Death, Dying, and High Blood Pressure


Sometimes, how a person will die is predictable by how they're living.  It's like watching a runaway train going too fast.  We watch in horror when the train barrels around a curve and the wheels leave the tracks.  Or when a helmet-less cafe racer passes us on the freeway at 120 mph.  We can almost envision body parts and brain matter splattered all over the highway, yet we're helpless to stop him. For him, the thrill of speeding outweighs the risk of dying.  We might know of a friend who spends time sitting on the barstool, day after day, the obese person in the buffet line, or the worker standing behind the office building smoking during a break.  The thrill of racing or the pleasure from drinking or eating or the narcotic high from smoking is somehow worth the risk of dying.  The problem is some of those habits don’t result in immediate death after a crash or from continuous overeating or from getting drunk or from a pack a day of cigarettes.  I've known too many left in vegetative states from crashes or alcoholism or obesity, or smoking.  Sometimes dying from those behaviors is gradual; sometimes not.   But the trip is never pretty.

A lady in her nineties came for bridge almost every Tuesday at the Senior Center in Washington State, where I volunteered to take blood pressures.  She was well dressed, articulate, and vivacious.  When I first took her blood pressure, the systolic number (upper) was close to 200, and the diastolic number (lower) was in the low 100s. A reading of 180/110 means a person is in Stage Four of severe hypertension.  I told her she was in a hypertensive crisis and needed immediate medical attention. She laughed and replied, "Oh, honey, I'm healthy!"  I responded, "Oh, no, you're not!"  Her friend chastised me for 'scaring her.'  I related the seriousness of her situation and the risk of stroke or heart attack.  When she refused to go to the ER or her physician, I simply handed her literature on high blood pressure. Before leaving for the day, I pulled her out of her bridge game and retook her blood pressure.  Although it was lower, she was still in a hypertensive crisis.  She promised to tell her daughter about it. 

When she arrived the next week, I told her I had been worried about her and begged her to let me take her blood pressure.   Unfortunately, it was just as high as the last time I took it.  And again, she laughed when I told her she needed to see her physician.

She reminded me of the cafe racer.  She knew her blood pressure was high, but she had lived a long life, so what the heck?  Besides, she enjoyed life, and going to the doctor or ER is not fun!  She had no time for such nonsense.  After all, she had no bad habits that would lead to death in her mind.  The damage to her body from uncontrolled high blood pressure is deadly.  It's like watching that runaway train as it approaches the curve.  We can make a good guess about what's going to happen, and the guessing part is burdensome.  Hopefully, her friend called her daughter, and action was taken before it was too late. If she still chose to not get treated, I can only hope for her sake that her last days on this earth were not be spent in a coma, or even worse, totally dependent on others, yet cognitively intact.  There are far worse things than dying, and no one wants to burden others.


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