 And we are navigating the journey. Navigating the journey is dedicated to exploring the options and choices for the end of life care. And to assist people to talk about their wishes. It's time to transform our culture so we shift from not talking about it to talking to and about it. It's time to share the way we want to live at the end of our lives. And it's time to communicate about the kind of care we want and what we don't want for ourselves. For ourselves. Not anybody else. We believe that the place for this to begin is not in the intensive care unit. But together we can explore the various paths to life's ending. Together we can make these difficult conversations easier. Together we can make sure that our own wishes, those of our loved ones, are expressed and respected. If you're ready, I ask you to navigate the journey. Now, for those of you that have been with us for the last twenty years, this is a very special program. We just, the bill of our care, our choice just became law January 1. So today, today, we're going to talk with Scott Foster. Scott everybody you know. Scott's been with us. We've been together for twenty years on this path of navigating the journey to reach a point where people get to choose when and where and how they want to live and end those last few minutes of life. So Scott, Aloha, and welcome. Aloha, Marcia, again. Again, yes. Scott's been on this path longer than I have. But I think the first time Scott and I had a conversation about choices in the end of life was when I met him and his wife was at the end of life and all of the crap that they went through. So Scott, is that okay if we talk about it? Certainly. Yeah. So tell us, I remember so much of sitting on a bench in the beach park and you telling me about what she was going through and what you needed to do because you were the caregiver. Dear Lenny, my late wife, my soulmate, my best friend was diagnosed with terminal cancer and I left it up to her, you know, how far she wanted to go with treatment and she went through the whole thing. In fact, she went through far more than I will choose to go through. I can tell you that. And it was a stomach cancer diagnosis and it was a malignant tumor where the esophagus enters the stomach. So she couldn't eat and that's how we first knew there were problems. And major surgery, removed her stomach, chemo, radiation, metastasized into her bone. They did a special experimental implant in the bone marrow and that didn't work. And so that was it. Fortunately, I was able to take care of her at home. We had hospice, which I highly recommend. Anyone that's diagnosed with a terminal disease, whether they choose to fight it all the way or not, I do recommend that they look into hospice. And so Lenny passed. She, of course, did not have the option, although I did have enough IV meds that I could have sent her over. And we talked about that. She asked me, she said, Scott, if it gets too bad, will you help me? And I said, sure, of course, not knowing what that meant. But after about, I don't know, four or five months, she suffered that long. Oh, she suffered for over a year. But the last four or five months, which which I might add, aided with marijuana, the prescription meds, took care of the pain. And the marijuana took care of, I say, her head. Emotionally, and she was a basketball fan. And she enjoyed that right up till three days before she became unconscious and slipped, slipped away. But it went on and on and on. And she tried everything. My first involvement with what I continue to call death with dignity, as you know, because it was your idea to change the name to our care, our choice, which most of us believe helped seal the deal last year to pass the bill. Okay, let me tell you this, that we went through several generations of names from death with dignity, physicians assisted suicide, medical aid and dying and all this. And I had a conversation with Scott. I said, you know, we have got to take a position on changing the name. This name is scaring the bejesus out of people. And well, mainly the legislators will ask who we're talking about. Now, I want you to know all of you from the minute that we got a Mizzuno, a John Mizzuno to agree to change the name to our care, our choice, act 38 days later it passed. When people stop being scared of death, when people stop being scared of dying, and when we frame it, this is our choice. It's our care. We, 38 days. And that was just, the bill didn't change. The concept didn't change. All of these things that are in the bill did not change. It's just the legislators, the way they reacted. And that was I hate to say that that was all, it wasn't all, but that made it, like I said, 38 days. It certainly helped. What can I say? People simply are not comfortable talking about death and dying. It's not my favorite subject. I've been kind of branded the death with dignity, but I do a lot of other things other than this issue. But nonetheless, because we are one of the oldest organizations in the country, the Hawaii Death with Dignity Society, I've had people as far as Tokyo, London professors at universities calling me, interviewing me about their books or pieces on death and dying that they're writing about. I mean, there's a lot of literature on the issue. Everybody seems to know all about it, and nobody's reported back what it's like after passing. But my point is, it sounds corny to say you and I stand on the shoulders of of great people who were before us. Well, starting with Andy, A&I, Vanderbord, Andy, Andy was the head of the Hawaii Hemlock Society, the Hawaii chapter of the national hemlock society, which was begun in England by a fabulous gentleman by the name of Derek Humphrey. Derek is in San Diego, I believe San Diego now, and he has an organization now called Ergo, which is also known as Final Exit. He wrote literally the book