The novelist
Richard Ford, writing in the New York
Times soon after 9/11, contrasted the enormity of the terrorist attacks
with the intimacy of his father’s death when Ford was sixteen years old. Ford
had woken to his mother’s pleading voice, trying to shake Ford’s father into
consciousness.
“‘Daddy, Daddy,
wake up,’” Ford recalled saying. “I could smell his large, sweaty body, feel his flaccid self,
loose-limbed and malleable, his cheeks and mouth relaxed. He had quit gasping.
I tried to open his mouth with my fingers and breathe in air. I tried to push
down hard on his chest. I tried to move him. I put my arms around his shoulders
and shook him. I heard my mother say, ‘Oh, God, no, no, no.’ And I felt dread
and terror, love and ferocity, confusion, physical exertion, a need for greater
ingenuity, for greater efficiency, and I felt failure. In short, I experienced
all the small and large coefficients of a son's unswerving love.”
The passage is similar to something I came across by Elisabeth Kübler-Ross, who in 1969
published her influential book On Death
and Dying. At one point, Kübler-Ross describes the fatal injury to a farmer
in Switzerland who had fallen out of a tree. Kübler-Ross was a child at the
time, and she later commented on the stoic calm of the dying man.
“He asked simply to die at home, a wish that was granted
without questioning. He called his daughters into the bedroom and spoke with
each one of them alone for a few minutes. He arranged his affairs quietly,
though he was in great pain, and distributed his belongings and his land, none
of which was to be split until his wife should follow him into death. He also
asked each of his children to share the work, duties and tasks that he had
carried on until the time of the accident. He asked his friends to visit him
once more, to bid good-bye to them. Although I was a small child at the time,
he did not exclude me or my siblings. We were allowed to share in the
preparations of the family just as we were permitted to grieve with them until
he died. When he did die, he was left at home, in his own beloved home which he
had built, and among his friends and neighbors who went to take a last look at
him where he lay in the midst of flowers in the place he had lived in and loved
so much. In that country today there is still no make-believe slumber room, no
embalming, no false makeup to pretend sleep.”
Since On Death and Dying was published forty-six
years ago, much has changed in
American health care. Advances in medical technology continue to extend many lives.
But these advances come at a significant cost. End-of-life expenses, in
particular, can be obscenely high, and dignity is sometimes sacrificed. In
“Seven Keys to a Good Death,” an article published on the Berkeley, Calif.-based
website, Greater Good: The Science of a
Meaningful Life, Charles Garfield recounts an experience he had with a
friend who was terminally ill.
“Near the end of his life,” Garfield writes, “he had
reached a place of equanimity about dying. But instead of honoring his wishes
for a peaceful death, his doctors ordered aggressive chemotherapy, which did
nothing to halt the cancer. The treatments caused him immense suffering,
rendering him unable to sleep, eat or converse with family and friends as he
was dying.”
My dad, who died of congestive heart failure in his late
eighties, had the good fortune of dying in the home he had lived in for
forty-five years. He died in late March, amid pleasant early-spring weather,
and, in his last days he had the consolation of not just his loved ones and his
Catholic faith but his familiar surroundings, which included a view of Bellingham
Bay, the body of water he traversed in
his fishing boat thousands of times.
My dad died in 2004, when I was forty-two, and I pretty
much took it for granted that, barring some terrible accident, I too would live
into old age. But it is always foolish to assume that one is exempt from bad
luck.
Greg O’Brien, a prominent figure in the Massachusetts
Alzheimer’s community and author of On Pluto: Inside the Mind of Alzheimer's,
also has been diagnosed with stage-3 prostate cancer, a disease that he does
not intend to have treated. His logic strikes me as airtight. No one wants to
enter into the fog of advanced dementia, a place that might as well be
festooned with signs proclaiming, “Abandon hope, ye who enter here.”
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