Dr. Charles Baxter
Good Life, Good Death Fail to Go Gently into That
Good Night
I found the obit late Sunday, buried in the Metro Section of my Sunday Chicago Tribune:
Surgeon tried to
save Kennedy,
operated on Texas governor
operated on Texas governor
The Associated Press story was datelined Dallas,
Texas, and it told of the death at 75 last week of Dr. Charles Baxter, one of
the surgeons who tried to save the life of President John F. Kennedy on November
22, 1963. Baxter was 34 and the emergency room director at Dallas' Parkland
Hospital, where Kennedy was taken after being shot in Dealey Plaza. He always
had a clear view of that fateful day and his place on the stage of JFK's
passing: "As soon as we realized we had nothing medical to do, we all backed off
from the man with a reverence for one's president. And we did not continue to be
doctors from that point on. We became citizens again, and there were probably
more tears shed in that room than in the surrounding hundred miles."
I met Baxter in the Eighties, while planning a medical documentary film titled Dax's Case: Who Should Decide? on a less famous patient -- a man named Don Cowart who shook the very conventions of the Hippocratic oath for Baxter with his demands to die. After being burned over more than 65 percent of his body in a freak propane gas explosion, Cowart was transported 140 miles from Henderson, Texas, to Parkland to be treated in its special burn unit. Cowart's face suffered third-degree burns and both eyes were badly damaged. He ultimately was hospitalized for 232 days at Parkland and endured countless whirlpool tankings to cleanse his wounds, procedures to remove dead tissue, grafts to protect living tissue, the amputation of badly charred fingers from both hands and the removal of his right eye. His damaged left eye was sewn shut. And there was terrible pain.
I found Cowart in the East Texas piney woods, locked deep inside a scarred and disfigured body, after a search through newspaper morgues and library microfilm in the cities of Tyler, Kilgore and Henderson. Seven years of unimaginable pain, horror and medication had dulled many of his memories, but the demands he made to Baxter and his caretakers remained razor-sharp: "Let me die. Take away the treatments, take away the medications." He did not want his life extended, and from the beginning he exhorted all who would listen to stop treating him.
"It was against my nature," Baxter told me when I met him. "Physicians are trained to save lives, not to end lives." He remained undaunted by Cowart's pleas to stop treatment, dismissing them at first as the typical response of burn victims to the pain of their wounds and treatments.
In time, however, Baxter openly discussed Cowart's wish to die with Don, his mother, his attorney and others, considering all the moral, ethical, medical and legal ramifications of letting a patient choose death. "In treating a patent declared 'brain-dead.' it was a much easier and acceptable course," he said. "I sat with a patient's family, we talked about the course of treatment and expected outcomes, and the decision to remove life-support and let the patient die. With Don Cowart, it was not that easy." Failing to get the consent that he sought to withdraw treatment, Baxter continued to care for Cowart.
The poet Dylan Thomas reminds us: "Do not go gentle into that good night. Rage, rage against the dying of the light." Don Cowart raged, but not against death. Or did he?
In a darkened hospital room, the patient asked a nurse for an overdoes of medication that would end his life. She would not consent.
In that same darkened hospital room weeks later, the patient asked a lifelong friend to help him get a handgun he could use to kill himself. He would not consent.
Finally, again in the the same darkened room, the patient asked his attorney to help him to a sixth-floor window, where presumably he could leap to his death. Again, no help was given.
Who should decide? Who will help?
Through more than 20 years, I have thought often about Baxter, Cowart and all who were affected by what became a seminal case on the center stage of medical ethics and patient rights in the decades of the Seventies and Eighties. Dax's Case became a powerful teaching tool at Cornell, other medical schools and allied health centers, where physicians and nursing professionals struggled with the right to die argument. I struggled personally with the issue and wondered often whether Don Cowart really wanted to die.
I say no.
Will we remember Baxter as the surgeon who worked to save a dying president? Or will we remember him as developing a formula for treating burn patients? Gone is the man who discovered that patients with severe burns need tremendous levels of fluid in the early hours of their ordeal. Gone is the man who founded a tissue bank at Parkland to provide skin grafts for burn patients.
