What to do while you are dying

It’s a little more complicated than that title suggests. Not a great deal, but a little. [1]

It will simplify things a great deal to make the distinction between “it,” the body that serves us well or ill by turns, and “I,” meaning the sense of myself I have. This is a crude distinction, of course, but I am relying on your own knowledge of your life in which on some days “you” are just fine, while “it” is acting up; then there are other days when “it” is entirely free of any symptoms at all and “you” are miserable.

I live in a Continuing Care Retirement Center (CCRC) and when I moved here a year and a half ago, I told friends I trusted that I was coming here to die. It was only the phrasing, not the idea, that was open to misunderstanding. That phrasing could be understood “coming here for the purpose of dying” as if it were a hospice. The friends to whom I trusted that phrasing knew I didn’t mean that. What I meant is that I wouldn’t have to move—or be moved—to any other place when either “it” or “I” neared the end. [2] It was a very comforting thought to me and still is.

Death as a commonplace

So…where I live, a lot of people die. That means that I get to see all the paraphernalia that goes with all those deaths. A lot of ambulances pull up to this address. There are lots of notices on the front desk that someone died yesterday. There are lots of memorial services, some of them here in the Penthouse. [3] The families of the recently deceased residents show up, the grandchildren and great-grandchildren having no clear idea what is going on.

death 1The same thing happens on the social side. A resident I have gotten to know in my brief time here shows up in the little coffee nook where world problems are hashed out every afternoon [4] and today, he has a cane. Tomorrow—or some tomorrow or other—it is a walker. Then a wheelchair; then a wheelchair with oxygen. Then he doesn’t come all the time; then he doesn’t come at all. These are perfectly ordinary signs that “it” is failing.

And that brings us to the meaning of “you” in the title. Nothing I have said bears at all on the “you” of that resident and friend who kept coming to Drasko’s Seminar. He may very well continue to be as cantankerous or irenic or liberal or conservative or as disciplined or dilatory as ever. It’s harder to be cantankerous when you’re on oxygen, but aside from that, everything is the same.

This person is the best answer I know to the question of what to do while you are dying. Living. That is the best thing to do while you are dying. You keep going to the places you can go; you keep hanging out with the people you used to hang out with. You keep on pointing out to them that they missed the whole point of movie by failing to appreciate the fundamental contradiction in the character of the eldest son. You keep hoping the Steelers can figure out a way to beat Jacksonville.

It should be pretty easy to nod your head affirmatively as you read through that paragraph. Maybe not the part about the Steelers. But because of where I live, I see it every day. There is nothing subjunctive about it for me, as if I were trying to imagine what it would feel like to be running with the bulls in Pamplona. It is subjective for me; it is experiential. I get to see these amazing people living fully—to the full extent of their capacity—even as “it” declines. It is a powerful experience for anyone with the eyes to see it and I count myself as one of the fortunate ones in that I have learned to see it for myself.

I had no idea when I moved here that you could continue to express all of who you are, subject only to the limitations of what “it” will allow. It sets a standard I can aspire to.

death 3The other side of that dichotomy is harder. The other side is when “you” begin to suffer losses so that you are “no longer yourself.” That’s the way they say it, but, of course, you are “yourself;” you are precisely the self you now are. You are not the self you used to be, of course, which is what everyone who uses that phrase is understood to mean. [5]

I have declined a good deal, myself, in what I would call “peripheral” functions. I don’t remember names and faces as well as I once did; I forget authors I have cited effortlessly for decades, and so on. These are “peripheral” not only because they allow more important functions to continue unimpeded, but also because quite a few of the people I live with are experiencing the same decrements of functioning. These deficits are something we share and that makes it easier to treat them as a standing joke at no one’s expense.

There are more fundamental losses, however. I don’t know what those are like. You can’t tell by looking and you can’t find out by asking. I am hoping that I could feel that I was doing my best under difficult circumstances, but I don’t know if dementia really allows you to feel that way. When the “you,” not the “it” declines, your standards for understanding what is going on decline as well.

Maybe it’s like this. When my father was well into his Alzheimer’s phase, he was visited by my brother Mark, a physician, and his wife, Carol. When they came into the room, Carol went over to him and kissed him on the cheek and said, “Hi, Dad.” Mark and Dad made conversation of some sort. I am sure it was generous and situationally appropriate because that is the way Mark would do it. When the visit was over, Mother asked Dad if he knew who that was who had visited. The question presumed the answer, “My son, Mark.”  The answer was, “His wife kissed me.”

I think the gift Mark gave was every bit as good as the gift Carol gave. For many years, Dad had been appreciative of the gifts Mark had to give, in part because they were so much like Dad’s gifts. But he wasn’t able to appreciate that kind of gift any more; he was still able to “understand” the kiss of an attractive and warm-hearted woman. Maybe that’s what it’s like.

Death as a brief interruption in the community’s life

The other thing I have noticed here, being a participant in a community that sees so many deaths, is how brief the period of public reflection is. I take great comfort in that.

There is always grieving when there is death, but grieving isn’t always the most death 4prominent response. When a person has lived a long and successful life, it is perfectly appropriate to celebrate that life as a whole and at the same time to mourn the loss the the person.

