Preamble (modified below at my brother’s request):`
First of all, don’t panic–I’m just kidding. Well, maybe not entirely. But I’m certainly not suicidal at the moment. But I said that earlier, didn’t I?
Still, I am running out of time; and that is important to me.
So I shan’t stop speaking my mind just because others might misinterpret me.
This has been a tough year for me. In July, as mentioned before, my best friend died with me at his bedside. Earlier this month I went to visit my second best friend from college, Bob Stringall, who wasn’t expected to survive his most recent bout with pneumonia.
Like so many of us who are growiing old, his is a sad story. He had been in surprisingly good health for an almost life-long chain smoker and, especially toward the end of his cognizant years, a heavy drinker.
But his life changed in an afternoon or two. Perhaps in an instant. We’re not sure. He wasn’t found immediately, so we don’t know how long he lay on the floor in the hallway of the large house he’d built as a young man and where he’d lived alone for years.
I’m not sure what got him, except that it was not the standard stroke that so many older people suffer. In addition, my recollection of what transpired afterward is cloudy.
He was in intensive care for a number of weeks, where his life was saved via use of “heroic measures.” Following that, he went straight into a nursing facility, where he remains today.
Although he’s had his ups and downs, he’s never been the same. And, while he was an “at risk of escape” patient for many months, he eventually seemed to settle in. In the last few years, though, he’s essentially lost the ability to communicate. At first he was someone who you could make out a little. But now you can rarely hear, let alone understand, him at all.
But you don’t need the details. I’m sure almost all of you have your own story. Many of you, most likely.
The reason I mention it is that the juxtaposition of Bob and Pann prompted me to think about how people tend to die. At least, the people I’ve known who died.
I don’t think my experience is unusual. At sixty-seven, I can easily recall the deaths of some ten to twelve people close enough to me that I can speak about the circumstances with some authority.
There are quite a few more that I’ve heard fleeting news of, mainly because of the unexpected, and usually sudden, nature of their passing. But I can easily come up with a comparable number I know of who have gone out in ways similar to what I’m about to claim, so I won’t count them. The blaze of a fiery crash always gets much more press than the quiet death of someone who’s been semi-comatose for months or years.
Most people in America, as I’ve known it, go through a prolonged period before they actually expire, in which they are no longer living a “life of the living,” as it were. By a ratio of about seven or eight out of ten, most of the deaths I’ve been close enough to to monitor have been of this nature.
What is equally noteworthy, and probably more telling, is that virtually all of them moved from totally alive and vibrant, to “dealing with nothing but their own impending death” in an instant, with no forewarning worth mentioning, at all. I think it definitely much more the rule than the exception.
Of course, this observation is murky at its core. For I can only guess at whether someone’s imagined torture through the loss of bodily function is truly something that would lead the sufferer to prefer death to the life he/she has.
Maybe life is even more precious to the almost dead. Maybe all that “important” stuff fades out of focus when breathing, or talking, or holding out until you get to the toilet, is no longer automatic.
Maybe none of it is so important when getting that next breath, or whatever, isn’t easy at all.
Even who should be counted as an example is often unclear. Some, like Bob, I counted even though they are still alive, in the sense they have not expired. But his demise is only a matter of time, and how his end game is going to be played out is quite obvious, so why not list him?
Luckily, alzheimer’s doesn’t run in my family, but I’ll bet anyone in whose it does will relate. And, besides, the death of even the healthiest of us is only a matter of time. Like life itself, we clearly know nothing of death and dying until we’re doing them.
But the sudden nature of the transition from the living to the almost dead demands our attention. Doubly so when we’re thinking about whether we’re accomplishing what is important to us in this life or not. Like it or not, once that barrier has been crossed, it’s behind you and so is any additional work on whatever it is you think “important.”
Pann chose to go into hospice prior to his last bout with the cancer. Bob, not having any particular concerns, had done nothing, so far as I know, about advanced directives. He never got the chance, because there was plenty of reason to doubt his competence to make such a decision after his attack. In view of how much we all hate to contemplate our own last days, I’d suspect Bob entered his end game in the more common manner. Most of us probably get caught with our directives down. Even after the evidence of these two clear cases, I’ve yet to fill out mine.
Pann’s position was clearly the better, as was his choice to accept death rather than to fight a prolonged battle past the point where medicine had any real livable solutions for him. His death was a model of “death with dignity.”
He was as clearly cognizant up until the moment of death as if he weren’t sick, except for when the morphine he had at his disposal took him away from both pain and our company.
By contrast, Bob has been almost nothing but “away from us” for at least a year. I have no idea what was important to Bob since his attack. But I’m quite certain it either isn’t the same that was important to him before the attack, or he is no longer able to work on it. To me, from the perspective of someone who is still willing and able to work on what I perceive of as “important,” that constitutes a very undignified way to die.
So. Can this be an avoidable tragedy? And how long can I continue to obsess on this line of thinking and maintain/obtain readers?
Maybe Daddy was right. I do have a tendency to wallow in it, don’t I?
Next time let’s talk about the positives!
Footnote: Bob passed this afternoon, December 27, 2011.