A New Difficulty for Mankind: How to Die

This holiday weekend is a time when many people gather with those they love and trust the most.  It is traditionally a time of fun, laughter, warm feelings, and full tummies.

It can also be a rare opportunity to speak in-person with the most beloved people in your life about an incredibly important topic, and that is end-of-life health care decisions.  I know, I know, that is not what anyone wants to do.  Personally, I am not convinced this weekend is the ideal time, given all of the other emotions and events that tend to swirl in the mix of family Thanksgiving traditions.

But it is a good time to think, I am certain about that.  Look around the table, the living room, the front porch.  Do you know what your parents want at the end of their lives?  Does your partner know what you want if the worst should come unexpectedly?  It is crucial now that we deal with a monumental change that grips modern life.  I found the following line from an excellent article in The New Yorker  by Atul Gawande to present the issue in a nutshell:

(My patient) was unmarried and without children. So I sat with her sisters in the I.C.U. family room to talk about whether we should proceed with the amputation and the tracheotomy. “Is she dying?” one of the sisters asked me. I didn’t know how to answer the question. I wasn’t even sure what the word “dying” meant anymore. In the past few decades, medical science has rendered obsolete centuries of experience, tradition, and language about our mortality, and created a new difficulty for mankind: how to die.

Until fairly recently, dying was a rapid event.  It was rare to know one was facing terminal illness much before the end.  Today’s health care environment brings many opportunities and much hope in many cases, but it has a side as dark and disturbing as anything I’ve ever read in the bleakest novels.

Dr. Gawande’s article is difficult to read, especially for those of us who have seen people we love battle on through Gulag-like regimens of “care.”  The good news is that I see more friends who are ill choosing to die at home, with the human touch of the most important people in their lives.  They can do this because they made the decision to establish a living will, and to communicate with their family and friends before anything happened.

I am participating today and through the rest of the weekend in the blogger rally created and supported by Engage With Grace – a movement aimed at making sure all of us understand , communicate, and have honored our end-of-life wishes.  I especially am grateful to my friend Bob Coffield for this opportunity.  His Health Care Law Blog is recognized nationally as one of the finest resources for current law and policy issues affecting health care.  (He’s also a Twitter maniac.  You can follow him @bobcoffield.)

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started.  In the spirit of Esse Diem‘s commitment to Read Think Speak Write, I hope you will take the opportunity to do each of those things around this critically important issue.

Real Friends: Manning Up to Curve Balls, Together

A very good friend of mine from college shared with me this (edited) email that her own father recently wrote to a group of his fraternity brothers.  My hands-down favorite has to be the “we all manned up” comment at the end.  The timelessness of the friendships moved me, and got me thinking about my own feelings about old friends.

Despite our ever more technologically connected world, I generally feel more disconnected from my friends.  I love Facebook for its capacity to keep me from not losing touch all together with far-flung relationships; and yet there is the danger of buying into the dynamic that people are products.  We set up our own profiles, we decide what photos go up, what stories are shared, what image or slice of our realities we want to present.  I only know what you want me to know, and vice versa.

I miss that greater sense of entirety about my friends’ lives.  When we all were in the same physical space more often, I knew that you said that dumb thing in front of an important person.  I knew your mom was mad at you, that your dog was really sick, that you wondered why I hadn’t called.  I knew you liked peanut butter in your milkshakes and had to take a nap every day or you became an unbearable pill to be around. 

We could talk about politics and sex and religion because we weren’t afraid the other one would walk if we said the “wrong thing.”  I knew you were a cheap date, that you were not sure you liked girls “that way,” and that you cried when you woke up from a bad dream.  I knew you were under too much pressure, that you had almost cheated on your taxes but didn’t at the last-minute.  I knew you were afraid, really afraid, that you had picked the wrong career, or the wrong life partner, or the wrong dress.  I knew you were an unrepentent dork about Star Trek, and that you were not even joking when you said, “Worf’s hair looks really good like that.”

Knowing these kinds of things is what makes for real friendship, and we can only know them from time spent together.

Here’s to real friends…………

Dear brothers, I certainly enjoyed seeing all of you this past weekend.  Sarah and Tim overdid the hospitality and I know everyone appreciated their generosity and hard work as much I did.

Many thoughts hit me on the rainy ride home.  I did not take notes, but I should have because the details were as interesting as the big picture was chronological — our “here’s what happened to me” stories.  Following are my general impressions of our collective “my life so far”stories:

  • Small decisions can have big long-term implications and impact.  Many of those “small decisions” start with a whim and develop into life changes.
  • Big decisions that turned out to be questionable can in fact be course-corrected for the better.
  • We are a funny bunch.   Our collective sense of humor has only gotten better over the years and  probably has served us well in life.
  • In spite of the very different paths we each have taken over the years we are a relatively homogenous group, sharing the same values, stories and friendship.
  • Fifty three years is a long time not to see someone you like to be with.
  • We have accomplished much, yet retain modest egos.
  • We received a damn good education at our school. The Liberal Arts degree (that some of us initially did not know how to turn into jobs) gave us a wonderful foundation for a wide variety of challenges.
  • It seems like we are all happy with the way things turned out and are content. Those of us who have retired seem to enjoy being irrelevant compared with the stress of running businesses, practices and careers.   Those of us still working have figured out both what we like to do and a way to get paid to do it.
  • We have all “manned up” and dealt with the curve balls life sends us all.

Image credit: The Complete Pitcher