New Book Review in JOURNAL OF PALLIATIVE MEDICINE on “Last Wish: Stories to Inspire a Peaceful Passing”

Book and Media Reviews
Feature Editors: Juliet Jacobsen and Jane deLima Thomas
Last Wish: Stories to Inspire a Peaceful Passing. By Lauren
Van Scoy, MD. San Diego, CA: Transmedia Books, 2012, 144
pages, $14.99.

Readers will find themselves drawn into the five stories shared within the pages of Last Wish: Stories to Inspire a Peaceful Passing. Van Scoy writes from the perspective of a medical provider in the midst of training but tells these stories in a way that speaks of the courage of real people making difficult, real time, real life decisions.

The narratives shared by Van Scoy give a glimpse into the lives of patients and families who are at their most vulnerable as they are faced with the complicated dynamics inherent in any serious illness. By sharing the experiences of some of those for whom she has cared, she brings readers to the realization that ‘‘there’s no wrong or right in these matters.there’s only choice.’’

Although Last Wish is written by a person immersed in the medical establishment, the language is such that even readers who are not medically savvy will be engaged from start to finish. As you read these stories you may imagine that the characters represent your mother, or sister, or husband, or best friend. The scenarios described are commonly encountered in patients with serious illness, whether it be a decision about the risks versus benefits of initiating or terminating life support, when to transition the goals of care to focus exclusively on comfort and quality of life, or how the lines of communication can be kept open between patients, their families, and those who provide their care. Last Wish does not shy away from identifying the physical, spiritual, and existential suffering that patients and their families experience as they navigate the unfamiliar territory of critical illness.

It is clear throughout this book that Van Scoy has gleaned something meaningful from each patient, something that has helped to guide her decision making in subsequent patient encounters. In the story of Bruce, Van Scoy shares that through her experience with him she ‘‘learned something new about survivors of critical illness..For every patient we can’t save, there is always a patient we can save. With such uncertainty in matters of life and death, you might consider the obvious question: When can you really know when enough is enough?..There is no easy answer and no magic cure..The only thing we can promise is to try and reverse what’s reversible in hopes of establishing a meaningful recovery. What defines a truly meaningful recovery is different for each of us.’’ This captures the essence of this book: that the reader examine for him or herself what it is that gives meaning to their lives and allow this discovery to stimulate open and honest dialogue with those closest to them. Last Wish brings home the point that while living wills and advance directives are important, they are only a small part of understanding a patient’s wishes. Van Scoy endorses the belief that initiation of these difficult goals of care discussions falls to the clinicians who ‘‘have the experience and expertise in their daily lives and careers to facilitate meaningful discussion.’’ She acknowledges that ‘‘perhaps the hesitance and reluctance on the part of the physician to initiate these difficult discussions comes from not wanting to give the impression of giving up.the feeling of helplessness that is hard to reconcile. Perhaps these emotions push the initiation of end of life discussions to the wayside far too often.’’

The significance of these discussions is reinforced in ‘‘A Courageous Choice,’’ the story of a young man, Patrick, who gave his family the gift of time to ‘‘accept and embrace his impending death.’’ Having made his choice to focus on comfort, there was now time to focus on the important work of closure, giving both him and his family the opportunity to say to each other the things that needed to be said. Van Scoy writes that Patrick’s story serves to illustrate that ‘‘taking charge of one’s own medical decision making, whether young or old, can not only relieve your own suffering, but that of your loved ones.’’

Last Wish: Stories to Inspire a Peaceful Passing is difficult to put down. It is a well-written book that serves to get readers thinking about life and how they wish to live in the face of serious illness. It normalizes the fact that discussions about death and decisions about medical care in face of serious illness are difficult for all of us. There are no statutes that dictate right or wrong answers to questions about goals of care and quality of life. Each of us needs time and encouragement to thoughtfully consider the things we deem important and the ways we find meaning in life, and to share our philosophy with those who will speak for us when we are unable to do so for ourselves.

—Reviewed by:
Patrice Richardson, MSN, APRN-BC, AOCNP
Dana Farber Cancer Institute
450 Brookline Avenue
Boston, MA 02215
E-mail: PatriceA_richardson@dfci.harvard.edu
Maureen T. Lynch, MS, ANP-BC, AOCN, ACHPN, FPCN
Dana Farber Cancer Institute
450 Brookline Avenue
Boston, MA 02215
E-mail: mplynch@partners.org

JOURNAL OF PALLIATIVE MEDICINE
Volume 16, Number 8, 2013
ª Mary Ann Liebert, Inc.
DOI: 10.1089/jpm.2013.9488 993