In 1990, Hattie Bryant stumbled upon her life’s calling. Bryant’s mother had suffered a devastating stroke, and after five long weeks of watching and waiting, it became clear to Bryant that her mother wasn’t going to recover. “She didn’t know us. She couldn’t communicate. She couldn’t swallow,” she recalls. After poring over the medical chart and asking detailed questions of her mother’s doctors, Bryant determined that no single doctor had taken charge and explained the full situation to her family.
So, Bryant gathered her father and siblings for a frank conversation, and they all agreed that it was time to remove the medical supports. In a few days, her mother died “sweetly, peacefully, gently, pain-free.” But before that, a stranger appeared in the hospital room and asked to meet Bryant. “She took my hand in hers and leaned into me,” Bryant recalls. “She said, ‘I’m the social worker on your mom’s case. Everybody needs a Hattie.’ A social worker taught me that I did the right thing. My mother could have passed three weeks earlier.”
End-of-life decisions became the work Bryant still talks about today. She travels the country speaking to groups at hospitals and elsewhere. “I want the consumer to take ahold of themselves,” she says. “You are in charge. If you don’t make decisions, medicine can’t but do everything they know to do.” Bryant recently met with us to discuss her book, I’ll Have It My Way.
AFM: What can readers get out of your book?
Bryant: The name of the book, I’ll Have It My Way, is really important. I want people to understand that doctors do not make end-of-life decisions. There are 5,500 hospitals in America today, and there are probably five families in every single one of those hospitals trying to figure out what to do with Aunt Hattie, because Aunt Hattie didn’t tell anybody anything. So, I’m putting the onus on my own cohort and older. Sort it out. You’ve got choices.
You won’t get a sweet, peaceful passing out of the natural flow of our lives in the 21st century in America unless you do the four things I’ve outlined in the book. One, accept the inevitability that you are going to die. That will happen someday. Two, understand the limits of medicine. There’s a benefit and burden to every medical treatment you accept. Number three, understand your choices. Your choices are to do whatever it takes or ask some hard questions and get involved in comfort care, palliative care sooner. Four, name your proxy and provide instructions to the proxy.
And then go have fun with the rest of your life, because you’ve taken the burden of fear of death, and even the process of death, off your shoulders. You’re not gonna go through the stuff that so many people go through.
AFM: What should we do to understand our choices?
Bryant: You ask hard questions. Physicians can’t tell us everything for a lot of reasons. They don’t have time to tell us everything they know. They don’t think you can handle it — and a lot of us can’t. They say things and we don’t hear it. So, the minute you get a difficult diagnosis, ask for a palliative care consultation. Every hospital in America, they have somebody who can consult with you on that topic.
Palliative medicine is about the whole you. You’re not just a heart. The heart doctors, that’s what they studied for, to keep your heart going. We want someone who can look at our whole life — physical, social, mental, spiritual, financial, family.
AFM: Tell us about the proxy, the person who makes healthcare decisions when we can’t.
Bryant: Here’s what I want everybody to realize: a proxy is not pulling the plug on your life. Your disease has taken you. Depending on the stage of it, without modern medicine, you would probably already be gone. The proxy shouldn’t feel burdened at all. They should feel honored to do this for you.
Do not choose your spouse. I didn’t understand why my dad didn’t step up to the plate. He was the named proxy, and he had the paperwork in place. But he was watching the love of his life slip away, and he was broken-hearted.
What do you tell your proxy to do? Use the list on page 208 in the book. It’s easy for laypeople. Every advanced care directive I’ve ever seen gets caught up in complexities: “I don’t want this treatment. I don’t want that feeding tube.” We’re gonna flip it around to be positive. “I want to be able to chew and swallow.”
Isn’t it easy for my proxy? She knows if she finds me in the ICU, she’ll ask the doctor, “When you unplug all that stuff, will she be able to swallow? Will she be able to talk? Will she be able to toilet herself?” And if I am in a huge trauma, the answer’s going to be, “No. No. No.” And she’s going to say, “I want to take her for comfort care.”
I teach people to tell their family, friends, clergy, physicians, neighbors, everybody. And I’m getting people now to make little videos. If you go to my website [illhaveitmyway.com] and choose “Who’s your Hattie,” you’ll see where I say, “My Hattie’s Falyn Curtis.”
A famous person did exactly what I teach. In May 2017, Gregg Allman died, and his spokesperson said Gregg told everybody, including the doctors, “I want to be able to sing every day until the day I die.” He’s my hero, because he provided clarity about what was important to him. He took the burden off everybody.
AFM: This is a hard conversation to have. How do you start?
Bryant: Monday, I was in Chicago, and I had about 85 people between 65 and 75. And they were all over this. They loved it. They could handle it. If your elder is over 80, I guarantee you they need you to help them answer the questions. I mean, not give the answer, but say, “OK, we’re going to sit here and do it.”
If you want to know what your parents think, you could just say, “I want to know the answers to these questions.” They will love you for it. Some of them are going to say, “I’m not gonna die.” Well, no, I’m just saying, if there was a trauma right now, I want to know what to do. And once you’ve gone through this process, I say you’re ready to die, which means you’re really ready to live.
“I have chosen my proxy. She is a distant niece whom I chose because she is a nurse with a backbone of steel. She is 34 years my junior, she has listened to my wishes, she has read my healthcare directive and can be trusted not to fold under the pressure.” – Hattie Bryant
By Sherida Mock