Who is your decision maker?

Real life is often stranger and oftentimes more dramatic than fiction.

Sometimes when I watch movies and see family chaos and commotion that people would otherwise dismiss as bad Nollywood scripts, I laugh inwardly. Wetin musa no see for gate?

One fine day, a few years ago, I went to the ICU to check on a patient. At the entrance, I met a rowdy crowd and thought to myself, ‘somebody just died’. I tried to maneuver myself against the crowd blocking the entrance while trying to make eye contact with the security, when one morbidly obese middle-aged woman pushed me away. I was annoyed. ‘Why the violence?’ I thought. She looked triple my size and was no match for me. I decided to respect myself by standing quietly by the side while waiting for the security to notice me. Meanwhile, I was watching the drama unfold.

Three women were involved in a shouting match. One woman who appeared to be the oldest had positioned her seat at the entrance of the ICU, effectively blocking the entrance and exit. She seemed to be in her sixties and wore a long flowing boubou with a matching veil and had mighty gold bangles on both wrists. The second woman, the large lady who had rudely swatted me away like a fly, was standing in front of her, hurling insults: ‘Munafuka,’ ‘Tsohuwa’, ‘Muguwa’. And standing by the side was a very beautiful, fair-complexioned young girl who could not be more than twenty. I noticed her immediately because of the heavy makeup she wore, which seemed out of place in a hospital setting. On her fingers were huge gold rings. The rest of the people had formed camps around the three women, urging them on.

Eventually, the security man noticed me and waved at me to come forward. For where? My gossip centers had already been activated. Instead, I waved at him to come and meet me.

‘What is happening? Did someone die? What is all this drama about?

Apparently, the three women were co-wives who lived in separate houses. Their husband was on admission in the ICU. Alhaji was a wealthy businessman who suffered a stroke a week ago. The doctors had come to the conclusion that he should be discharged since his condition seemed to have improved. He was conscious but weak. The drama that erupted was because the women could not decide to which wife Oga should be discharged. The senior wife who was blocking the entrance was insisting that she should be the one to take him to her house and nurse him back to health. The second wife (the fatty bom-bom) flatly refused, saying that the first wife just wanted to control him and exploit his weakness so that she could take away all his money. Meanwhile, the young Amarya was insisting that since he had suffered the stroke while in her house, she should be allowed to take him home; after all, technically, he was still supposed to be in her company. Madam first wife simply hissed at the young girl and called her a gold digger. The middle wife seemed to agree with the senior wife because she too turned in the direction of the amarya and accused her of trying to kill their husband with her ‘kayan mata’.

As for me, I had totally forgotten why I went to the ICU, so engrossed was I in the real-life drama that I was watching. It wasn’t until more security arrived and dispersed the Fuji house of commotion that I was jolted back to my senses. On entering the ICU, the nurses filled me in on the remaining gist and pointed at ‘Alhaji’, the subject of all the chaos, looking frail, slack, and sleeping like a baby on the hospital bed.

Bros, if only you knew the war going on outside.

The drama sparked a conversation amongst us that day. Why don’t Nigerians believe in delegating a ‘health proxy’?

But first, what is a health care proxy?

A health proxy (or medical power of attorney) is a document that legally designates a trusted individual (the “agent” or “proxy”) to make medical decisions on your behalf if you become incapacitated and unable to communicate your wishes. Sometimes, the person does not have to be unconscious; he or she may be fully conscious but would like someone better informed, or with a stronger will, to make an objective decision on how best to move forward with care.

Usually, the medical or health proxy comes to play during end-of-life care, to make decisions about how the patient wants to die or if life-sustaining measures should be taken or not. Nowadays, however, a health proxy is employed as a decision maker, especially if a person has just received a devastating diagnosis and would like to rely on someone else to help him make decisions; it could be a wife, son, daughter, parents, siblings, or even a trusted friend.

Let me give you an example of a real-life incident.

On February 25, 1990, Terri Schiavo collapsed at her home in Pinellas Park, Florida, and suffered severe brain damage when her heart stopped beating for several minutes. While Terri was able to breathe and maintain a heartbeat on her own, she never regained any higher brain function and was determined to be in an irreversible persistent vegetative state. Her husband, Michael Schiavo, thought that her feeding tubes should be removed, saying that his wife wouldn’t want to be kept alive artificially if there was no chance of her recovery. Terri’s parents, Bob and Mary Schindler, disagreed with the husband and proceeded to go to court and entered a legal battle that lasted 12 years! Eventually, the court ruled in favour of the husband, and Terri’s feeding tubes were removed. After two weeks without food and water, Terri died of dehydration.

With no living will or health care proxy, Terri’s parents and husband were forced into a legal battle as to how to interpret Terri’s own wishes. Would she have wanted to die with dignity or remain in an irreversible persistent vegetative state while her husband argued with her parents? Or would she have wanted to keep fighting with the hope that she might be able to recover? Without a living will or health care proxy, the one question that will always plague Mr Schiavo and Terri’s parents is whether either of them knew what Terri really would have wanted to happen.

You see the problem?

Having a health proxy solves all these problems. Just appointing someone to help make decisions for you, to advocate for you, to act in your best interest when you are at your most vulnerable is a decision that one will never regret.

And while a health proxy may not be able to solve the marital problems of a certain Alhaji in the ICU, having someone who knew him and his family intimately, someone who could objectively decide where he would receive the best care, would have helped guide the nurses and prevented the family drama that ensued.

Nobody knows tomorrow. Appoint a healthy proxy for yourself today.