Ventilator-Assisted Living©

Spring 1991, Vol. 5, No. 1

ISSN 1066-534X

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Read selected articles from this issue ...

Georgia Ventilator User Now Lives Independently
Judith R. Fischer

Cost Comparison of Ventilator Care in Minnesota: Is Home Really Cheaper?

Who Pays for Ventilators for Polio Survivors?

Health Has No Frontiers
Evelyne Valliere, France

Complete Home Attendant Care ... Someday
Ira E. Holland, New York, New York

Musings: About a Fatal Cliché
Karan McKibben, PhD, Riverside, California

A Ventilator-Assisted Child Becomes an Adult: What Then?
Jerry Daniel, Vancouver, Washington

Potpourri: SKIP Camp; Directory of Sources for Ventilator Face Masks

Musings: About a Fatal Cliché

Karan McKibben, PhD, Riverside, California

Usually I do not object too much to clichés, regarding them as mostly embarrassing in their display of unexamined thinking and careless writing. There is one cliché; however, that I find not simply embarrassing but actually life-threatening.

This cliché is the one television presents with the familiar scene of a patient surrounded by various and sometimes irrelevant medical equipment. While the camera zooms into a closeup of a ventilator, someone voices the opinion that death is preferable to being hooked up to a machine.

If the show is a documentary, the speaker is usually an authoritative commentator, perhaps Dan Rather on "48 Hours," who defies challenge. If the show is a soap opera, the speaker is a convincing peripheral character whose emotional intensity defies all reason, at least while the program is on.

But when my remote control snaps off the television, I begin to think about how natural it is to use machines to make life worth living. In fact, I am as happy as a kid with a new toy whenever I discover a new device that works and gives me more control over daily life.

The ventilator I use is thus not a fate worse than death, but rather just another machine that makes it possible to use a PC to create masterful documents, or a remote TV control to capriciously flip through channels, or a motorized wheelchair to mechanically stroll through the magnificent gardens of the Huntington Library.

Indeed, all of us, disabled or not, are hopelessly dependent on machines. We cannot clean our clothes without a machine, or cook a dinner, or tell the time.

We can make neither music nor war without machines. Yet no Guns and Roses fan would refuse to go to a concert because the music is "heavy metallized" with loud sound machines. And General Schwarzkopf would never refuse to wage war because he must use technical wonders like Patriot missiles and bombs that are "smart."

To be sure, there are many people, especially environmentalists, who decry our dependency on technology and dream wistfully about a romanticized state of nature, where machines are not necessary. But in a state of nature, as Hobbes said long ago, "The life of man is solitary, nasty, brutish, and short."

More recently anthropologists have pointed out hat we are by nature toolmakers; by making tools and machines to help us survive and enrich our lives, we express our nature. Even the most avid environmentalists cannot sidestep our toolmaking nature, for they conclude their legitimate complaints by advocating more technology, e.g., recycling technology, alternative energy sources, machines to make fake furs.

Since it is more natural for us to live with machines than without them, there must be some other, unspecified fear that makes a TV viewer accept so readily the cliché about death being preferable to life sustained by technology. Perhaps this fear is the one Dr. Frankenstein experiences in all the reworkings of Mary Shelley's story about a technological marvel taking on a life of his own and escaping human control.

Perhaps we are afraid that our machines will escape our control and wreak havoc not only on our environment but on our very humanity. Perhaps we are afraid that too much reliance on machines will somehow allow the uncompromising laws of science to tyrannize the human spirit. Perhaps, too, the fear is simply the fear of losing personal independence.

Whatever the cause of the whole nightmare, it can be dispelled by realizing that we are not simply toolmakers but also rational beings. By making rational choices about what serves our interests and what does not, we can indeed remain in control and maintain our self-determination.

In the case of the cliché, the TV viewer should notice that the words are uttered by others, not by the patient, and that the camera is focused on the machine, not on someone using a ventilator to live an active life. With the cliché , there is no rational decision-making, but simply emotional reaction to some unspecified fear.

Of course, the cliché owes its existence to the need for a dramatic sound bite to capsulize the very serious issue of whether the life being sustained is actually worth sustaining, of whether there is enough human life to take control. But by focusing on the machine rather than the life, the cliché leads the viewer to a conclusion that belies our experience as born toolmakers and rational thinkers. Like all clichés and sound bites, this one passes on opinions and conclusions that are unexamined and likely to be based on false assumptions. When this cliché becomes part of someone's thinking about a real life decision, as I overheard in a hospital corridor, the cliché can be fatal.

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