Then there is the question of the setting in which those emotions are noted. I, myself, have lost a wife I adored and I now believe that you never really get done grieving. It just comes and goes and you call it for what it is when it comes and you say a gentle goodbye when it goes. That personal level is one where grief doesn’t “go away;” it just comes and goes.

But there are smaller communities of friends—people you always went to the movies with or played bridge with or served on committees with—some of which should really have come with combat pay. The occasional return of the conversation to the member of our group who is no longer with us may continue for quite a while. But if the other members of the group keep on living—actively investing themselves in their lives—the death of that one member begins to recede. Other complicated events take up part of the space it once took. Also, the group that was once the “community that knew him” is itself reduced in number over time.

The public grieving is remarkably short. There is an equanimity that characterizes community life here. The death of one of us causes a ripple on the surface of the pond which we all notice. Some are able to comment more than others, but I have never seen the topic linger at this level—at the most general level—for more than a day or so.

We appear, as a community, to have made our peace with the loss of a friend. The death is most often not a surprise. It is on some occasions a relief for everyone—the person, his family, and all of us who knew them. If the effect of the death of a member were given in points of a Richter scale, I would say most deaths here are well below 3.0. That is what I hope for my own death. I would want to say, after the formal notice has been paid, “Go on with what you were doing;” meaning, “I know you were all busy living and I know that is what you should be doing. Please continue.”

There are people who have known me well and loved me dearly. I think I would hope for them the kind of grieving I have had for Marilyn. It comes and brings with it most often some really sweet memory, and then it goes and you smile with the memory. And then you go on living.

[1] Throughout, I will be distinguishing between things that are complicated, i.e. hard to understand, and things that are grievous. I am going to be thinking in this essay about how to understand things, not about what it might cost to endure them..
[2] “Nearing the end” gets more complicated when some parts of you are mechanical. I could hardly stop laughing when they told me last year that the battery in my pacemaker was guaranteed for ten years. It was hard to avoid the sense that I had just been given a warranty.
[3] I would like mine to be at our church because I understand my own life in fundamentally Christian terms, but if the setting were all that mattered to me, the Penthouse is a lovely place for a memorial service.
[4] For the sake of convenience, I will all it Drasko’s Seminar. That is what everyone else calls it, in honor of Drasko Jovanovic who, just by his presence, convenes the daily mix of attendees, of whom I am sometimes one.
[5] Just when “once” was is a little more complicated. It might mean “what I was like at the height of my powers.” More often, it seems to mean, “what I have been like in recent years.” But you still see once-beautiful women yearning for the effect on men they used to have and the same thing goes for once-authoritative men. That seems unnecessary and sad to me.

About hessd

Here is all you need to know to follow this blog. I am an old man and I love to think about why we say the things we do. I've taught at the elementary, secondary, collegiate, and doctoral levels. I don't think one is easier than another. They are hard in different ways. I have taught political science for a long time and have practiced politics in and around the Oregon Legislature. I don't think one is easier than another. They are hard in different ways. My wife, Bette, is the First Reader (FR) of the posts. I have arranged that partly because she helps me write better posts than I would otherwise and partly because I can hold her responsible for the mistakes that I would, otherwise, have to own up to myself.. You'll be seeing a lot about my favorite topics here. There will be religious reflections (I'm a Christian) and political reflections (I'm a Democrat) and a good deal of whimsey. I'm a dilettante.
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7 Responses to What to do while you are dying

  1. Bonnie Klein says:

    You make me cry…and laugh.

  2. Melisa says:

    I like to think that you leave a little piece of yourself with everyone you meet. The size of the piece depends on how long you spent with the person and the type of interaction you had. I also would say that by leaving a piece of yourself I do not mean you become less as a result ; ) I know that I have pieces of you that I carry with me and they make me smile often, think of puns and also think more critically of certain topics (mostly political). I know for my children the piece of you they carry with them is learning about American Football and Tennis. Maybe ‘piece’ is synonymous with ‘memory’, it is always there it just gets brighter or fainter depending on the day. Thanks!

    • hessd says:

      I agree entirely, Melisa. I think your language of “piece” is much richer than “memory” and I am glad you used it. If I have made you more likely to hear puns and smile, I will add that to my list of wonderful memories.

  3. thinkydoug says:

    I don’t suppose it should surprise anyone that this was difficult for me to read. I know you’re going to die; we’re all going to die. But I’ve been pretty fortunate to not have lost anyone I “wasn’t supposed” to lose.–i.e., my grandparents. I have my parents and even all my aunts and uncles, and haven’t lost any close friends.

    The thing you’ve given me over the past decade or so is a blueprint for how to view and handle decline and demise. You have a detached interest about it all that I’m positive I won’t be able to replicate but it’s something to aspire to. If it’s true that you have to see it to be it, I can at least say I’ve seen it. Thank you for that.

    • hessd says:

      Bless you, my son. I do feel detached from anxiety about it. But maybe just confident that I am in the place where I should be; in the right space, in the right relationships. If you do it right, it will look very different from the way I am trying to do it. It will look wonderful and VERY Doug.

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