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I'm at the funeral of a friend who drank himself to death.
I was not the only one who warned him. Alcoholics are notorious deniers and have decades to save themselves before their liver goes. At some point, they have nothing left to do but die.
Jim signed up for hospice, and they killed him within five hours using intravenous sedatives.* Hospices are paid a fixed fee for care that can last between a few hours and a month.** For my friend, all they had to do was make his bed, start an IV, put his body on a gurney, and wheel it to the morgue. It is a profitable business model if you have a taste for it, and Jim knew the score because he was once a nursing home administrator.
*This is a common enough practice with COVID patients, but he did not have that.
**This is close, but not exactly how it works.
The following might be TMI (Too Much Information). In California, physician-administered intravenous drugs for suicide were frowned upon until recently. Terminal patients had to somehow swallow 100 secobarbital capsules (or their contents mixed with syrup) through dry mouths and then struggle to avoid barfing. Although this medication was invented in the 1930s, Valeant Pharmaceuticals recently managed to re-patent it. They charge $3000-$7000 for a fatal dose that should cost only a few dollars.
As I reflected on my friend, I realized that our relationship was the story of my life. Even when I was prancing around my office in a white coat seeing patients, they were nearly all already sure what they needed. Thousands of people passed by me, and they mostly ignored whatever I said.
I do not advocate blindly following anyone's words or knowledge. Everyone must come to their hard personal truths. But if you listen only to your biases, you are playing Russian Roulette with your health—and everything else. Although a lot of what physicians believe is wrong, and cynicism about them is justified, ignore them entirely at your peril. Changing your mind is painful, but dying is worse.
I am not a sage, a guru, or an original thinker. All my insights are derivative of others' work and hard-won after years of dogged study. Any art I bring is simple synthesis, and I share everything I learn in real time. This endears me to some but is hard on those closest to me. I am an acquired taste for most.
And so I am a Cassandra. My failures include the following:
For more see here: https://robertyoho.substack.com/p/211-people-do-not-freaking-listen#details