on people taking things in their own hands, the turkey bag and helium. That was all from Derek Humphrey. In fact, he changed the composition of helium because all of the helium manufacturers for toy balloons and we say recreational uses of helium, the other uses, to a mixture of oxygen and helium that it doesn't work for euthanasia now. But nonetheless, Andy Vanderbord, I went through the AIDS pandemic as a gay activist and helped pass many pieces of legislation here locally and nationally to get the government to pay attention to AIDS. And at that point in time, which was 1983, 1984, it was right in the epicenter, right? I saw some of the most horrible deaths you can imagine. Now, we all lose mothers, fathers, grandmothers, cousins, friends. If we're lucky, their life course runs and they die naturally. But the statistics on cancer now, it's going to the rough for all sorts of, I think, environmental issues and our food supply and the water. There's just more cancer now than there's ever been. But then when I met Andy, which was just a little after the AIDS pandemic began raging, he was down at the legislature running around with a picture, terrible picture, frightening picture, which I thought was funny because a picture of what? Well, an emaciated dying person in a bed. And there she is running around the halls of the legislature just freaking out legislators when they saw her coming. She had never been able to get a bill introduced somewhere around that same time. Governor Cayetano created the governor's governor's blue ribbon panel on death and dying. Out of that came a number of recommendations. And again, this is back in, you know, the late 80s, early 90s. He was first selected in 1994. But he was lieutenant governor, wasn't he, at this time? I believe that well, okay, well, ancient history. But nonetheless, he was responsible for that blue ribbon panel. The only thing on the original list that did not pass unanimously was position aided death. At that point in time, hospice was there were hospice or two maybe operative, but that hospice and palliative care were new. And one thing that this 25-year-old battle to pass this bill did do was it brought, first of all, the whole conversation of death and dying into the public arena. And it also, I believe, stimulated the growth and acceptance and use of hospice. Stick a pin in it, because we have to take a break. And when we come back, let's talk about what is hospice and what it isn't. Okay, we'll be right back. This is Stink Tech, Hawaii, raising public awareness. Hello. Welcome to Sister Power. I'm your host, Sharon Thomas Yarbrough, where we motivate, educate, empower, and inspire all women. We are live here every other Thursday at 4 p.m., and we welcome you to join us here at Sister Power. Aloha and thank you. Aloha, and I'm Marcia, and we're back. We are talking about the new law, our care, our choice, and, or as so many of you remember, medical aid and dying, or death with dignity, and all of the other things. We're talking with Scott Foster, whom you know, because he's been with us. We've been together on this issue for 20 years, at least. And we are talking about it to summarize it, because January 1, it became law in the state of Hawaii, as it is in what, seven other states? I think- Yes, seven other jurisdictions, which includes- The District of Columbia. Yes. And so we were just doing a history on how all of this came about. So we were at hospice. People are asking me now, now that the law is passed, and I get a lot of phone calls, what should I do? And the implementation of the law is like any law, and even one that's certainly one that's complicated is this one. The State Health Department, I think, has done an admirable job of setting it up. The documents are all online at the Health Department's Hawaii State Health Department website. The first thing I would do, will do, if I get a terminal diagnosis, is I know the hospice that I'm going to call. But what I recommend to every single one of you out there in the audience who are interested in this issue, talk to your personal physician now. Just ask him the simple question, will you support me in this or not? If not, you might want to consider finding another doctor, which is a big deal. But it depends on your age. People don't start thinking about death and dying, usually, until their our age. And we can see it coming down the road. Oh yeah, the finish line is in sight, yes. So to be a little redundant, what everybody out there that supports us as you can do to help right now is call or talk with your personal doctor and begin talking to your friends about it. It's not the favorite dinner table subject, but it should be. I told all of my children, all of them, no. So I said, okay, well let's forget this. Let's just push me over the lini and into the drink, into the water, and let the fish have, and one friend said, oh no, no, no, you can't do that. And I said, why? She said, because you're toxic, you'll poison the fish. So much for that conversation, you know. I was like, okay. But nonetheless, the hospice is very important. And I think it's going to continue having a growing role. There is some reluctance in some areas. For example, Queens and Pacific Health say that they will not be selling the drug. Let me put a pin in there. No, they're not. However, this is from me. This has nothing to do with the hospital. Nationally, Medicare says the biggest cost to the taxpayers, that's us, are the last days of people in the hospital at $10,000 a day. And they don't send you to hospice until they run out of the insurance. So ah, this is my recommendation. You tell you, Dr. Marsha said, before you start putting in all of these tubes and all of this stuff, and you know that another surgery is not going to save grandma, think about hospice. Think about before you start spending $10,000 a day, and