I just read a Time magazine cover story by Joe Klein about his parents’ dying and his role as their “death panel” (his words). He had to make decisions about which treatment his parents would receive and how their last months would be spent. The article is about what he learned about dying, and dying well, in the process. He’s especially clear about the kind of medical care he found for his parents—and about his firm belief in this medical model. (The article is online here, or find it in the June 11, 2012, issue.)
Reading this, I started reflecting on my own views about the end of life. So, now I’ve decided to write a blog about death and dying. Usually not considered an uplifting topic. But the reality, as we all know, is that we all die. And as we age—which I, at least, am doing these days—that reality inches (or rushes) ever closer.
Many of us, like Klein, have already encountered death in the passing of parents, other family members, close friends, or acquaintances. Each of these events is a reminder that we’re all on the same path. That path leads off this plane of existence (I’m reminded of those old pictures of ships sailing off the edge of a flat world) and into … what? Many folks believe that death is followed by another life, maybe an exalted existence, eternal joy or damnation, or another incarnation. Others folks believe it leads to some universal level of reality where we merge with a cosmic Oneness, become part of some eternal existence with no persisting sense of personal identity.
For others, there is no continuing existence in any spiritual form. Instead, after the end of life as we know it, there is only the absorption of our cells into the physical makeup of the physical universe. I count myself in this last group. My own view of death is that it is, quite simply, the end of personal identity. Life stops. Identity ends. And our bodies become part of the material make-up of the universe. I like this image, actually. I like the thought that “I” (i.e., my cells) will nourish some other growing, living thing. And I am fine with the notion that “I” won’t continue. Well, “fine” may be an overstatement. I have pangs of deep regret that I won’t have any more experiences. But I am confident in and settled with this belief—as opposed to miserable about and resistant to it.
So, how does our understanding of death in the abstract affect how we experience it in our own lives? So far, my closest encounter with this question has been through the deaths of my parents and my younger sister.
My sister knew she was dying. Her melanoma was spreading relentlessly, and she was in home hospice care. She died in her sleep, after an evening spent saying goodbye to her immediate family. My father chose his time to die, in the face of progressively more invasive medical procedures. Another heart surgery and ongoing dialysis were more than he wanted to endure, and he chose to stop treatment. He died in hospice with his immediate family around. My mother died last, unresponsive in the hospital after numerous medical crises. I was at her bedside, having come from New Hampshire. My older sister, who was Mom’s primary companion and support in her last years, had gone home to get some sleep. Mom died just seconds after I told her she could go if she was ready.
I would expect that how I understand death would shape how I have responded to their passing. Yet, I am struck by certain contradictions between what I deeply believe about dying and how I behave in its presence. For instance, here are two paradoxes:
First, since I believe that death is truly the end of individual consciousness, I don’t think that folks who have died are “looking down,” that they speak to us, or that they hear our pleas, prayers, or apologies. Nonetheless, I have occasional “conversations” with my mother and my sister—as if they existed somewhere as conscious persons, listening to me. So, I ask myself, why am I talking to them if they are simply and utterly gone? Have I so deeply internalized the storyline of our culture that tells of an afterlife, of their watching over us? Or do I not really believe that they are simply gone? Is that just an intellectual argument, while deep down inside, I really believe they still hear me? Or am I really just talking to myself, completing unfinished conversations, seeking reassurance or advice from some part of myself even though I’m addressing them? I think it’s the last. But sometimes, I wonder about my casual intellectualization of death—and about why it dissolves so easily.
The second paradox is in an entirely different vein. I know the importance of making sure that my wishes for end-of-life care are known. Both of my parents were absolutely clear about these things, and that fact eased the burden on their kids tremendously. Dad chose to slip into unconsciousness and die quietly. Mom chose to refuse “heroic” procedures, so no breathing tube was inserted to keep her “alive.” On the other hand, my sister was not as clear, and that fact made for some very difficult times, especially for her own adult children, who were charged with her care. So I’ve seen real-life examples of the difference it makes to decide in advance and to let others know my choices.
I also know the importance of what is routinely called “getting your affairs in order.” My father’s affairs were in order because my mother had always managed such matters, and she was (literally) a pro at managing financial records. For the same reason, her affairs were well under control when her time came. Both had clear wills and detailed financial records, and both had already arranged (and paid for) their cremation. My sister, on the other hand, lived a very chaotic life. She hand-wrote a fragmentary will the evening before she died, and her other records were virtually non-existent. I was the executor of her will, and trying to create order from this chaos was an awful task.
So, I am totally aware that I need to tend to all of these things for myself. But as I reflected on this, my first thought was that I haven’t done any of it. Feeling embarrassed about my near-total lack of attention to “final things” in my own life, I shared this with my partner. Ever the realist, she pointed out that I have, in fact, taken care of most of these things. I have a will (although it’s way too old), I have long-term care insurance, I have identified my “last wishes” for medical care and cremation, I have a durable power of attorney for medical and financial decisions, and she knows who handles my annuities and, more or less, where my financial records are. There are a few things I should do: update my will, organize my financial records, and arrange in advance for my cremation and all the other things that others shouldn’t have to decide about. But mostly, I’m not so embarrassingly irresponsible in this area.
So, this raises an interesting question: Why am I so convinced that I’ve done nothing about this, when, in fact, I’ve done most things I should do? One possibility is that I continue to believe that there must be ways to “manage” death. If I just get this in order and that in line, death will be packaged, controlled. It’s not that I believe this intellectually—I really do know better. But this denial thing takes many forms, and one of them is surely the belief that we can somehow corral death. Since we can’t control the fact of death, at least we can control the circumstances of dying. So, in a paradoxical way, thinking that I still have things to manage may hint at my lingering belief that death can be tied up if I just apply enough twine. Not tying those last knots leaves me with unfinished tasks, so I still have something to do that will wrap this thing up.
But somehow, I just don’t get to these last tasks. I tell myself I’m too busy. This means that (1) I’m too busy to find the time to take care of it all, so I keep putting it off. And (2) the fact that I’m so busy proves that I don’t need to take care of it all. How can I be close to the end when my life is so full? I know this is nonsense. “It” could happen any day even though I have no reason to expect it. Besides, by the time I grasp that “it” is close, I could be physically or mentally unable to get my affairs in order. Obviously, this is not a good excuse. But it’s the only excuse I can articulate: I’m too busy.
Another way of understanding this might be that having a full life is another strategy for keeping this thing at bay. It gives me another layer of insulation, another way of denying what I know full well—intellectually, at least. My partner told me long ago about a book I should read: The Denial of Death by Ernest Becker (which is, amazingly, available online as a google book, or in old-fashioned book form at Amazon).
Maybe it’s time I picked it up … if only I weren’t so busy.
No comments:
Post a Comment