By my count, this is the 100th "Letter From Tom". These monthly communications began in January 1986 and have continued since, although they were threatened with suspension or even termination due to factors beyond my control. (See March 1992.) The 100th of something often results in a special notice or even a celebration.
The advantage of an anniversary, such as a Centennial, is the opportunity to reflect on the past eight plus years, since these newsletters first began. Quite frankly, from the outset, I had no notion that these messages would continue to be so well received. You readers have given me great feedback letters which have encouraged me to continue to write about new developments in our understanding of COPD and related topics, and new treatments. I've also used these letters as a vehicle to express some of my philosophies abut life and coping with disease.
In the interval several advances have occurred. That ambulatory oxygen is no longer challenged by HCFA is a major victory. Transtracheal oxygen is a benefit to some patients. Lung transplantation has been perfected and is regularly being performed in more than 20 centers in the United States. Small, but definite, increases in smoking cessation are occurring. New medications and medical devices have been introduced.
Of at least equal importance is the realization that patients have a right to privacy and self determination. They can refuse or discontinue any form of therapy that does not offer comfort or if they just plain don't want it. The realization that quality of life is often more important than length of life is a principle that most of us embrace. Death really should be viewed as a natural process and the end to natural life. The pursuit of happiness is available to all of us but it is up to us to pursue it.
Remembering to Live (see Feb. 1994) should be the motto for all of us. I certainly got my "wake up call" in 1992 when I needed emergency heart surgery. Everyone should wake up to the joys of living.
I'll be in touch next month.
Thomas Petty, MD