How much money should be spent to prolong a life?
That’s what Amanda Bennett, a Pulitzer Prize-winning journalist set out to determine following her husband’s death from a rare kidney cancer in 2007. Bennett’s new book, “The Cost of Hope” (Random House) started as a story called “Lessons of a $618,616 Death” for Bloomberg News, where she is in charge of investigations. She navigates the alien and frightening world of illness and her insights have particular relevance at a time when debate rages about the role of government in health care.
Q: Did you ever get a satisfactory answer to your question about how much care should we consume — especially on end-of-life care?
A: I never got a full answer. We never really got a clear idea about what things cost. … We chose to take everything because it was basically free. Over the course of his seven-year illness, I would have thought he had a dozen or so CT scans; he actually had 76 scans. They were covered, so why not? Were they ordered up for a good reason? Did we need them all? I don’t think so.
Q: You tracked down all of the physicians who treated your husband, Terence Foley, and reviewed their decisions. Did they make sense, given the information you had at the time?
A: I think so … but I was struck with how confusing the process turned out to be. … I needed to find out “Where were the best hospitals? Who were the best experts? How do I get them on the phone? And if you pick this expert, which treatment are they going to favor?” I have pretty good investigative skills, but this was like doing a massive research project at the same time I had a sick husband, a job, two kids and a dog.
Q: What would you do differently?
A: I think we were really glad we were aggressive. He wasn’t done living his life, we had two young children and I don’t regret what we did … but I do think I would have been more realistic about what some of these treatments could and could not do. I was looking for something to fix him, not prolong his life for a couple months.
Q: Do you have any regrets?
A: That we kept on being so aggressive and pushed a little too far. When I did realize (that he was going to die), it was too late to say goodbye because he was in a coma. So, I wish that maybe we had some more realistic conversations during the process.
Q: Can you be more specific?
A: I think we’d be more thoughtful. … Some treatments made him really, really sick. So, even if it extends his life, will he wish he were dead? If treatment makes quality of life so unbearable … what’s the point? Since no one is immortal, maybe we need to think more about “Did we choose the right path?” instead of “Did we do everything we could?”
Q: Do you think that medicine is behind all this aggressive and excessive treatment?
A: We’re all caught in a machine. … It’s not an evil machine, but it’s one that moves forward. It doesn’t feel like the system is designed for me — or for someone who is sick. We need to focus it around patients, not practices or hospitals. After I wrote the story for Bloomberg, I heard from so many people whose stories sounded just like mine. … We need to start pushing from the bottom to get the system to recognize us as intelligent and informed consumers.
More Top Picks Dewalt Atomic 20 Volt Max Brushless Cordless 1 2 In Drill Driver Dcd794b
Q: What do you think Terence Foley would think of your book? And what did you get out of it?
A: I think he would be so tickled that his experience could benefit other people. As for me, I could go back and use a journalist’s skill to figure out important issues and help other people with them. And besides, writing the book also gave me an extra year to be with him.