As I mentioned in a post last week, I've been through a lot of pain over the past few weeks. It's much better now but was the worst I had felt during this cancer odyssey since recovery from the Whipple surgery in the summer and fall of 2017.
When I hurt or am sick, my mind wanders to the dark sides of life - in this case, frequent thoughts about when, with a terminal illness, it is time to go. Is it now?
My palliative care physician tells me his patients invariably know when that time arrives - time to stop treatments and for some, to invoke Oregon's Death with Dignity law.But even with that, my mind was also its usual busy self: things to know, books to read, people to talk with, blog posts to write. Etc.
Stepping back from myself, I could see – if I make it my choice - it was not yet time to die.
When you are healthy and particularly if you are also young, you think you know what you're talking about when in reality, you will come to see one day that you were fooling yourself.
Well, maybe not you, but certainly me. All those big life questions I thought I had so diligently explored over years and, as much as possible, answered? Piffle.
Even with plenty of evidence to the contrary (all but one in my family died of cancer), somehow I believed that I would be healthy and hale until, at an advanced age, I would die quietly in my sleep.
As it turns out, according to a quick trip around the internet, the number of people who do so is hard to calculate and often – especially with elders - the result of underlying disease which may or may not make death while sleeping a “quiet” experience.
Further, until I sat down to make some notes for this post, I had not realized that for many years – decades, to be truthful - I also believed in a contradiction: I had come to see death as life's last great adventure and I wanted to experience it while awake, not in great pain and lucid.
I still do. So what is it? Die in my sleep or die wide awake? You can't have both.
When I moved to Oregon nearly a decade ago, I was pleased to know that along with seven other states and the District of Columbia, physician-assisted dying is allowed by law.
Among other requirements are that the patient be mentally competent, be diagnosed with a disease that will lead to death within six months as confirmed by two physicians, and be capable of administering or ingesting the life-ending drug without assistance.
The drug, I am told by a physician, puts the patient into a coma within a few minutes and death results shortly thereafter.
How is it I didn't realize before that I cannot be awake and lucid enough to experience the main event and also be in a coma? Not that I know what goes on in anyone's mind while in a coma but I doubt I would be aware in the way I want to be during the last moments of my life.
What a dilemma – because I don't want to die in an anonymous bed somewhere in a “facility”, but at home amongst my stuff and one or two or three loved ones. If you let a disease run its course, there is no way to guarantee that.
Which is where I'm stuck.
And here is another thing I hadn't considered: The drugs, acquired via doctor's prescription, cost between $3,000 and $4,000 – and I doubt Medicare Part D pays for them. That pretty well guarantees physician-assisted death is a privilege reserved for the middle and upper classes.
Do the inequities in American life actually follow some people to the grave?
An old Yiddish saying tells us, “Man plans and god laughs.” No kidding.