Ten Years Ago ~ Life Support Began

MARCEL -  Ten Years ago 7.21.2005, asked to be placed on Advanced Life Support

by Joy Krauthammer  7.15.2015  (2 days before Tisha B'Av)

Reading a story in NY times* shared by Kalsman Institute and writing a REPLY note:

My emotions are running wild from tears and joy of gratitude that you share this important difficult article on 'end-of-life' "life support" (regarding the woman) to the pain that I experienced with my own hubby, z"l on 'advanced life support' for the last 6 months of his brave suffering. My own husband, an ICU MD, clearly wrote NO "life support" on his Medical Directive. At the 911 moment that it was clear he would die (after having already 9 lives), our daughter on the midnight phone said, "I'm getting on a plane to come". That moment Marcel then said, "Put me on, I'll try it." Life in hospitals was beyond miserable with that new decision, but Marcel got to spend more time with our daughter (and family and friends who loved him and could tolerate this). This is exactly the week TEN YEARS AGO (July 21, 2005) that the decision was made to accept 'Life Support'.

The serious Halachic* problem that I encountered was when only machines and tubes were keeping alive a body, and following *Jewish law, they could NOT be turned off or removed, and the Medical Directive was NO longer valid.

I share here good photos, not medical photos during the 18 years of cancer:

Shalom FB friends,  Entering the time of Tisha B'Av so I share about life and death. Haven't before shared this site on my husband, Marcel, z"l, but it is exactly 10 years this week that Marcel chose to accept 'Advanced Life-Support' for the following 6 months, and with a heavy heart I share with you this photo-filled site, and a single post, "Marcel, z'l: The Hero Within". 
What LIFE decisions do we make in our life about the control we have or don't have at 'end-of-life'?
Do YOU have a Medical Directive? Have YOU talked with YOUR loved ones?

Marcel's first night on life-support 7-23-05

Marcel's first night on life-support

July 23, 2005 3 AM
ICU Waiting Room - freezing cold, Northridge Hospital

Marcel's first night on life-support

Marcel was put on a Respirator and medically induced coma (sedation) three hours ago when he could no longer breathe on his own while on oxygen assist.
Earlier in day and night, following ER the night before, my supportive sister Faye was with us, dear friend Shelly R., and Rabbi Eli Rivkin, offering prayers.

MY Bear overcame fear.
Marcel worked hardest to overcome all obstacles to be #1 and he was.  A really hard challenge for Marcel was his severe scoliosis getting in the way of his good golf swing.  (The corrective Harrington rod was always in the way of reading x-rays and diagnosing tumors fully).

The last thing Marcel did tonight was to try to breathe on his own.  Marcel told us that he was really scared and asked us not to leave him. Marcel needed the help of Hashem. The breath of G*d.  Marcel chose to battle like a warrior and do it. He wanted the chance to try his best, so he chose to try the respirator, his own tool of his Pulmonary ICU trade; To see if he could do it on his own.  Marcel had written in all his Medical Directives "NO" and said, "NO" to the respirator in front of all the doctors when he could no longer breathe.  Marcel told me whom to call. 

I called Aviva and I then told Marcel that Aviva would come the next day.  Marcel said, "Give me a few days and I will see how I do."

Prior to that in his last days of physical therapy, I watched Marcel as he was directed and motivated to sit on the edge of the bed (in his paraplegic condition) and to let go of his two hands, and not hold on. Not with even one.  The fear factor was great but Marcel showed all of us watching that he could do it!  I remember a couple years ago at Cedars-Sinai hospital following another spinal cored decompression surgery, that Marcel was petrified getting out of bed with PT assistance with paralysis beginning, and the bed was right next to a big scary clear glass picture window on a high floor overlooking the city.  Marcel did his best.

Just before entering the hospital this time and on Marcel's last outing a couple days ago in the wheelchair van after visiting the plastic surgeon, wearing his beautiful new Hawaiian t-shirt that Aviva and Brett brought back from their honeymoon, I ran (so that we would not miss the van) a couple of blocks in 100* + temp to get Marcel the sandwich he loved from the kosher butcher - turkey with corned beef on rye with pickle.  The night before that I brought Marcel an Indian vegie meal which he loved and the night before that I brought to Marcel a Chinese fish dish with cabbage, his favorite, and also a Subway tuna sandwich, all his favorites in the last few days, not knowing that these were his last meals.  Not doing well, Marcel worked hard at enjoying his meals, and especially that Kosher sandwich which I had cut into small portions.  We shared the pickle. Marcel was #1 in enjoying his meals.

love, JOY

Joy's Gratitude. Tough stuff

Joy's UPDATE Letters to Friends
more difficult info not on top
Jan. 6, 2006

Dear friends,
I was inspired by this week's Torah.  I just finished writing in Marcel's webpage and thought I would share it with you, as sometimes I do.
I hope that you are well.
Blessings, JOY
news updates

06-Jan-06  - Joy : 
Marcel when he could talk up to July 21, 2005, believed and expressed himself to be a LEADER.  Even if he went to play poker with the guys and ate chips and yummy cookies at their home, Marcel did differently and offered lots of pizzas.  To Marcel, that was showing the way.  Marcel stated that his father, zt"l had taught him this.  When verbally expressive, Marcel let us know that he always wanted to be the best that he could be, in ways he believed.  Marcel needed to reach his highest potential and he struggled at it.  And he did. Somehow, Marcel continues even on paralyzed on a life-support system, to show us leadership. Marcel is awesome. I invite your comments here.

