June 6, 2011 - By Lia Steakley
In 2005, Jim Cooper thought his lung disease left him with only six months to live. Instead he spent the next five years making a video about his life and palliative care. Even as he was dying, he insisted to his doctor VJ Periyakoil ( left) that the camera continue to roll.
Doctors had told Jim Cooper that he had less than six months to live, and, true to his military background, he started stoically marking the days off on a calendar. Diagnosed with advanced lung disease, Cooper, a Korean War veteran, had been sure that his days were numbered — until he visited the Veterans Affairs Palo Alto Palliative Care Clinic in 2005.
Dependent on oxygen and a wheelchair, Cooper arrived at the clinic suffering from post-traumatic stress disorder, chronic chest pain and extreme air hunger , which prevented him from completing sentences without gasping for air. He met with VJ Periyakoil, MD, the VA’s associate director of palliative care and a clinical associate professor of medicine at Stanford, whose opinion was that Cooper would live far longer than six months provided he had access to ongoing palliative care.
Cooper was skeptical. “They sent me to palliative care to die. Is that not what palliative care is about — helping people die?” Periyakoil told him that palliative care was about making feel better and when they feel better, they often live longer. “He didn’t believe my prognostication,” said Periyakoil. “So I jokingly told him I was going to film him to prove to him that he would still be alive in six months.”
Periyakoil’s joke about making a video became Cooper’s mission. What Cooper had thought would be a death fraught with suffering turned out to be the beginning of the last and most meaningful chapter of his life: He dedicated himself to increasing awareness about palliative care. He discontinued his regimen of ticking off days on the calendar and asked Periyakoil to film the remainder of his life and experiences with advanced lung disease and palliative care treatment.
The video journal of his treatment evolved into a six-year project. As the project progressed, his initial symptoms of pain and shortness of breath improved, and Cooper was able to address his PTSD and depression. In the process, he recounted life stories, reconciled with his son, remarried his daughter Kellee’s mother and came to terms with his death. All the while, the cameras rolled.
The project culminated in the creation of a poignant, 14-minute documentary that offers a snapshot of Cooper’s life from the year Periyakoil began treating him until his military funeral last year. Titled Jim Cooper’s Legacy: A Veteran’s Story, the film was released online on Memorial Day and will be used to continue Cooper’s commitment to increasing public awareness about palliative care. (To view the video, visit http://stan.md/iZXk7n.)
Shortly after Cooper began receiving palliative care, his spirits and health improved.
“The more he benefitted from palliative care and the better he felt, the more committed he became to spreading the word about palliative care,” said Periyakoil. “It bothered him that millions of Americans were dying without access to palliative care. He made it his life mission to increase awareness about this medical subspecialty.”
Palliative care is specialized medical care focused on relief of suffering and support for the best possible quality of life for anyone with any type or stage of serious illness, such as cancer or congestive heart failure, through intensive pain and symptom management. Many people often confuse this medical subspecialty with hospice services, which is an insurance benefit providing care for terminally ill patients with an anticipated life span of six months or less. By contrast, palliative care can and should be given with concurrent curative care and seeks to prolong life and promote the best quality of life for individuals suffering from any serious illness.
“We have a hard time making patients understand and not fear palliative care. Mr. Cooper understood it better than most doctors I know,” said Periyakoil. “Once it became known he was participating in the film, many veterans called him and he would counsel them for hours about palliative care and symptom management.”
One such phone call came from a veteran who confessed he was considering taking his own life. The caller confided in Cooper about his lifetime struggle to forget the gruesome and terrifying scenes of combat and the excruciating mental anguish he was living with daily. Rather than continue to suffer, the man explained that he would prefer to die on his own terms. Cooper patiently listened. He shared stories of being haunted by flashbacks, the overwhelming pain he was in prior to receiving palliative care treatment and his own fears about dying. In the end, he convinced the caller to seek treatment rather than to end his life.
Cooper’s success in counseling fellow veterans was no doubt due to his unique background. He joined the military at the age of 17, serving as a member of the Navy’s underwater demolition operation, commonly referred to as “frogmen.” Soldiers in this elite special operations group, a precursor to today’s Navy SEALS, underwent grueling training designed to select the fittest and prepare them to conduct clandestine amphibious operations. During the Korean War, frogmen performed treacherous, tactical missions ranging from destruction of underwater obstacles in preparation for large-scale amphibious landings to infiltrating behind enemy lines from the sea. Until retiring from the service in 1954, he marked underwater mines for destruction by minesweepers.
In the film, Cooper discloses a painful tale of personal loss and the grief that he silently endured for years. The story involves a young, orphaned Korean girl who routinely visited his ship to ask for food. Cooper, then 18, and his wife had decided to take steps to adopt the child, but their dream became a nightmare. Before the paperwork could be processed the girl was killed — before Cooper’s eyes — during an attack on his ship.
“I dream about it constantly. It lives with me every single stinking day of my life. I can’t get over it,” he says in the film. “I’m not over it today.”
In the final days of this life, Cooper insisted Periyakoil keep the camera rolling. Frail and weak, he speaks softly while lying in hospital bed about how a sense of duty to other veterans compelled him to participate in the film.
“This was my idea to show benefit to my comrades,” he says in the film. “This is my way of showing them how it comes down.”
Cooper died peacefully on May 23, 2010, at the age of 79.
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