Counseling Terminally Ill Patients and Families

When our kids were small, they had to spend time in hospitals several times because of injuries or severe illnesses. Just the act of putting them in a strange, frightening place beyond our control was a very traumatic experience for both the parents and child. I can only imagine the trauma involved in condemning a fat child, already unhappy about being different from other kids, to the surgeon's knife and other hospital terrors.

Before surgery becomes an option, parents should talk to the family physician and/or the appropriate specialist to discuss every possible alternative to surgery. It could be as simple as a strict diet combined with vigorous exercise. I know they're contrived TV productions, but those programs that begin with grossly fat contestants and follow them through weight-loss competition are good examples of establishing similar family routines.

Of course, any family plan determined to help obese children must be pre-approved and monitored by competent medical experts. However, in virtually every case, surgery should never be an option. The most effective options are establishing a sensible health, diet and exercise regimen; abiding concern for the health of the child, continuing parental love and just plain old-fashioned common sense.

I didn't experience much death in the next 16 years, except for a schoolmate who was killed in an auto accident. I was about ten at the time, and at the funeral had a slightly better understanding of death. I remember the parents of other students standing closely with the grieving parents and comforting them. There were school officials there to counsel them.At age 19, death came close to taking me while I saw many of my young Navy and Marine Corps friends die. Our troop ship disembarked Marines on the Iwo and Okinawa campaigns. It was in the last months of World War II, and the most bloodiest in the Pacific. It was the time of the Kamikaze, the last gasp of Japan, and they sent out thousands of suicide planes to bomb the fleet. Our ship wasn't hit, but many others were.

After the first waves went ashore, our landing craft were used for bringing back casualties. It was my first experience in counseling, if that's what it can be called. Most of the 500 casualties we took aboard were from artillery and mortar fire, and at least half of them died while being treated. I was assigned as a helper to the pharmacists' mates, bringing medicines and bandages and do whatever else I could to make the living ... and dying ... easier.

Most of the wounded Marines were kids. I mean really kids! Seventeen and eighteen. If they were conscious, I talked with them while fibbing about their conditions. Some asked me to write to parents and girlfriends, choking out names and addresses. I promised to do it, and for nine of the boys who later died on our ship, I was determined to live up to my promises.The war ended just a few months later, and in less than a year, I was back home and due to start college after another six months. As a Navy reservist, I could bum rides on military aircraft around the country. I spent my waiting time visiting the families of the Marines who had died. My amateur counseling consisted of telling the families how heroic their boys had been, and how they died peacefully. Well, I was telling half of the truth. No one died peacefully at Iwo Jima or Okinawa.

As for counseling the terminally ill and their families, all another person can do is to try to make the passage easier for all. If the family is religious, an ordained person of their faith can help in the traditional way, and serve as a calming influence with prayer and encouragement. Some hospitals, nursing homes and hospices also offer in-house religious and professional counselors who've had extensive experience with death and dying.

If it is an old friend visiting the terminal patient, talking about old times and adventures can help bring some much-needed humor into an otherwise sad room. If the patient or family request it, small children can also help brighten up the room. However, parents should first consider the possible trauma it could cause the children to be exposed to such a situation.

We all face that time when we'll be in the same situation. We can hope those we love will be with us for those final moments, and they will get the emotional help they need to get back to their own lives.