La Cross Wisconsin


The conversation about death is not just avoided by doctors talking to doctors, but also doctors talking to patients. Except in La Crosse, Wisconsin, “The Town Where Everyone Talks About Death”. Where Bud Hammes pioneering approaches has transformed how at least this town embraces the ultimate failure (thanks Eileen)…

  • “In La Crosse, Wisconsin, you’re unusual if you don’t have a plan for your death. Some 96 percent of people who die in La Crosse have an advance directive or similar documentation. Nationally, only about 30 percent of adults have a document like that. In this community, talking about death is a comfortable conversation…basically because of one guy in town. Bud Hammes works as a medical ethicist at a local hospital called Gundersen Health System. For years, he was called when someone’s dad had a stroke, was in a coma, on machines. Bud would sit down with the family and try to help them figure out what to do next. And every time, he says, the discussion was excruciating. ‘The moral distress that these families were suffering was palpable," he says. "You could feel it in the room.’ Most of the time, Bud says, they’d be talking about a patient who had been sick for years. Why not have that conversation earlier? So Bud started training nurses to ask people ahead of time, would you like to fill out an advanced directive. It took a while but the idea caught on. Nurses started asking patients questions like: If you reach a point where treatments will extend your life by a few months and side effects are pretty serious, would you want doctors to stop, or continue to do all that could be done? And a lot of patients said: Stop.”