I live with elevated blood pressure and take daily medication to lower it. The reason for my high blood pressure is irrelevant at this point.
When I forget to take my medication, I get a headache. If I forget to take my blood pressure medication two days in a row, I become high risk for a stroke.

Because I am a nurse, I know that a stroke could mean sudden death or a drawn-out season of dying over a few days, months or even years.

A long, drawn-out death means I would need someone to bathe me and keep my diapers changed.

If I can no longer get my blood pressure medication because of an inability to pay or a lack of product allocated to older persons or any other reason, just how will I live with that reality?

Am I entitled to have vital medications provided to me? Can I be at peace when I know the medication is not coming? Can I accept the inevitable? Is there going to be someone to care for me?

Regardless of what happens with the current healthcare legislation, we need to be about the business of living in peace with what we are provided each day.

A grateful heart today is the key to the provisions of tomorrow. An Old Testament prophet asked, who can we trust when there is no blossom on the tree and no fruit on the vine?

When we place demands on what we expect tomorrow and feel we are entitled to things that are not available, we are choosing an attitude of ingratitude.

An attitude of ingratitude creates a downward emotional spiral, and we lose our focus.

We need a reality-bound focus so that we can be a part of solutions and learning ways to be supportive of one another during the societal changes that are approaching.

Most of all we need to be spiritually anchored, understanding our reason for living. Understanding our life and living is preceded with understanding our death and dying.

Modern medicine of the mid- to late-20th century created some expectations of always having medications and cures available.

As a society we laid aside preparation for dying and thoughts of lingering seasons of suffering. Are we afraid to think about life after death because our daily life is so miserable we cannot bear continuing the same in death?

We underwent a major paradigm shift in healthcare during the 1990s when the reimbursement system for care was changed.

The forthcoming paradigm shift is challenging our core, giving us the option to accept each day with gratitude or to live with ingratitude having unrealistic expectation and feelings of entitlement.

If we can get our heads around the thought that less healthcare is going to be reality, the question becomes: Where will I go to get help learning how to live with less healthcare?

How do I learn how to accept and make peace with things I cannot change? Is there a place to learn about death and dying? Do I have to fear death?

When I can no longer obtain my blood pressure medications, I will be at peace, thankful for each day I awake.

I will live with less coming and going and with less noise and gadgets in my life. I will clean out and declutter my environment. I will read my Bible, pray and enjoy family and friends. I will live dependent on my Triune God. I will thank God for loving me before I understood radical dependence on Him.

With a heart of gratitude, I can live without feelings of entitlement for healthcare and services not available to me. I will be able to accept the consequences. While I am able, I will continue to serve others as needs present and I am capable.

We are challenged to view healthcare politics with new thinking. The healthcare paradigm is in shifting mode once again. Courage is required for new thinking.

Ingratitude and entitlement thinking go hand in hand with unrealistic expectations. Gratitude and thankfulness can lead to reality-bound thinking about life, living, death and dying.

SybilSmith, a registered nurse, lives in Lyman, S.C. She leads workshops on congregational caregiving ministries and teaches a course on poverty and health.

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