid the intensive care unit. All patients will receive comfort-focused treatments. TREATMENT PLAN: Provide basic medical treatments aimed at treating new or reversible illness.
  • Comfort-Focused Treatment (Allow Natural Death). Relieve pain and suffering through the use of any medication by any route, positioning, wound care and other measures. Use oxygen, suction and manual treatment of airway obstruction as needed for comfort. Patient prefers no transfer to hospital for life-sustaining treatments. Transfer if comfort needs cannot be met in current location. TREATMENT PLAN: Maximize comfort through symptom management.

 

E. ADDITIONAL PATIENT PREFERENCES (OPTIONAL)

  • ARTIFICIALLY ADMINISTERED NUTRITION Offer food by mouth if feasible. Long-term artificial nutrition by tube. Defined trial period of artificial nutrition by tube. No artificial nutrition by tube.
  • ANTIBIOTICS Use IV/IM antibiotic treatment. Oral antibiotics only (no IV/IM). No antibiotics. Use other methods to relieve symptoms when possible.
  • ADDITIONAL PATIENT PREFERENCES (g. dialysis, duration of intubation)

POLST was started in the early 1990s by a group of Oregon medical ethicists, and then in September 2004 the National POLST Advisory Panel (later known as the National POLST Paradigm Task Force and now known as The National POLST Office) was convened to establish quality standards for POLST forms and programs and to assist states in developing POLST as a model process. [4]

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[1] This blogger has decided to periodically post his reactions to living through this pandemic. Here are the earlier such posts to dwkcommentareis.com: Living Through the Coronavirus (COVID-19) Pandemic (# 1) ( Mar. 23, 2020); Living Through the Coronavirus (COVID-19) Pandemic (# 2) ( Mar. 24, 2020); Living Through the Coronavirus (COVID-19) Pandemic (# 3) (Mar. 27, 2020); Living Through the Coronavirus (COVID-19) Pandemic (# 4) (Mar. 28, 2020).

[2]  National POLST, POLST Fundamentals ; Sandler, Time for Death Panels? No. Care directives? Yes., StarTribune (Mar. 26, 2020).

[3] Minnesota Provider Orders for Life-Sustaining Treatment (POLST). Here is the national form.

[4]  National POLST, History.

Living Through the Coronavirus (COVID-19) Pandemic (# 4)

Important reminders of more important issues for us all as we live through this stressful period of the coronavirus (COVID-19) pandemic are found in different places. [1] For example, in organizing some personal papers I came across the following poem by Kristi Brown, the daughter of my cousin, Lloyd William Brown, Jr., and his wife, Karen Brown.

Life

 Life is not long enough to accomplish all your goals.

Life is too short to waste a minute of .

Life always has to end sometime or another.

It ends when you least expect it.

 

Life ends instantaneously for some,

Life’s end is long and painful for others.

Life’s end is known by some, but for others,

It ends when you least expect it.

 

Life is good to most people for a long time,

Life takes some people very early on.

Life fights with death for the cream of the crop.

It ends when you least expect it.

 

Life is taken advantage of by some, others live

Life one day at a time, and cross bridges when they come to them.

Life usually ends for the careful ones, not careless.

It ends when you least expect it.

 

Life’s end is welcomed by those who are suffering.

Life’s end is not welcomed for those who are not.

Life is hard after a loved one dies, but

It ends when you least expect it.

 

Life is a terrible thing to waste.

This poem in her handwritten spiral notebook was discovered in her nightstand drawer in the summer of 1987 by Kristi’s parents. This discovery was necessitated by Kristi’s having been killed, at age 19, on June 24, 1987, in a terrible multiple-vehicle crash on the Capitol Beltway outside Washington, D.C. on her way home from a summer job following her first year at the University of Virginia. Pursuant to her written instructions, Kristi’s heart, cornea and kidneys were donated to the Washington Regional Transplant Community.

Thereafter her parents organized an annual event they called “Kristi’s Christmas” when students from her high school in Springfield Virginia joined her parents and siblings to provide breakfast to a group of underprivileged grade-school kids and then escorted and provided money for them to go Christmas shopping followed by a special visit with Santa Claus. After her mother’s death, the West Springfield Rotary Club has taken over the organization of this annual event.[2]

Thank you, Kristi, for reminding all of us that life “ends when you least expect it” and that “life is a terrible thing to waste.” I am truly sorry that I never had the privilege of meeting you and learning about your inspirations for these amazing deeds.

