PART 1:   I am a palliative care social worker who believes intrinsically that there are things worse than death

CommunicationInterprofessionalPalliative CarePalliative Care Community Specialist

My mom had a catastrophic stroke in December of 2017 – almost five years to the day after a more mild one – that ended her life at the age of 72. Following the craniotomy from her previous stroke, she drove again, lived independently, had no perceptible deficits. She went on to sail through treatment for an early stage breast cancer and three joint replacement surgeries. She had a tooth extracted and then regrown from a cadaver bone graft. She was determined. Any time you asked, her plan was to live to be 94 years old. She was in the now, and she was in the future. She would talk about plans for her body after death, but mostly due to legalities; her initial wish, which thankfully evolved over time, was for her bones to be placed in a cave to be picked apart by animals. Famously, when my mom was in labor with my sister, she did everything that a human could do to give birth at home; she didn’t trust medical settings. My mom was wise, connected to the earth, practical and everywhere. She would have loved to Know you.

In the twilight zone that took place after her devastating stroke, I stood next to my husband, talking with the neurosurgeon who had been there for the first stroke and who was miraculously on service this time as well. I still can’t believe the great fortune that we already knew this man; he has seen inside of my mom’s brain. I also count my blessings that his man who saved her life once was willing to put the worst possible choice in simple terms: he could attempt to surgically remove damaged tissue and blood which, due to the size of the stroke, would leave her non-verbal, non-ambulatory, unable to read or comprehend or interact with others – or she would die. I asked him more questions about what state she would be in, my sister asked by phone if she would even be able to see. I told him I was scared, that five years prior he had said surgery was the only way forward and that this time I didn’t hear him saying that. He looked down at his clasped hands. I know enough about surgeons to be terrified when they do not recommend surgery. He gently told us we had four hours to decide. I still have the surgery consent form tucked into a box of important papers. His half was signed, dated, time-stamped; he didn’t want to do the surgery, but he would have.

It took the synchronicity of connecting with my uncle and sister together on the phone, as they anxiously waited for their flights from California to Denver, to confirm what I knew in my marrow but that was lost in that ultimatum: my mom – who had over a thousand books and was a professional textbook editor throughout her adult life – would never want to live if she couldn’t make sense of the world around her. I admit that, had I not been able to get ahold of these family members that formed the decision-making triumvirate (and this was a real possibility, as my uncle was on the plane ignoring requests to turn off his cell phone for take-off) this story would likely have resulted in a doomed surgery. I am a palliative care social worker who believes intrinsically that there are things worse than death, and yet I almost got stuck.


PART 2 next week…

Laurel Eskra Tropeano …After receiving her MSW from New York University, Laurel completed a fellowship in the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center. After moving to Denver and joining the palliative care community, Laurel serendipitously met like-minded social workers with whom she founded The Holding Group – a social work led consultative palliative care agency that currently provides advance care planning to Kaiser Permanente-Colorado members in long term acute care hospitals.

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