Death is quotidian, isn’t it?

There is a movement to make death more ideal. I agree that we should talk more about death and find out what people want, but ideal is complex. The VA did a survey and found three ideal deaths. Which is your ideal?

1. The Hallmark Death. In hospice, surrounded by family and friends, making peace with everyone, visitors from all over. My mother died of ovarian cancer. We had a hospital bed and a baby monitor and when she was awake, she would say, “I am ready to be entertained.” It lasted for 6 weeks and my grandmothers bones rose out of her face as her weight dropped. I was so tired by the end that I couldn’t see straight. She did not want us to cry, so my sister and I did not cry. Afterwards I wished that I had cried.
2. No warning, sudden death. Take me, in my sleep, or suddenly, with little or no warning. The heart is the number one cause of death. My father went this way, in his home. I was the one who found him, though I’d expected it for over a year. He was a bit of a hermit and had horrible emphysema, was on oxygen and steroids, but he stayed at home. That’s what he wanted and I did not fight it. It was not much fun finding him.
3. Fight every step. There are some people who remain full code, who have end stage cancer and want dialysis, who will not give in. My sister was in this category. She was a truly amazing fighter and refused hospice until the last week. This can be about believing that one can continue to hope for a miracle or it can be about social justice or about a promise to one’s family. Some families have said, if father had been able to access care earlier, he wouldn’t be dying, so he wants everything done. I can understand all of those feelings.

So which would be your ideal? Ideally we would talk to our parents and our children and explore these different ideals. I did that with people in clinic. There are interesting openings. A patient would say, “I don’t want to die of cancer.” I would say, “How do you want to die? What is your ideal?” They would be surprised and I would explain the three different scenarios above. “Put in your order, though we do not have any control.” I would say.

We do not have control. I did prenatal care and deliveries for 19 years and didn’t have control there. I always preferred to intervene as little as possible and only if I had to for mother or baby’s health. Once our surgeon went to take out an appendix and it turned out to be something else, so took three hours. I had called a cesarean section, but had to wait. The baby had a fast heart rate and it rose in those three hours. We finally did the c-section and the baby promptly looked completely fine. I have no idea why the heart rate rose from 140 to 180. We were all hugely relieved. Sometimes the cause was obvious: a short umbilical cord or a cord wrapped four times around the neck, but sometimes the cause is a complete mystery.

I talked to a person yesterday who has a frail 90 year old in their life. They said something about keeping them from dying. I said, “Well, they are going to die eventually.” Then I thought, I wonder if they have had the discussion: what is your ideal? Do everything, which may mean being in a hospital? Hospice? At home? And I sometimes see families fight, because siblings have different ideals and may not even be aware of it.

Blessings.

For the Ragtag Daily Prompt: quotidian.

I took the photograph of the neighbor’s flowers while I was walking the cats in the dark. I like it.