This profound and beautiful poem helps me cope with the morning news on March 28th that  the world in at least 171 countries has seen 585,500 coronavirus (COVID-19) cases with at least 27,164 deaths while the U.S. has become the epicenter of the world with 102,838 cases and 1,646 deaths. My state of Minnesota has had 398 cases and 4 deaths, including 1 death in Hennepin County, where I live.[3]

My wife and I continue to be in good health while sheltering in our downtown Minneapolis condo with occasional outdoor walks on nice days and trips by car to buy groceries and once-a-week take-out dinners at restaurants, gas for the car and necessities at drug stores.

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[1]This blogger has decided to periodically post his reactions to living through this pandemic. Here are the earlier such posts to dwkcommentareis.com: Living Through the Coronavirus (COVID-19) Pandemic (# 1) ( Mar. 23, 2020); Living Through the Coronavirus (COVID-19) Pandemic (# 2) ( Mar. 24, 2020); Living Through the Coronavirus (COVID-19) Pandemic (#3), (Mar. 27, 2020).

[2] Korff, ‘Kristi’s Christmas’ honors the late Kristi Brown with day of giving for Fairfax kids, WJLA (Dec. 11, 2014); Ours, Kristi’s Christmas makes the holidays merry and bright, The Oracle (Dec. 15, 2016).

3] Coronavirus Map: Tracking the Global Outbreak, N.Y. Times (Mar. 28, 2020; Coronavirus in the U.S.: Latest Map and Case Count, N.Y.Times (Mar. 28, 2020); Olson & Snowbeck, Stay-at-home order now in effect to fight virus that has killed four Minnesotans, StarTribune (Mar.28, 2020).

 

Living Through the Coronavirus (COVID-19) Pandemic (# 2 ) 

“The Power of Community” was the title of the March 22 sermon at Minneapolis’ Westminster Presbyterian Church (delivered in a live-streaming service with around 2,000 watching at home) It provided this blogger with comfort and courage for living with the Coronavirus (COVID-19) Pandemic.{1}

Scripture for the Day

 The Scripture for the day was Ephesians 3: 1-21 (NRSV):

  • “This is the reason that I Paul am a prisoner for Christ Jesus for the sake of you Gentiles— for surely you have already heard of the commission of God’s grace that was given me for you, and how the mystery was made known to me by revelation, as I wrote above in a few words, a reading of which will enable you to perceive my understanding of the mystery of Christ. In former generations this mystery was not made known to humankind, as it has now been revealed to his holy apostles and prophets by the Spirit: that is, the Gentiles have become fellow heirs, members of the same body, and sharers in the promise in Christ Jesus through the gospel.”
  • “Of this gospel I have become a servant according to the gift of God’s grace that was given me by the working of his power. Although I am the very least of all the saints, this grace was given to me to bring to the Gentiles the news of the boundless riches of Christ, and to make everyone see what is the plan of the mystery hidden for ages in God who created all things; so that through the church the wisdom of God in its rich variety might now be made known to the rulers and authorities in the heavenly places. This was in accordance with the eternal purpose that he has carried out in Christ Jesus our Lord, in whom we have access to God in boldness and confidence through faith in him. I pray therefore that you may not lose heart over my sufferings for you; they are your glory.“
  • For this reason I bow my knees before the Father, from whom every family in heaven and on earth takes its name. I pray that, according to the riches of his glory, he may grant that you may be strengthened in your inner being with power through his Spirit, and that Christ may dwell in your hearts through faith, as you are being rooted and grounded in love. I pray that you may have the power to comprehend, with all the saints, what is the breadth and length and height and depth, and to know the love of Christ that surpasses knowledge, so that you may be filled with all the fullness of God.”
  • “Now to him who by the power at work within us is able to accomplish abundantly far more than all we can ask or imagine, to him be glory in the church and in Christ Jesus to all generations, forever and ever. Amen

The Sermon

“As the coronavirus sweeps across the globe causing a rising level of fear, and leaving anguish in its wake, it’s tempting for us to be overwhelmed by a sense of powerlessness.”

“But there is a power of community that will be examined by “how scripture views it, how the church uses it, and how we can benefit from it as we face this crisis together.”

“One of the impulses driving creation, as the story unfolds in the Book of Genesis, is the divine desire to generate human community. When humanity is made in the image of God and placed in the Garden, we’re told to steward the earth. We usually think of that solely in terms of the environment – but we are also stewards of the gift of human community.”

“The Presbyterian Church’s Brief Statement of Faith, adopted in 1991, says: “In sovereign love God created the world good and makes everyone equally in God’s image, male and female, of every race and people, to live as one community.” (emphasis mine)

“Today we might say, ‘male, female, and non-binary,’ but the point of this affirmation of faith is that the goodness of God’s love – the imago dei – is embedded in all of us. God’s image is seen most clearly in us when the human family lives as one community.” (Emphasis added.)

