I must admit it’s my greatest fear. Heights? Closed spaces? Losing my ability to get around?
All of those rank high on my list. But my number one fear is not being allowed to die when it’s my time. As a senior citizen, I know that more of my life is behind me than ahead of me. That’s the way of nature – the circle of life.
But when my time comes, I am concerned that medical science will try to prolong a life when the qualities that make it ‘life’ are gone.
Home was for Living – and for Dying
It wasn’t always this way. In times past, and not all that long ago, people who weren’t killed immediately in an accident or other circumstances were taken home to die.
The person might be placed on a bed in a corner of a room, near a window. They might be propped up with pillows, a blanket to keep them warm. As their life faded, it was accompanied by the sounds of life continuing all around them.
Children played in the same room, or outside where the elder could watch through a window. Maybe she can sit up for a while, her eyes filled with the joy of life going on, even as hers faded. Perhaps the elder reflected on the times her own children played in a similar yard, and the joy those times brought to her.
Adults – the children of the elder – attended to the elder’s needs. It was their duty, accepted without question, just as they had seen the elder care for her dying mother or father.
Maybe there was an ever-present pot of soup on the stove, just in case the elder need nourishment at an unusual hour.
And the adults, who had been given life by the elder, spent time at his bedside, holding a frail hand – comforting a waining life.
Death wasn’t something to be feared, nor something to be pitied. It was, and is, life – just as birth, adolescence and middle age are.
Science Takes Over
But scientists made huge leaps in understanding the mechanics of life. And somewhere along the line in recent years, we as a people decided that we could rewrite those rules of nature.
“Life” was no longer defined as conscious awareness of one’s surroundings, one’s family. “Life” came to be defined as the mere presence of a life function – blood flow, breathing, nourishment – even if those functions were solely continuing as the result of machines.
Medical science had triumphed, vanquishing death itself – if only in the coarsest of terms.
As Dr. Louis M. Profeta, an emergency room physician, put it in a 2016 article: “Our end-of-life psyche has slowly devolved and shifted and a few generations have passed since the onset of the Industrial Revolution of medicine. Now we are trapped.
“We have accumulated so many options, drugs, stents, tubes, FDA-approved snake oils and procedures that there is no way we can throw a blanket over all our elderly and come to a consensus as to what constitutes inappropriate and excessive care. We cannot separate out those things meant to simply prolong life from those meant to prolong quality life.”
Today in the United States, more than 50% of the elderly live their last days and hours in a hospital or nursing home.
The Sterility of Dying
And what of the elder – what does this do for them? Instead of the familiar surroundings of home – theirs or a child’s that they have visited many times in the past – they are surrounded by sterile white walls. White walls devoid of photos of familiar objects and places – devoid of the sights and sounds and smells that have always defined ‘life’.
Tubes and monitor cables snake out from frail arms and hands. Instead of drifting off to sleep to the magical sounds of children, they are serenaded by the incessant beep of a heart monitor.
Instead of taking in the smells of their adult child cooking dinner in an adjacent room, their noses are invaded by the smell of antiseptics and latex.
Contact with family is limited to short ‘visiting hours.’ Time with the elder must be planned – get everyone together, drive to the hospital, keep an eye on the clock to get back to the daily routine.
People crowd around a small room, making small talk that passes for ‘quality time’ with the elder. There will be no children running by, brushing the elder’s hand as they streak past. ‘Experts’ feel that children shouldn’t be ‘exposed’ to death – beyond, of course, their daily dose of mayhem in video games.
It’s hard to think back on all the good memories of a life well lived when he lies alone – ‘protected’ by shiny chrome bedrails until the next scheduled check by the nurse. The final hours and minutes drag by in loneliness, punctuating an inner plea for the end to come soon.
And when life drains away, it is as likely as not that the only people in attendance will be medical staff. The elder’s last vision may be a glaring florescent light above his bed rather than the fading scenes of home.
No, this is not the kind of end that I want. I often make a gesture to my wife – a flick of my finger indicating “turn off the switch.” My wish is memorialized in a living will. But even then, I know it is possible that my wish may be overridden by medical personnel whose idea of ‘life’ differs markedly from mine, and the power to substitute their views of life for mine.
I certainly appreciate the advances in medicine and medical treatment. While I’ve been fortunate not to have needed much in the way of medical treatment over the years, my current life is better because of the advances that made needed treatment possible.
But I’m also cognizant that there will be a time in my future when “keeping the patient alive” won’t be the choice I want. And I make sure my family knows that.
When my time comes, I have one wish: “Family, I know you love me as I love you. Now let me die.”
One of the many things I think about as the years roll by. Thanks for writing it so it’s more tangible.
I really like how you compare and contrast how things used to be and how they are today. Although our standard of living has improved, the end of life can be very bleak now! My husband and I have a living will and have spoken to the executor to reinforce the idea that we trust her decision – she will know when it is time. (She’s a nurse, so that helps too…)