It may help to know that Don Cowart emerged to live a new life. He became an attorney. He fought to preserve the rights of others. He rejoined the community that once left him behind. Bitter life gave way to a better life.
I will always remember Dr. Charles Baxter, his deep Texas drawl comforting those around him as they struggled with life and meaning. Gone is the man who raged against the dying of the light most every day.
I met Baxter in the Eighties, while planning a medical documentary film titled Dax's Case: Who Should Decide? on a less famous patient -- a man named Don Cowart who shook the very conventions of the Hippocratic oath for Baxter with his demands to die. After being burned over more than 65 percent of his body in a freak propane gas explosion, Cowart was transported 140 miles from Henderson, Texas, to Parkland to be treated in its special burn unit. Cowart's face suffered third-degree burns and both eyes were badly damaged. He ultimately was hospitalized for 232 days at Parkland and endured countless whirlpool tankings to cleanse his wounds, procedures to remove dead tissue, grafts to protect living tissue, the amputation of badly charred fingers from both hands and the removal of his right eye. His damaged left eye was sewn shut. And there was terrible pain.
I found Cowart in the East Texas piney woods, locked deep inside a scarred and disfigured body, after a search through newspaper morgues and library microfilm in the cities of Tyler, Kilgore and Henderson. Seven years of unimaginable pain, horror and medication had dulled many of his memories, but the demands he made to Baxter and his caretakers remained razor-sharp: "Let me die. Take away the treatments, take away the medications." He did not want his life extended, and from the beginning he exhorted all who would listen to stop treating him.
"It was against my nature," Baxter told me when I met him. "Physicians are trained to save lives, not to end lives." He remained undaunted by Cowart's pleas to stop treatment, dismissing them at first as the typical response of burn victims to the pain of their wounds and treatments.
In time, however, Baxter openly discussed Cowart's wish to die with Don, his mother, his attorney and others, considering all the moral, ethical, medical and legal ramifications of letting a patient choose death. "In treating a patent declared 'brain-dead.' it was a much easier and acceptable course," he said. "I sat with a patient's family, we talked about the course of treatment and expected outcomes, and the decision to remove life-support and let the patient die. With Don Cowart, it was not that easy." Failing to get the consent that he sought to withdraw treatment, Baxter continued to care for Cowart.
The poet Dylan Thomas reminds us: "Do not go gentle into that good night. Rage, rage against the dying of the light." Don Cowart raged, but not against death. Or did he?
In a darkened hospital room, the patient asked a nurse for an overdoes of medication that would end his life. She would not consent.
In that same darkened hospital room weeks later, the patient asked a lifelong friend to help him get a handgun he could use to kill himself. He would not consent.
Finally, again in the the same darkened room, the patient asked his attorney to help him to a sixth-floor window, where presumably he could leap to his death. Again, no help was given.
Who should decide? Who will help?
Through more than 20 years, I have thought often about Baxter, Cowart and all who were affected by what became a seminal case on the center stage of medical ethics and patient rights in the decades of the Seventies and Eighties. Dax's Case became a powerful teaching tool at Cornell, other medical schools and allied health centers, where physicians and nursing professionals struggled with the right to die argument. I struggled personally with the issue and wondered often whether Don Cowart really wanted to die.
I say no.
Will we remember Baxter as the surgeon who worked to save a dying president? Or will we remember him as developing a formula for treating burn patients? Gone is the man who discovered that patients with severe burns need tremendous levels of fluid in the early hours of their ordeal. Gone is the man who founded a tissue bank at Parkland to provide skin grafts for burn patients.
It may help to know that Don Cowart emerged to live a new life. He became an attorney. He fought to preserve the rights of others. He rejoined the community that once left him behind. Bitter life gave way to a better life.
I will always remember Dr. Charles Baxter, his deep Texas drawl comforting those around him as they struggled with life and meaning. Gone is the man who raged against the dying of the light most every day.
Posted: Mon - March 14, 2005 at 08:55 PM
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Published On: Mar 16, 2005 10:59 AM
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Published On: Mar 16, 2005 10:59 AM