Passages

So this whole blog is nominally about passages, and today I read a David Brooks piece that got me to thinking about the final passage. Brooks was writing about someone who faced a deteriorating life with ALS (Lou Gehrig's Syndrome) and concluded that life wasn't about simply living as long as you can, but about what constituted life--what made life worth living as it were. Brooks was exploring this to pose some questions about how health care costs have balooned largely in the endeavor to eke a few more weeks or months out of an existence that is hard to characterize as living, with no "cures" for cancer, stroke, heart disease, or alzheimers in sight.

I live in one of two states with an assisted suicide law, and my wife and I have had conversations about this. I'm pretty clear that I wouldn't mind simply passing on when the quality of my life deteriorates to the point that it is not worth it to me to continue. The law isn't set up that way. You have to be definitively diagnosed as dying within a few months and have that confirmed with a second opinion. It is not about quality of life.

We have also done all the right stuff about medical powers of attorney and DNR directives and the like. I have elected for no extraordinary means, no hydration, and no feeding. Of course one hears the horror stories about hospital staff that fail to read or honor instructions in the moment of crisis and heroically violate the patient's wishes. Too bad it isn't respectable to just off yourself when you think you are done.

Stop. You can have your reaction, but don't make assumptions about what I know or don't know about this. There aren't many people outside of my familiy members whose deaths I have known about at the time or close to the time they died. Maybe a dozen or so. Of those, four were suicides, suicides in the prime of life associated with some kind of deep malaise or depression. There were three men and one woman. Two of the men were gay men: one who could not reconcile his orientation with his own vision of himself, the other in the throes of a depression about the loss of relationship. The other man and the woman were apparently despondent about their loss of identity because of the loss of jobs with long-term employers as well as suffering longer term depression.

I was particularly close to the man and quite angry about his decision, because it came at a time when he was making a transition that I had made only a couple of years earlier leaving the same company and moving to an entirely different part of the country and then starting over. He had stayed in his lovely colonial home with a new bright and charming wife.

So I don't think about this casually. One could argue I have more experience than most to draw on. My father's adult life was effectively a slow and very destructive suicide by means of alcohol, not to mention the fact that there were two suicide "attempts" while I lived with him in my late teens, and another that resulted in severe nerve damage about a year later.

I've survived depression. I've survived more transitions than many people have--big ones that make my current passage seem like small potatoes. But when the time comes for that last passage I sure would like to make the choice to just go without any hospital heroics. And if I am threatened with being in a condition where I could not make that decision, I hope I am able to make it early.

Meanwhile there are things to do and enjoy.