From skiing to golf to baseball to scrabble to teaching and practicing medicine to being the best Torah reader-Ba'al Koreh, whatever activity Marcel addresssed, he tried his best and he never gave up, especially as a cancer patient since 1988.  With Marcel's severe scoliosis, many of these activities posed their own problems which Marcel compulsively struggled non-stop at overcoming.  Today, I believe that Marcel continues this struggle in his own way, and Marcel always did it his own way, as you who know him, knew.  Yes, Marcel is a  *"first born" (as I am also).

If only Marcel could talk and tell us how he is now doing this struggle.  Marcel did not like sharing intimate emotional details, so hopefully he is doing OK with NO verbal communication. (And our daughter is a speech-language pathologist.)

I believe that Marcel personifies a REFUSAL TO GIVE UP. I think he is # 1 at this.

Whereas others have always referred to Marcel being a "cat with many lives", I think Marcel is a lion, as we read about below.

Torah. "She is a Tree of life to all who cling to her."

I want to share the following drash excerpt on this week's Torah PARSHAT VA YIGASH, with you from R. David Fine of Kansas.

"Perhaps one of the greatest keys to Jewish survival throughout its long history has been an unbridled optimism, a strong belief in the future and a refusal to give up. Even at times of great challenge, Jews have continued to maintain this belief in the future.

When one considers Jewish history, it seems strange as to why Judah, out of all of his brothers, was given the blessing of royalty (see B'reishit 49:10 "The Scepter shall not depart from Judah). Usually it is the * first born who is given these privileges. Judah is special because he personifies this unique Jewish quality of never giving up. This is an inherent component of Judah's personality as indicated by Jacob in the blessing given to Judah in Chapter 49 ("he [Judah] crouches; lies down like a lion"). Judah seems like he has given up because he is in a lowly position. Immediately, however, the verse continues "and like an awesome lion, who dares arouse him?" A lion does not stay in a lowly position for long. He does not give up so easily. Judah exhibits this resolve in our parsha.

Immediately at the beginning of VaYigash, Judah summons his strength, refuses to give up, and approaches Joseph with new-found strength and compels Joseph to become submissive and back down. The lesson from this commentary is clear. In order to be the leader of the Jewish people, one must epitomize these critical characteristics of being an optimist and a refusal to never give up.

This idea should provide the Jewish people, who have indeed suffered from a long and bitter exile, with some much-needed solace and consolation and even optimism. Perhaps it does not make the exile any easier to bear, but it does demonstrate that G-d has a plan for us. Even though it may appear that others are controlling us, in reality it is G-d who has control over the Jewish people. It points to an end to the exile when this realization will become clear to all.

It is not only Judah, therefore, that should have this optimism, but it is all his descendants. We are all known as Jews as we are descendants of Judah. Judah as our leader has taught us how we are not only to survive, but to lead."

MY HOPE is that our/my friends do not give up on visiting Marcel, as hard as that visit is. This is your greatest gift, to all of us, in helping to sustain Marcel while he lies on this life-support system at this time.

Shabbat shalom,
With love and gratitude for all that you do,

~ ~ ~

Jan. 3, 2006

Rabbi Stan, Ruchl Laia and our loving B'nai Horin community,

I just want you to know how deeply moved I have been each time one of our B'nai Horin members visits my husband, who as you know, is on a life support system lying in a bed in Los Angeles far from my Northridge home.

For years I have asked you to make Misheberach in the prayer circle for Menachem Elimelech ben Tova Matil.  Finally in my last letter I asked for you to visit because it is so difficult for me, and you have. I knew that Marcel would benefit from your visits, yet I did not expect this outpouring of love.

From the deepest place in my heart, please know how much I appreciate you love which you have shared with both Marcel in person and myself.

These visits have meant so much to me.

Marcel has heard your songs, and your prayers and even received one of Charles' famous ceramic rings.

Friends who don't know Marcel have visited.  Charles, Batya, Shoshi, Reb Alicia, Rina, Shira, AriellaShira and Paulette.  Dov has shlepped me back and forth to the LA facility because I can not drive with my very painful legs, post surgery.  Dov has been teaching Marcel sign-language on each of his visits.  Dov was also a emotional boost to me as always especially because Dov came on discharge day from ICU and admission day to Sub-Acute. These are always terribly difficult days with ambulance transfers and something always going wrong.  This time I had not even seen the new facility and the transfer was traumatic.  The nurses accompanying Marcel on the gurney on this day had to remind me to keep my love message short to Marcel at the elevators because his "oxygen was limited."  That was reality with a fast good-bye.

