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.
I still think of Dad frequently although he died three years ago at age 90. The hospice group which cared for him at the end offered grief counseling. I turned them down. I had been grieving for Dad for two years. When his ordeal ended, peace and relief filled my being.
Dad deserved to pass peacefully in his sleep before the ravages of age destroyed his independence. Dad was the kind of person who would stop and hand a $100 bill to a distraught woman weeping as firemen struggled to extinguish the blaze destroying her home.
He cared for my young, dying mother until cancer consumed her life, then cared for my younger brothers and me while running the family business. He remarried to give us a mother and submitted to a miserable relationship for years—unwilling to hurt my half sister by leaving.
If the point of suffering is to teach and refine the human spirit, Dad earned a Ph.D. in life experience. The only thing he ever asked for himself was not to become a burden to his children. Yet God did not see fit to take my dad before a series of strokes and blocked carotid arteries eroded his reasoning capacity to match his weakened body.
For two years before his death, I grieved for the father I’d lost: The father who followed the news and scoffed at the misbehavior of elected officials—George’s Bush’s deficit spending—Bill Clinton’s unzipped trousers. The father who could haul limbs from a tree without straining his back and hiding his pain until he couldn’t walk to the bathroom. The father who didn’t nap all day and wake at midnight wondering why it was still dark.
As I cared for Dad, I grieved for myself. That I could not make him better. That I found his care a burden. That I too am mortal. That I must either die while life is still a joy or decline into helplessness.
Did I receive benefits from caring for Dad? Of course. I am grateful for his courage and for his gentle, loving disposition which lasted nearly to the end. I’m grateful I learned how difficult taking an elderly parent into your home is. I will never do that to any of my children. But I wish Dad hadn’t paid the price for my learning. He didn’t owe me anything. He deserved a merciful death.