Letting Grandma Die

Letting Grandma Die
Editorial from The Fringe

Because the Prospect’s stance on marriage equality and medical ganja haven’t rattled our conservative readers enough, today’s rant is on letting grandma die.

In one sense, this is a discussion about health care funding, but in a larger sense, it’s about our society’s fetish for life and the lack of humanity that can result from it.

An important preface is that the Fringe Editor knows his oldies. My first course of study was social gerontology, the study of the social construction of oldness and the life experience of the old. I’ve worked variously in long term care homes as everything from a maintenance worker to a LTC home family council advocate. I’ve also watched the elders of my family pass over. I’m well familiar with the process of dying slowly, day by day, like a screw unwinding the last few twists before falling away from the wall of the living.

And, I’m here to say, we treat our dogs better. When our pets, many of whom have spent their lives with us, become so ill there is no recovery, we reconcile ourselves, comfort them, and then let them slip from their misery.

For our old, though, we are unable to do that. We house them eventually in austere rooms, and dab at their escaping fluids, and cycle medications through their struggling livers, and do everything our sorcerers of science can to keep the lungs wheezing for the millionth time, and the heart lubbing past its proper rest.

Why do we do this? Unless it is for those condemned in human courts, as a society we have a childish fear of dying.

Not that death isn’t always a big thing for human groups. There is strong evidence that Neanderthals buried their dead with rituals, flowers, and even ochre. Modern humans nearly always have rituals to observe death. Some eat their dead in a ritual of absorbing them into their bodies, to keep them from truly dying. Some dry their relatives and keep them in an alcove in the wall, and when they have to move, they lug the relatives along. Humans have filled caves with the bodies and bones of the dead. In some cultures, mostly but not completely vanished, the wife is expected to throw herself on the funeral pyre of her husband, or snuggle into the crypt with him. There is almost no end to the rituals and mythologies humans have about death. As Pink Floyd pointed out, life is a short warm moment, death is a long, cold rest.

But, that’s death. The avoidance of dying is something we have raised to a social neurosis. You can’t turn a page or watch the news without learning how your favorite food is going to kill you; in a delightful example of real life imitating itself, television viewers were treated to the results of a study which said watching television is going to kill you. People munch down statins, beta-blockers, supplements, all the manna of science, all intended to scare away death. Even when the ride is clearly over, we stream the meds, draw the blood, and hiss the oxygen. As the old saying goes, everybody wants to go to heaven, but nobody wants to die.

Contrast that to other cultures where grandma, when she’s to the point that someone else has to chew her food, or when the endless dark of winter is coming for the sixty-ninth time, will walk out to meet the wolf or the polar bear. Some cultures have a death watch, where the elderly or sick announce they are done with this world, and they lay down, taking only water, and family members sit with them and wait for death, which is usually not more than a few days.

To be clear, it is our view that if you have your wits together enough to call the family to watch you gasp your last, it might be premature. Further, if one calls it in too soon, and the family watch goes into weeks, one might be pressured to get on with it. It’s got to be embarrassing to call the cousins together for your death only to find it was just gas.

No, here, we’re talking about people for whom the majority of what makes us human has passed. People who sit, strapped to day chairs, remembering nothing, and experiencing nothing of the life they once loved. We’ll keep an old dog pal well past the time he can hunt, but not past the time he remembers hunting.

Part of our fetish of life stems from the bureaucrats and technocrats entrusted with keeping us alive. As always, when we are in such positions, we seek to expand our "service". Very old or sick people make good patients; they are compliant for the most part, they don’t generally demand much, and their care is regular and easily billed. There is more than just greed at work, though. Whether doctors or other medical staff, or health educators, or researchers, a good bureaucrat always seeks expanded opportunities for funding, broadened purview, increased client saturation and penetration. Besides, they’re saving lives! Why shouldn’t they go at their work with gusto.

This has brought us to our "for your own good" society where tobacco smokers can be publicly ridiculed, and governments pass laws on fat and salt. Information is one thing, but a lot of information isn’t even information, it’s just repaving the same ground; eggs will kill you; no, they won’t. Oats will save you; no, they won’t. There is a movement now to start giving statins to children and people who show no signs of high cholesterol (for example here). Even though they constantly contradict themselves, their thrust is generally the same: you can do more to avoid dying. (We note that the advice that has never been proven wrong is to eat plenty of veggies, and get plenty of exercise.)

The cumulative effect of this death avoidance is that we have lost the beauty and rightness of death in our culture. Certainly, we study death, indeed, our neurosis about it is played out every night on television, where people die for entertainment on cop shows, and as a morality play on TV news, and in countless movies where healthy young people die in countless ways*. But that still plays into our fear of dying, our childish, unhealthy fascination, which by adulthood should be resolved.

Yes, dying certainly can suck. It can be associated with pain and fear. Dying is terrible for loved ones to watch or imagine. There is no way to take the trauma from some deaths. The aftermath of death is typically years of mourning for those closest. No wonder we want to avoid it, no wonder we turn our scientist sorcerers to prevent it, we are Americans, we shouldn’t have to die, and many of us are Baby Boomers, we will be young forever, we can’t die. Yet, we will.

With Boomers moving, kicking and screaming, toward 75 and the end of our expected life span, perhaps we’ll see a new approach. Perhaps we’ll see more movies and television programs directed towards a more rational and pragmatic approach to death. Maybe the children of Woodstock will make possible a new approach; maybe the generation that stopped a war will come to meet death face to face; maybe a cocktail of mescaline and hemlock will be come popular. Probably not, though.

More likely it will be the young who bring a change, far more likely it will be those who need medical care and who are tired of seeing health resources being poured into those who can not, will not, ever get better. Pulling the plug will be considered humane as much for those who are finally released as for those who might finally get treatment.

It isn’t pleasant, but, really, neither was high school, and we got through that. Let’s make a cultural commitment to understanding and valuing dying as a part of life.

*For a truly meaningful movie about dying, there is no substitute for Emma Thompson’s "Wit", which I can’t recommend enough. Emma Thompson

The memories of a man in his old age
Are the deeds of a man in his prime
You suffle in gloom in the sickroom
And talk to yourself 'till you die

Life is a short, warm moment
And death is a long cold rest
You get your chance to try
In the twinkling of an eye
Eighty years, with luck, or even less

So all aboard for the American tour
And maybe you'll make it to the top
And mind how you go
I can tell you, 'cause I know
You may find it hard to get off

You are the angel of death
And I am the dead man's son
And he died like a mole in a fox hole
And everyone is still in the run
And who is the master of fox hounds?
And who says the hunt has begun?
And who calls the tune in the courtroom?
And who beats the funeral drum?

The memories of a man in his old age
Are the deeds of a man in his prime
You suffle in gloom in the sickroom
And talk to yourself 'till you die