“The author of Ephesians speaks of the creation of community that heals a fractured humanity. This new community – really the recovery of the one humanity envisioned at Creation – is made known in Jesus Christ.”

 “’In former generations,” the writer says,”this mystery was not made known to humankind, as it has now been revealed…by the Spirit: that is, the Gentiles have become fellow heirs, members of the same body, and sharers in the promise in Christ Jesus through the gospel.” (Ephesians 3:5-6) (Emphasis added.)

“The promise of our faith is that the human family is one. The Gentiles – previously outside the circle – have become fellow heirs, members of the same body. The gospel makes the bold claim that the human family is no longer divided. We are one community, and there is power when we are united in purpose.” (Emphases added.)

“A friend who has been in recovery for many years told me their AA group met this week via Zoom technology. They didn’t know how to start the meeting, so my friend suggested they begin with the first of the 12 steps: ‘I am powerless.’ As they talked they acknowledged their individual powerlessness, something started to happen. They began to find strength in one another, even though they were not actually together. My friend said, ‘The sense of community was palpable.’” (Emphasis added.)

That’s the power of human community.” (Emphasis added.)

“One of the ironies of this time of being apart from one another, isolated in our homes, perhaps feeling helpless, is that the power of community is so much more evident. Just when we thought our culture and our politics and our nation were flying apart, now that we are apart we’re suddenly and keenly aware of what was missing, because we’re discovering it anew.” (Emphasis added.)

“It’s as if the biblical story of the purpose of human life has been instantly clarified: we exist to live together, as one community. Our insistence on the independence of the individual is giving way to an awareness that we cannot live long without one another. The best chance we have against the coronavirus is to exercise the power we have as a community to stay isolated and work together. All of us. If the community acts as one, we will slow the pandemic.” (Emphases added.)

The power of community.” (emphasis added.)

“Last week the New York Times ran a story with the headline, When the World Falls Apart, People Come Together. It was a report on the Great Alaska Earthquake of 1964, a disaster of biblical proportions visited upon the young city of Anchorage. With a magnitude of 9.2 that lasted four and half minutes, the earthquake destroyed much of the city of 100,000 people.”

““Life,” one person said, ‘Was ripping into a before and af

“That may be happening among us now, if only more slowly. In the future we may come to reckon time in terms of before and after the pandemic of 2020.”

“What will we remember most about this time? That question was the focus of the article on the Alaska earthquake. Experts had predicted that survivors of a major disaster would be desperate and panicked, and that pandemonium and chaos would reign. When researchers arrived on the scene only 28 hours after the quake, they were stunned at what they found.”

People immediately began helping others, pulling them from the rubble and leading them to safety. Boy Scouts entered a damaged hospital to help patients find their way to the cars that had pulled up to ferry them to another facility.” (Emphasis added.)

“Now, an earthquake is not a pandemic. The one occurs instantaneously and is fairly localized; the other is slower-moving and global. But neither is predictable. Neither is a respecter of persons. And the traumatic impact of both depends largely on people’s response to them.”

“’Everybody was trying to do a little bit of everything for everybody,’ one man in Anchorage said. That’s what people remembered.”

“What will endure from our experience of the pandemic unfolding around us?”

“A nurse named Dolly Fleming was in a stairway that day in Anchorage when the earthquake began. She saw a young boy in front of her being thrown around. Instinctively, she grabbed him and held him close to keep him calm and protected as they rode out the shaking together. Nurse Fleming would report many decades later at age 93 that being with that child was her lasting memory of the disaster.”

“’Something surprising had been shaken loose in Anchorage’ – the researchers in Alaska concluded – ‘A dormant capacity — even an impulse — for people to come together and care for one another that felt largely inaccessible in ordinary life.’ (NYTimes, March 15, 2020)”(Emphasis added.)

“They had discovered the power of community. That power is at the heart of the Christian gospel. It was the center of the ministry of Jesus. It is God’s hope for the world. And it is the mission of the Church. Jesus came to save us from our human tendency to break apart into divided groups: the Gentiles – in the language of that era…those deemed “other” then, or in our time– have become fellow heirs, members of the same body. We are in this together. We all share in the promises and risks of life.” (Emphasis added.)

Our best hope right now is that we would recognize the power in our being one, and acting together, like nurse Fleming, to protect one another.” (Emphasis added.)

