Barbara Tuchman, one of my favorite historians, died from cancer in her early 70s. When doctors could give her no hope for a cure, Tuchman refused further treatment saying, “A lady knows when to leave the party.”
No one wants to die, not even people who maintain strong religious beliefs in a hereafter much better than this world. But watching terminal people cling to life, enduring painful surgeries and treatments that only prolong suffering, makes me wonder if I will have the courage to say, “Enough,” when I reach that condition.
My 86-year-old aunt recently suffered a stroke which left her blind. A CT scan revealed a congenital hole in her heart that prevents her blood from being fully oxygenated. Doctors gave the family three choices: surgery to repair the hole, blood thinners to prevent clotting, or—nothing. I believe they chose wisely to do nothing. Putting her through heart surgery to prolong a life of helplessness and increasing confusion could hardly be considered humane.
My Aunt Dolly is 94 and lives in a care center, confined to a wheelchair or bed, with oxygen tubes for breath. Macular degeneration prevents her from reading or watching TV. Aunt Dolly wishes she could pass peacefully in her sleep. Unfortunately, she is cursed with a strong heart.
Aunt Resolve left the party in her 70s. After years of taking steroid prescriptions to control her asthma, her bones were brittle as glass. A fall from her wheelchair broke her hip. When Aunt Resolve was hospitalized, she refused to eat or drink. The family respected her wishes, and she did not have to suffer months, possibly years, as an invalid—enduring one painful break after another.
Woody Allen wrote a very short play, “Death Knocks” about a 57-year-old man negotiating with Death for more time. Allen’s protagonist outwits Death in a card game and prolongs his life. Like the card game in Allen’s story, modern medicine provides tools to postpone our appointment with death. The trick is to know when it’s not to anyone’s advantage to stay in the game.