Katherine (Kit) Meshenberg lived in Chicago. In 1999, she discovered she had serious cancer, and started aggressive traditional treatment to fight it. Kit also began to use alternative medical treatments; looked at what she could do to improve her quality of life through spiritual and religious undertakings, and began to record her thoughts and activities on video and audio tape. From the beginning, Kit wanted to make her life as “normal” as possible. Kit’s entire story can be found on the web site, Kitslegacy (
site, we have excerpted parts of her story and included them in seven of our nine categories.
Kit : We were going over this living will with my family, just reminding each other what this is, and there were questions we couldn’t answer. This is the standard form and it’s very general. When you start asking about specifics, it gets more complicated.
Dr. Jamie Von Roenn (Kit's oncologist): If there is the hope for meaningful quality of life because of an intervention, it is worth doing. If there isn’t, it isn’t. And I know, from talking with you about it, that what is important to you as a person is your interactions with people. So if you’re incapacitated, my opinion would be no fluids, no feeding.
Kit : Our son said, “But if you withhold food from Mom, she’s going to be uncomfortable and in pain.” So we need to help him understand that that’s not the case.
Jamie Von Roenn: Well, if you’re awake and enjoying eating, nobody would withhold food. But if you are unconscious and in the process of dying, withholding those things does not cause discomfort. What this means is: one would not put tubes in you to force calories if you were unable to take them.
Mike Meshenberg (Kit's husband): A lot of this comes down to definitions. We had questions about the definition of two words here – “imminent,” as in imminent death, and “sustenance. ” What is the definition of “sustenance?” I looked it up in some Partnership for Caring booklets on hydration and nutrition, and it was very explicit in saying that, at the end, “sustenance” is, in fact, a medical procedure. And the effects of withholding are, in fact, to increase comfort, rather than to decrease comfort.
Jamie Von Roenn: Yes, in fact, what usually happens is, even when you withdraw hydration and nutrition, people do not just suddenly die, because withdrawing things is not the cause of death.
Kit : And that was the question that my family raised – if both hydration and nutrition were withheld, then wouldn’t my death be hastened?
Jamie Von Roenn : By that time, there are so many things going on it is not clear that stopping nutrition and hydration has anything to do with the timing of your death. Actually, what often happens, and what ends up being very difficult for the people watching, is that you do stop and then nothing changes. People prepare themselves and nothing changes. No matter what we say, lay people assume it means that death is very close – hours or days – and often it is not.
Mike : Okay, that raises the question of the next definition. The document says: “When my physician has determined that my death is imminent…” As a physician, what does that mean to you? How do you define “imminent?”
Jamie Von Roenn: : I think it’s not so much about time. It’s about situation. It is the point at which there’s nothing I can do that will make Kit’s life better after I do it.
Kit : So if I’m in a coma, and it could be reversed and I could enjoy life again, then we would do that. Mike would say, “Well then, feed the girl,” right?
Jamie Von Roenn: That’s right.
Kit: But if there is no way for you to bring me back and for me to have some quality of life that means something to me, then you wouldn’t interfere.
Jamie Von Roenn: That’s right. And ultimately Mike knows best and will tell me.
Kit: Okay. So you and Mike and I are in agreement but what if one of our children gets cold feet?
Jamie Von Roenn: Legally, as your designated health care proxy, Mike is your voice. The proxy speaks for you when you can’t speak for yourself.
Kit: Now that it’s real, it’s become more complicated. We’re not that educated about this stuff.
Dr. Von Roenn: Nobody is. The only thing that works is conversations like this, over time.