“Children understand this instinctively. They crave community where they can belong and be safe. In this time of separation parents are helping them meet that need creatively. Technology helps. Our nephew sent a photo of his nine-year old daughter, isolated with the family at home in Portland for some weeks now, sitting before a computer having a play-date with about ten friends, all on the screen at the same time.”

“We will get through this together, even when apart. There is power in community.”

“I used to think that connections through technology were not genuine, but I ‘ve gotten over that. It’s real community. Like this worship service: this is not virtual worship. This is genuine worship. Our prayers are real, the sermon is actual, the shared experience of the music is authentic. We may be apart, but we are worshipping God together as the one Body of Christ.”

 “A Westminster member living alone at home emailed this week to tell me that online worship has become an anchor in their week. Without it, they said, the cycle of time in their life is so disrupted that it’s disorienting. Another member isolated at home alone emailed to say they watched all four of our online services last week, and each was a “lifeline.” (Emphasis added.)

“They were finding that they still belonged, were still loved.”

The gospel’s claim of the power of community is fundamental and foundational to our humanity. A recent article relates the story of anthropologist Margaret Mead being “asked by a student what she considered to be the first sign of civilization in a culture…Mead said that the first evidence of civilization was a 15,000-year-old fractured femur found in an archaeological site. This particular bone had been broken and had healed…A broken femur that has healed is evidence that another person has taken time to stay with the fallen, has bound up the wound, has carried the person to safety, and has tended them through recovery. A healed femur indicates that someone has helped a fellow human, rather than abandoning them to save their own life.’”  (Emphasis added.)

The church’s role in combating this pandemic is to remind the world around us of our oneness. There is no Jew or Greek, slave or free, male or female, insider or outsider, for all are one in the human family. That was God’s intention from the start.” (Emphasis added.)

“The power of community gives us strength and resilience.”

We are not powerless. The coronavirus is stirring the community to life, awakening an old memory that we are rooted and grounded in love for one another. “ (Emphasis added.)

“In this crisis moment the church – you and I, as followers of Jesus – the church is called to help the community know “the breadth and length and height and depth” of God’s love for all of us, equally and unconditionally. (Ephesians 3:18)”

“That’s the gospel of Jesus Christ, the One whom we follow in this challenging time.”

The One who, ‘by the power at work within us, is able to accomplish abundantly far more than all we can ask or imagine.’ (Ephesians 3:20)” (Emphasis added.)

Comments

The Scripture for the Day  from Ephesians and its discussion by Rev. Hart-Andersen uncovered for me a new and more powerful meaning. Previously I had thought that the English- word “gentile” (translated from the Greek) referred to the non-Jewish people that Apostle Paul traveled to meet in the Roman Empire. Now I see the word as referring to all non-Jews. In short, the Jewish prophets and scribes were dividing the entire world into two groups: Jews and non-Jews or Jews and all other people or Jews and gentiles.

Matthew Skinner, Professor of New Testament at Luther Seminary in St. Paul, Minnesota, Scholar for Adult Education at Westminster and a friend, provided the following in response to my question about the meaning of “gentile” in the New Testament: “From a first-century Jewish perspective, indeed anyone who wasn’t a Jew was a “gentile.” The Greek term rendered “gentiles” (ethnē) means “nations.” The New Testament and other early Christian literature adopts this same usage, describing the world in terms of Jews and gentiles. The Letter to the Ephesians places strong emphasis on the idea of the divisions between Jews and gentiles being destroyed through Jesus’ death and resurrection. The result of that is ‘a new humanity.’ See Ephesians 2:14-16 for a succinct statement of this. The basis of all that emphasis comes from the conviction that law obedience isn’t necessary for gentiles to receive the Holy Spirit and participate fully in the people of God (the church). The letter takes the notion of there being no special advantage or privileged standing before God and regards that as a new, singular humanity coming into existence.”

This fits within my sense that every human being in the world is a child of God regardless of race, color of skin and the specific religion they profess or none at all. All of these characteristics paint a wide variety of human beings. But nevertheless they all are children of God. Therefore, we need to be kind and generous to everyone.

When you recognize this and especially when you gather together with other human beings, there is power in community.

As Rev. Hart-Andersen said in his sermon, “The church’s role in combating this pandemic is to remind the world around us of our oneness. There is no Jew or Greek, slave or free, male or female, insider or outsider, for all are one in the human family. That was God’s intention from the start.”

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[1] This is the second in an ongoing series of posts about living through the Coronavirus (COVID-19) Pandemic. See Living through the Coronavirus (COVID-19) Pandemic (#1), dwkcommentaries.com (Mar. 23, 2020).