would grandma really want your whole estate spent $10,000 a day? That's when you think about hospice, not the last minute, but before you start using your estate, losing your house, everything. Somebody's got to pay for it. The feds say it's $10,000 a day. Now that was a couple of years ago. Who knows what the price is now. So back to hospice. Well, the Medicare statistics are scary. If memory serves, some 60% of the Medicare expenditures are people in the last six months of their life. And that is the $10,000 a day. Exactly. So before you get to that point, and they start giving grandma surgeries that she's not going to heal from, before they start feeding her with a tube and running up the bill, think about hospice. Now, of course, I've got to say that I'm biased. My daughter is a hospice nurse, and she absolutely loves what she's doing. And she says it is an honor to be with these patients and their family at that point in life. She loves what she's doing. She loves caring for these people and to see them taken good care of. And she's, you know, who knows how many hospice nurses there are. So, like I said, I'm being biased. When we had my mother at home, we had hospice, and they were wonderful. So, you know, okay, so that's my, yes, hospice. However, again, think about that. Not just for yourself, but for anybody in your family, because they will go after your estate, and you say, well, I don't have an estate year. You've got something. They'll go after something. So, yes. Scott, continue. So, I guess, I guess it's important to be thinking a little ways down the road. What comes next? We have two national organizations who are, like so many national organizations, when they get involved with an issue such as this, and they come to Hawaii, they always seem to know better than we do. And our little organization, we've never raised much money at all. As you know, you and I did most of the work pro bono. We got a little budget for a year or two, and nearly got it passed. And then, 2018, we were operating virtually with nothing. So, it's up to the large national organization to do the implementation. I encourage people and you and I have talked about what do we do at this point. I've never gotten so many phone calls, as now, people wanting to know how to access the system. And because we are a local organization, we know what to tell people. We know what hospitals, what hospices to avoid, usually the religious-based hospitals. Yes, of course. That's not going to work. That's not going to work. And they're entitled to not do it. It is our choice, remember? That's the title of the bill. It's our choice. But it means we must take ourselves to the right place. And that's one of the things that people call me. Well, where do we go? Who do we talk to? So, I guess we'll keep our little organization up and running for the time being. My vision is at some point that this law be applied to Alzheimer's, multiple sclerosis, all of those debilitating diseases where people waste away, sometimes for years, flat on their back in a bed, not even being able to talk or blink. I'm getting calls from some of those people. When will we ever be next? Maybe not in our lifetime, but we've got to look forward. While we're talking, and this never occurred to me until listening to you, perhaps we need a catalog, a listening listing of doctors, psychiatrists, that are willing to talk to the people because some doctors don't want to talk about it. We're not selling this service, but doctors that would be willing to talk to these patients. Can we do that? Could we do that? This was brought up in the press conference last week that Compassion and Choices hosted, which I thought was an excellent press conference. A lot of questions were asked. A lot of myths were dispelled, including the one that I was just highly offended, one doctor who was against physician Aiden Dying said that took a hundred pills, and that was another scare tactic. Now, my point is the aspect of... No, no, I'm just saying. My question about could we engage doctors that would be willing... That came up at this press conference. Sorry, I lost my train of thought. It was pointed out that people are reluctant to do that simply because if they're on a list in a book or on a website someplace, the people that are against this, who knows? They might pick at the drug stores. Now, CVS, which is long, has said that they're going to leave it up to the individual pharmacist and they may not even stock the drug. So there may be some problems getting the drug. That is a big question. There's got to be a way that when people call you, you preferably don't have a listing, a public listing, but when people call you and say, I really need to talk to a doctor, I need these... Can we enlist a few doctors that would be willing to talk and tell them exactly what it is and what they need to do? I hope to have... I hope to know who some of them are. Right now, the only one that we know is Dr. Miller, who's been very public about it and who took care of John Ratcliffe. But I can't refer everybody to him. No. And that goes back to people need to talk while they're still healthy to their doctors and find out if they're supported. If they're not, they might want to think about a plan B. Right. Well, yes. What can I say? 20 years goes by awfully fast and we have come to a point where the bill passed. It is now law and now we have to rethink our approach. We have to rethink of how we handle from this point to where do we go from here and how we support all of the people that have been with us and over these 20 years, some of them have already passed. And for those of you that have watched for the last three years, thank you so much. We're not going away. We just change focus. Now is to get you cared for. Again, thank you so much, aloha, and it's been a real pleasure. See you next time.