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| Medical Information: Fr. William Ralston Offered a Final Lesson to Physicians |
| Nicholas V. Costrini, M.D. Medical Director Georgia Gastroenterology Group, PC |
| The past few weeks have been very difficult for a great many people because of the death of Father William H. Ralston, Jr., the seventy-three year old emeritus rector of St. Johns Episcopal Church in Savannah. Father Ralston served God and the Church on Madison Square for twenty-five years. In the years that I knew him, I was privileged to hear him in the pulpit and at the dinner table. He possessed that kind of intellect that made the most educated enjoy acknowledging that they were in the presence of genius. He possessed that kind of spiritual humanity that allowed the least educated to feel comfortable discussing the pitching staff of the Braves. In the pulpit, he offered his beliefs in a scholarly manner that encouraged his flock to consider the beauty of Bachs music, the views of Shakespeare, and the mystery of the Holy Trinity in ways that could be found nowhere else on earth. For many, including myself, it was enough to understand only a fraction of what he had to say about life, the human condition, and message of God. He was particularly kind to physicians. As many of us tended to his medical needs over the years, we all were aware that he knew more about saving lives and caring for the spirit than we could ever hope to know. In the late stages of his prolonged illness, he continued to be the professor-priest without saying a word. He reminded his physicians that we are never the patient and never God and therefore cannot assume to know the wishes of the patient. His bedside, silent instruction calls to mind the singular importance of advance directives, living wills, power of attorney and patient advocates in our healthcare system. An advance directive is a document that provides guidance to health care providers regarding the patients medical decisions in the event that the patient becomes incapable of making these decisions. A Living Will is a legal document that is prepared according to state regulations and reflects a persons preferences for health care toward the end of life. Your state specific Living Will may be obtained from an attorney, a health agency, or even on-line www.choices.org.). A Durable Power of Attorney is a legal document that gives the person you designate the authority to make the healthcare decisions you would have desired had you been able to make the decisions yourself and communicate them to your physicians. You may choose a family member, a friend, or a physician not directly responsible for your care in the event of a health catastrophe. Advance care planning therefore is an ongoing discussion between the physician, the patient, and the designated proxy decision-maker to plan the future medical care in the event the patient is unable to provide the directions because of the severity of the illness and associated incapacity to communicate his or her wishes. To assist all parties in the event of a serious health crisis, the American Bar Association Commission on Legal Problems of the Elderly has developed the Five Wishes document that has legal standing in most states including Georgia. The document provides space for you to fill in the blanks in reference to five specific items. These are: (1) The person I want to make health care decisions for me when I cannot make them for myself. (2) My wish for the kind of treatment I want or dont want. (3) My wish for how comfortable I want to be. (4). My wish for how I want people to treat me. (5) My wish for what I want my loved ones to know. Five Wishes information or the document itself may be obtained by calling 888-594-7437 or on-line at www.agingwithdignity.com. In the final analysis, all of the end-of-life preparations are acknowledgements that physicians have no other way to know the values, interests, and expectations of the patient. As Father Ralston reminded us, we physicians are not the patients and we are not God. With reference to wishes at the end of life, I wish for my patient-priest-philosopher-pianist to Rest in Peace.
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