My friend Gretchen (not her real name) was thriving beyond midlife. A widow, she relocated a few years after her husband died to a warmer climate. A nurse by training, she worked in hospice and started her own business.
The business was struggling for several years but last year things started to gel and the business was succeeding. Her success was enough for her to plan her trip of lifetime, a bucket list item: a tour of the Holy Land. I was with her in February when she excitedly described her upcoming trip to Israel. I wrote a prayer on a piece of paper and asked her to put it in the Wailing Wall, a Jewish custom that is observed by tourists of all religions.
Having experienced death first hand from her hospice work, Gretchen was smart enough to have a health care directive, a living will and power of attorney as part of her financial plan. She was also smart enough to transfer the risks of travel to an insurance company when she booked her trip to Israel.
On her first day in Tel Aviv, Gretchen was hospitalized with a deep brain aneurysm. The surgeons stopped the bleed and relieved the pressure but the damage had been done. She had extensive brain damage that left her in a coma and on a ventilator.
The Israeli hospital did not recognize her living will/health care directive when it was presented. She was not an Israeli citizen and the documents were American. A week after surgery, the travel insurance company arranged for her transport by medical jet back to the U.S. It took three days to make the arrangements, have the Israeli doctor agree that she could be transported and settle the bill before discharge.
In the meantime, her niece exercised her power of attorney and started to manage Gretchen’s personal and business finances.
It was a twenty-plus hour flight from Tel Aviv to the United States in small Lear jet. Her niece and sister admitted her to the hospital presenting the records from Israel and the living will. The following day the ventilator was removed in accordance with Gretchen’s written wishes. She died within the hour.
One of her directives was for organ donation. Gretchen will be around for a while, helping others to thrive.