Inspired by the Dying

“Our ultimate goal, after all, is not a good death but a good life to the very end.”
― Atul Gawande, Being Mortal: Medicine and What Matters in the End

I am inspired by people who seem relatively comfortable with their own mortality. On Monday I spent several hours with an old friend who recently received a fatal cancer diagnosis. She has from 4 to 6 months left on the planet. Somehow, being with her and her frankness about her diagnosis, decisions, and about what's coming next, put me at ease in a deep, deep way.

K. is choosing quality of life over quantity. I have long believed that this is the best way to look at late life issues.

“Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, . . . But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being."  Gawande

Filip Zrnzević on Unsplash

For K, as Gawande says, her life's end is about her own well-being within the "constraints" of her biology, and to have a good life until she reaches the time when pain and discomfort become overwhelming.

Therefore, she has rejected the idea of chasing down doctors at the Mayo Clinic or Memorial Sloan-Kettering who might have the magic cell-killers that could defeat her extremely rare form of cancer. She does not want to spend her remaining time wired up in a hospital bed, suffering from the ravages of "helpful" poisons that might give her an extra year. Instead, she wants to stay at home in comfort. It makes a difference that she is in her late 70s, a reasonable time to be facing the Reaper. Frankly, I think that meeting him at my own age (70) is also reasonable, and if I am ever faced with the decision, I will make the same decision.

 The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labour and sorrow; for it is soon cut off, and we fly away. (Psalm 90:10)

I am inspired not only by K.s choices, but by her firm management of her doctors. She is deeply committed to being in charge every step of the way. In that, she reminds me of Will, but only because he refused to see doctors -- and he was ferocious about living life his own way, up until the end.

“You may not control life's circumstances, but getting to be the author of your life means getting to control what you do with them.” Gawande

I wish K. had more enjoyable time left. I am and will be sad about her dying and death. I felt honored (and ignorant) when she asked me if I knew what it would take to reserve Wille Hall, on the COCC campus, for a memorial, if that was wanted. I told her I'd be very happy to serve in any way (I had a funeral celebrant business for a short time) but that Holly Pruett was who I would recommend (she did Will's eulogy).

When I was a "direct report" to K., back in my working days, I admired her ethics, fairness, and ability to deal with bull shitters on staff. Now I have even more reason for admiration.

I just wish she didn't live on the other side of the mountains because it was hard, with the late spring snows, to get up north to see her.