Oregon Physician Orders for Life-Sustaining Treatment (POLST): Completion in Proximity to Death (FR415-A)

Abstract

Recognize the scope of the issues a teenager confronts in dying through the specifics of Hannah’s questions; fears that are not expressed cannot be addressed. Hannah’s physician, mother, and chaplain will explain how these medical, spiritual, and psychological questions were addressed and how they impacted those who engaged in the conversations with her. Hannah Duffy was a star soccer player, honor student, wonderful big sister, and adored daughter with many friends when she was diagnosed with anaplastic astrocytoma and gliomatosis cerebri in October 2012. She was 13. When her brain was biopsied, 30% of the tumor was removed; the rest was inoperable. Hannah and her family were told she had 6 months to 2 years to live. Despite beginning chemotherapy and radiation, Hannah was back on the soccer field in concussion gear 2 weeks after her surgery. Family and friends mobilized into an army of ‘‘Duffy’s Tuffys.’’ Everyone went to war with her against her cancer. Hannah was stable for almost 10 months. But then a scan showed her tumor was progressing rapidly. Hannah said, ‘‘I’m going to die.’’ Her mother and physician said, ‘‘Yes,’’ beginning a long and wrenching conversation over the final weeks of her life. Hannah asked if she was letting people down by dying. She feared being forgotten. She asked about heaven, dying, and pain. As those questions were answered, Hannah felt at peace and started issuing marching orders to those she loved. Her to-do list ranged from having her friends wear pink stilettos to her wake after gluing a big glittery ‘‘H’’ to the sole of their shoes, to asking her mom to hang her picture above her baby brother’s crib so he’d always remember her. She also asked her teenage friends to embroider her name in their prom and wedding dresses. Her ultimate wish was that she never be forgotten. On September 26, 2013, Hannah Rose Duffy died at home, surrounded by her family. As one of her friends said, speaking for many, ‘‘We cried a lifetime of tears, but nothing was left unsaid’’ because of the power and courage of Hannah’s questions.