Leonard Nimoy, a personality who everyone loved, died recently of complications of COPD. On the surface, COPD seems like a cause of death like any other serious chronic condition. We reflect on the life and living moments of this man.
His death also brings up an important topic. COPD is an irreversible and progressive disease, but it is usually not a cause of death, like a heart attack of which often causes instant death, or cancer which can cause a slow but certain death.
COPD causes complications, which makes the person struggle with breathing difficulties. You don’t die of COPD, you live with it and try to manage it the best you can. Ultimately, you die of "COPD complications," which is especially sad when you consider the vitality of Leonard Nimoy, actor, poet, director and beloved husband and father. For an actor of stature, and for an average person, the disease is not a glamorous way to die.
Other celebrities who had died from COPD
Other well known personalities who died of complications of COPD include Johnny Carson, a comedic icon. He was seen regularly on his show with a large ashtray on his desk, that he would share with his celebrity guests. He also served in the Navy, where free cigarettes were supplied regularly during service. Many soldiers came out of the military service with tobacco addiction. It is said that at age 76, Johnny Carson was still able to play tennis, and yet, only three years later he would succumb to COPD. He grew bloated from steroid medications, and would get winded when climbing a simple flight of stairs.
Dean Martin personified the elegant high life, with a cigarette in one hand and a martini in the other. Even while singing in his show, there was always a lit cigarette as a prop on the table. At age 78, Dean Martin died of respiratory failure. Lenard Bernstein, a world-renowned conductor, who displayed incredible physical energy while conducting the New York Philharmonic, would ultimately die of a heart attack brought on by progressive respiratory failure. He, like the others, spent most of his life hooked on cigarettes.
The point of this story is the contrast of what people see versus what is actually going on physiologically inside the individual with the advanced form of COPD. Death tends to occur after a prolonged functional decline. Every small physical exertion requires disproportionate effort, so that inactivity and idleness often prevails in the final days of life. A sense of hopelessness prevails in many cases, projected by providers who are frustrated by their inability to change the course of events and the suffering. This is certainly not the case with heart disease, which is treated very aggressively, or even cancer, which is approached with sophisticated tests and protocols that give the individual a sense that something is being done.
End-stage and end-of-life care
The new trend is for end-stage care to be provided by a new specialized group known as **Palliative Care Providers. **The practice of palliative care is often misunderstood because it is simplistically viewed as simply easing the suffering as one nears the end. The approach actually teaches patients how to live with the compromising elements of a disease like COPD.
Despite the ongoing care, complications can arise. Infections, falls resulting in fractures that require surgery, and last (but not least) heart disease, which is commonly present in cigarette smokers. In COPD, these are all major events. The common element in all these situations is an increased demand to breathe. And this is what "dying of complications of COPD" really means. It is terribly unpleasant to be breathless as you battle to recover from an illness. So it’s not uncommon for people to actually give up and accelerate the process. Death can then come quickly. COPD is a fierce and difficult disease that continue to learn about and how to handle it.
Eli Hendel, M.D., is a board-certified internist/pulmonary specialist with board certification in Sleep Medicine. An Assistant Clinical Professor of Medicine at Keck-University of Southern California School of Medicine, and Qualified Medical Examiner for the State of California Department of Industrial Relations, his areas include asthma, COPD, sleep disorders, obstructive sleep apnea, and occupational lung diseases. Favorite hobby? Playing jazz music. Find him on Twitter @Lung_doctor.