In Rina's message today to me she relayed how transforming it was in this angelic meeting for her to be with Marcel looking silently into his eyes, holding his hand, and with tears.  And Rina sang to him.  What a blessing again today Marcel received. I think G*d has kept Marcel here on earth just so that he can meet my dear friends.

Each time I replay Rina's message, the tears flood from me in my deep gratitude for your chesed.

Each time I think of each of your kindnesses, tears flow.

I asked Marcel about your visits, and he responded with a little nod of his head, how much he enjoyed meeting you and having you share your gift of yourself with him.

We can be so proud that what Rabbi Stan and others have taught us about Bikur Cholim is practiced so lovingly by our spiritual community.

Thank you.

One love, shalom and abundant blessings of health and joy to you, 
Joy Krauthammer
"Serve G*d With Joy"
~ ~ ~

news updates

09-Jan-06 09:13 AM - JOY : 
Yesterday Marcel slept the entire afternoon while I visited him. His fever was miraculously almost gone at 99*. Nurses explained that since Marcel had been kept awake with their sponging down of him during the night, along with Tylenol, he was now sleeping. I was sad because this was my time with Marcel. I had brought photos to share, letters and love. I connected to the bed rail (so it does not go out to the laundry and trash) with a three foot long colorful ribbon, a new fun feeling textured squishy ball for Marcel to hold in his hand, a gift from my sister. I had tied some knots in the ribbon to give it more texture. Marcel runs his fingers up and down the feeding and respiratory tubes so I thought that this would be more enjoyable.

I set up a new small radio which could fit between all the life-support machines on the small bedside table top. I set the dial to classical music 91.5 FM and taped it down so no one would change it. I taped down the volume and on/off buttons and clock dimmer and... so the radio would be always available to Marcel on the music he enjoys without ads. I hope it does not disappear.

I filed Marcel's nails and found that whoever had cut them roughly had left dried blood on the finger. (I had the uneasy feeling that probably no one had put on an anti-biotic ointment to the small wound.) I taped up on the wall, new cards with large Mogen Dovids. I took down the Chanukiyah. I added messages for the VISITORS. I added some history, and decorated the prayers.

I added more important hand-written signs in plastic clear views to the walls, explaining to the nurses how to properly care for Marcel. Worst of all for me is that when I came in, and as always, I found that Marcel's both feet were totally down on the mattress instead of being elevated, thus causing lymphedema and making for the possibility of decubitus ulcer wounds on his heels from the pressure. This is so upsetting to me and I had to find the head nurse and show her. Frustratingly, every single visit I explain this!

Then the next horrible issue was that Marcel's left eye was totally squashed from a large pillow pushed up over his eye. It was totally blinding his vision. I keep explaining that because of his eye, that the small towel to prop up Marcel's head must be added over the pillow against his cheek and not under it. This is so painful to see. It provokes such anxiety in me. Every visit I explain to the nurses how to prop up Marcel's head so that this does not happen. And then I ask Marcel if that is better and he nods yes, and the nurse sees Marcel nod.

Is there no sense? No Sechel? Each time I look at the staff and ask how they would feel if their vision was blinded, or if their head was fallen off to one side while their body was facing the other direction. This hurts. I explain that Marcel can not smell, barely feel, can't talk, can't taste. And now they are blinding him. I explain that this is morally wrong. So I add another big fat colored note to the wall and to the chart, and so it goes. This is why it is so important for every visitor to see Marcel's positioning and ask to have it corrected. I just called the morning nurse and reminded her to teach the day's CNA's how to do this. Every day...

As soon as I left Marcel, sadly without being able to otherwise communicate with him, friends of mine visited from B'nai Horin. Thankfully Gayle Gale and Alula reached me on my cell as I was in the car and I told them, TO WAKE MARCEL. Finally Marcel awoke to their concert. Can you imagine Marcel clearly looking out at Alula, Ethiopian with his many African hair braids singing to him, "A Yiddishe Mama?" I love it. GG and Alula sang many Jewish songs to Marcel and they had good eye contact. GG said she had made Marcel a greeting card. I wonder how the Chinese patient in the next bed enjoyed the concert. I then called Marcel's mother so she could have pleasure knowing that Marcel was receiving such divine gifts for his soul.

Love and blessings, 
~ ~ ~

Jan. 13, 2006

To our dear community.

Thank you especially for your recent support with visits.

My husband Marcel has been weakening and then last night gaining strength.
The process is very complicated 
and distressful due to "life support".

Marcel's blood pressure has reached very low levels yet fluctuates and is
getting higher, yet is low.
Marcel's eyes may open every 12 hours but he has not been communicating.
Marcel is receiving morphine for pain.

Aviva arrived last night and Marcel's mom is on a plane now.
Having more family present makes the end of life decision making much for
fraught with emotions and decisions.

This journey has been a roller coaster ride and this is no different.

And I thought I am a drummer. Marcel clearly marches to his own beat.

One love, shalom and abundant blessings of health and joy to you,
"Serve G*d With Joy"

~ ~ ~