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Beuna May Bugel: Discuss end-of-life decisions with family

Pat grew up in Lead, S.D. Red grew up in Barnum. Pat went for nurse training to Gustavus Adolphus College, where she was assigned to the Moose Lake psychiatric hospital.

They met at the Soo Hotel, near the Soo Line tracks in Moose Lake. They hit it off right away. They were married in 1952.

A few years later, Red would get hired at Reserve Mining in Silver Bay. Pat would then spend most of her career at Lakeview Memorial in Two Harbors. They would settle and raise their children in Silver Bay. Red and Pat have served as relationship role models for others throughout Silver Bay ever since.

From when Pat met Red, she admired his patience. Red enjoyed being around Pat's seemingly never-ending spunk. When their children were growing up, they knew love and respect of their parents would be constants regardless of the situation.

As their children entered into adult relationships, they would ask themselves: "How would Mom and Dad handle this?'

Sixty-six years together brought their share of challenges. They lost a child and saw their house burn down. They adopted the philosophy not to quarrel about the little things and the big things will eventually work themselves out.

Recent months, though, have brought the most uncertain challenge yet. Red was diagnosed with cancer. The cancer was aggressive, having spread to the brain, lungs, liver and adrenal glands. Red had a session of radiation, but this could merely temporarily slow cancer growth.

Red was recently placed in hospice care. Red and Pat's relationship will now consist of making the most of every day left.

The continued strength of their relationship in these days remains evident. Red's selflessness remains evident as he encourages Pat to take frequent respite from caregiving to play bridge.

The Silver Bay community has shown an outpouring of love to Red and Pat through visits and phone calls. Recently, they were named king and queen of Bay Days.

Red and Pat's circumstances should cause us to reflect on the question: "How do we want our final days to look?"

Twenty years ago, my grandma (Mom's mother) was diagnosed with brain cancer. Chances of survival were nonexistent. The decision was made to try experimental surgery hoping above all hope for a miracle outcome. She would never awaken and proceeded to spend the last three months of her life in a comatose state, never able to say goodbye to her loved ones.

This experience has caused plenty of conversations in my own family regarding end-of-life decisions.

Atul Gawande is a surgeon and author who wrote a book called "Being Mortal" dealing with what truly matters at the end of life. Gawande makes the point that advances in medical technology possess the ability to keep people alive for long periods of time, yet these advances do not ultimately guarantee a quality of life where Red and Pat can laugh together.

Gawande's advice is to have discussions with your loved ones early as to what constitutes a "quality of life" as one lives out their final days. Gawande cites the example of his father, who believed life is worth sustaining as long as he would be able to eat ice cream and watch football.

One practical step for people to undertake with their loved ones would be to fill out a health care directive together to best understand similar end of life wishes.

Upon receiving Red's diagnosis, Red and Pat sat down for dinner. They decided to toast each other to the blessing of 66 years of marriage. They celebrated their children, grandchildren, great-grandchildren and a life well-lived. Red hopes his final days will be spent with Pat, his family and friends.

While death for many represents uncertainty, for others it speaks to the meaning of their life. Red's purpose was being a wonderful provider, husband and father. When Red does leave this world no greater tribute can be given.

Pastor Stew Carlson is the grandson of Beuna May Carlson of Lindstrom, Minn. He is also the board chairman for North Shore Area Partners and pastor of Sychar Lutheran Church in Silver Bay. He can be reached at