Family Members Need to be Advocates

Rita Papazian
Norwalk Citizen Article  February 2007

Are there lessons to be learned from the life and death of Anna Nicole Smith? Let me count the ways.

It is no surprise that she died from an accidental overdose of drugs. "Accidental" may be the operative word here. How accidental is it when doctors prescribe at least nine drugs to one patient? How accidental is it when close friends witness the drug taking?

I guess the good news is that these were prescribed drugs. Tabloids call the overdose "a lethal cocktail" of nine drugs. The one drug that tipped the scale causing her to slide into permanent sleep was the chloral hydrate, a drug used for patients struggling to sleep or in great pain. Reportedly, she slugged the syrup from the bottle during intermittent periods of sleep.

Smith's death from a lethal cocktail recalled my own family's experience with the death of my mother in 1991 at age 81. She had been found on the floor in her bedroom unconscious from a stroke. She remained in a coma for a month and then died. When my brother and I went to her apartment, we found those small plastic bottles of prescription drugs. We were horrified. We had no idea that she was taking so many drugs. We didn't know why they were prescribed. We did not know how much she was taking, nor did we know how one prescription drug in combination with another could affect her health.

I know that my brother had gone to one doctor and complained about finding all this medication in her apartment. I scooped up the bottles, dumped out the pills and put the empty containers in a plastic bag. For some reason, I've held on to those pill bottles for 16 years. I have no idea why I've been doing this. Maybe I thought one day I would take these bottles out and research the drugs to determine if yes, indeed, they could have become, as in Smith's case, "a lethal cocktail."

Four different doctors prescribed the medications for my mother. I know that two of the doctors were in joint practice. My mother was prescribed antidepressants, including Prozac and Doxepin. This was shocking to learn that a doctor had prescribed Prozac to my 81-year-old mother, a woman who had seemed to be in good spirits, driving around town, volunteering and playing bridge every week with her friends. She also was prescribed medication to prevent colon cancer, heart failure and stroke. In total, I counted seven different prescriptions that my mother was taking at the time of her stroke.

I had no knowledge of these prescriptions, especially the Prozac, until she was discovered unconscious. Now, I don't know since I never did the research if these prescriptions caused the stroke. The point here and the lesson I learned only too late is that it is very important to monitor the medication that our loved ones are taking and to make sure that all is all right. How do I know that my mother's internal medicine doctors knew that she was seeing a psychiatrist who was prescribing drugs?

Whenever I talk with friends in the sandwich generation, I always bring up the subject of the importance of monitoring their parents' activities, especially their medical care. When adults find themselves members of the sandwich generation, dealing with raising children and caring for parents, it can become difficult to keep tabs on everyone. It can be difficult to ask the right questions that can bring forth information to help us monitor the habits that can lead to medical problems.

Obviously, Smith was surrounded by a lot of people who were there to fill her needs, but somehow no one had the smarts to monitor her actions and to keep tabs on the prescription drugs she was ingesting.

It's interesting that Smith's autopsy results came on the heels of John and Elizabeth Edwards' announcement that Elizabeth's cancer has recurred. In making the announcement, the Democratic presidential candidate and his wife have become a model of inspiration in many ways, most importantly in the manner in which people can choose to live their lives with a fatal disease. As Elizabeth Edwards said, her cancer is treatable, not curable. She doesn't know when she will die, but as with everyone else, she knows she will die someday. None of us really knows when. And if we did, would we lead our lives so differently?

What a contrast we see between two couples: John and Elizabeth Edwards and Anna Nicole Smith and Howard K. Stern. What lessons we can learn from them?

Where were the smart thinkers in Smith's life, who didn't see the signs that she was in a prescription drug spiral that drew her into a vortex to her death. So many questions. So many questions. We need to be advocates for our own family members, so that at the time of death we don't say, "How did this happen?"

Rita Papazian is a free-lance journalist who has covered Norwalk issues extensively. E-mail can be sent to her at ritapap@comcast.net.