Gershon and I met as teenagers and by the tug on my heart, I knew we belonged together. We were both born in Pittsburgh. I was almost 16 and he was 18 at the time. What fun we had together. We jitterbugged to tunes that spilled out of a lit-up flashing jukebox. He had rhythm and a serious smile. He was generous with the spending money given to him as an only child. He paid to take me to my favorite Bette Davis movie and I remember how we licked on the same chocolate ice cream cone afterwards.
During his freshmen year at college, he took a job at Kaufman’s Department Store. With the money he earned as a stock boy and with the discount he was given as an employee, he bought me a Zircon engagement ring for $75.00. I was in heaven. His parents had a party to celebrate our commitment to each other and I remember his favorite cousin, Georgia, holding my ring up to the light and declaring it wasn’t a real diamond. So what! I knew eventually we would get married and that’s all that mattered to me. I wanted to be with him the rest of my life.
Gershon was helping his parents decorate their children’s store for the Christmas holidays when Pearl Harbor was bombed by the Japanese. He rushed to my house to tell me that President Roosevelt had declared war on Japan. He was a junior in college, and he quickly enlisted in the Army Air Force. “I’m going to help end this damn war,” he told me as he left for basic training. I cried at work. I cried at home. I missed him. Finally I earned a one-week vacation as a secretary at Twentieth Century Fox and his parents generously gave me a gift of a train ticket to visit Gershon. The first thing I did when I got to South Dakota was to ask him to marry me so I could stay with him.
In South Dakota at the time, all males had to be 21 to marry. Females only had to be 14. So while I was 18 and could decide for myself, we had to ask the parents of 20-year-old Gershon for permission. They agreed, and a week later we were married by a drunken judge in the courthouse of Minnehaha County. The judge couldn’t stand up, let alone pronounce Gershon’s first name.
The marriage license issued just 57 years ago now lies tucked away in Miami Lakes as proof that this momentous occasion took place. The happy story that had been our lives ended three years ago, when Gershon had a devastating major stroke. It was his third stroke in a year. This one was different. I found him unconscious on the floor of our family room, bleeding profusely from his left ear. I had been away from home for less than an hour.
My first nightmare began as soon as I called 911. The ambulance came, and because Gershon was bleeding, the medics called the police. The police suspected foul play, and I assured them that I found nothing out of place when I came home, but they insisted on checking things out. I left them and followed the ambulance to the hospital to face my second nightmare.
Because I knew he would not want to be put on a ventilator, I told the doctors in the emergency room that Gershon had a living will. The two of us had taken the time to sign a document that indicated we did not want to be put on any life support system just to keep us alive if our lives would have no quality. We also had completed legal documents in which I was appointed to act as health care surrogate. These legally executed papers were to be used in case either of us was unable to make competent decisions. But those legal documents were worthless. By the time I was permitted to see Gershon, now a patient in the intensive care unit, he was already hooked up to a ventilator.
I was very upset with his doctors at the hospital because they refused to listen to me. Later that evening, I hurried home to find his living will and bring it to the hospital. As I was searching for it, the phone rang. Nightmare number three. The call was from a caseworker from the Department of Children and Families informing me that charges had been filed against me for abandoning and neglecting my husband. Because my behavior would undergo a 60-day investigation, I had to agree to keep Gershon on a ventilator for at least 24 hours. Finding myself between a rock and a hard place, I agreed. When the 24 hours were about to end, I got a call from his primary care physician telling me that he needed to keep Gershon on a ventilator for at least another 72 hours. With the investigation hanging over my head, I felt compelled to agree. But after four days had elapsed, Gershon’s doctors kept him on full-time life support, all without my permission. Six days later he regained consciousness on his own and within a couple days he was discharged from the hospital and entered a nursing home. He was unable to walk or talk. He did not know his name or mine and had no clue about what happened to him. The charges of abandoning and neglecting were dropped as “unfounded.” At the end of November, I wrote his three doctors the following letter:
“Soon it will be three months since my husband, Gershon Ruben, had his third stroke in less than a year. The last cerebral hemorrhage he suffered on September 8th, 1997, was the most serious. He was in a coma for over a week and because the two of you were unable to agree that he was “terminal” he was kept on full life support for well over 24 hours and his Living Will and my surrogate power over his health care were ignored.
“As a result of your decisions, the man I married over 54 years ago and the human being that I have deeply loved no longer has any quality of life. He is ‘warehoused’ at St. Francis/Mt. Sinai Nursing Home completely dependent on others. He cannot wash himself, shave himself, dress himself, stand up or walk on his own, nor can he make himself understood when he speaks. He is maintained by an abdominal feeding tube since he is unable to swallow. He cries continually and hollers out my name, ‘Annie,’ when I am with him or not with him. I wonder deep in my heart if any of you would want to trade places with him. I know I would not want that for myself…
“It is inconceivable to me that a complaint was filed against me with the Department of Children and Families citing me for ‘abandoning and neglecting’ my husband. I was told the charges were diligently investigated over a 60-day period and were judged to be ‘unfounded’ by them. I shall always wonder if one of you was responsible for the filing of this complaint since I pushed you to carry out Gershon Ruben’s wishes as specified in his Living Will. I want all of you to be aware of the grave disservice you have committed against Gershon Ruben and his family.”
Needless to say, not one of his doctors responded to my letter, but I shall always be grateful that I wrote it. It made an impact on members of Florida’s first panel convened by the governor to study the end-of-life care when I read it to them. I quote from it in talks I give at senior citizen centers to alert others to the reality that most of the time doctors in hospitals do not honor living wills. I remind them that Florida law, like those of 19 other states, declares that a patient can only be removed from a ventilator if two doctors declare the patient terminal. The Sun Sentinel in Ft. Lauderdale and The Daily Business Review in Miami have published an article I wrote in which I encouraged professional counselors to help their clients prepare living wills that work. I am not a bit bashful about sharing what I’m living through because I hope that it never happens to anyone else.
Even though I finally found a lawyer willing to file a “wrongful life” suit against Gershon’s three doctors and the hospital, the case was dropped because no doctor was willing to testify on my husband’s behalf. One well respected professor did carefully examine Gershon’s medical records. She concluded that “he should have had his life support withdrawn on day four and certainly by day five,” and that it was “unlikely that he would have survived at that point without a ventilator.” However, she refused to be involved in a trial. Other doctors and professors of bioethics agree that Gershon was grievously wronged, but they also tell me that in Florida it is not illegal to do what they did in disregarding my wishes and those of my husband.
Gershon’s three doctors will probably never face any legal action for their decision. But more than anything, I wish they had the courage to visit Gershon in the nursing home and tell him that never again will they ignore a person’s living will.
I truly believe that when our life here on earth ends, we all go onto another life; it would surely have been better than the one he is living now. I loved him enough to let him go.
Dr. Ann Moliver Ruben is an award-winning psychologist, an educator, author, public speaker and feminist. She specializes in marriage and family therapy and parenting education.