No Solace For Children

by Akim Reinhardt

Sunset.jptI sat on a friend's living room couch, waiting for her to emerge from her bedroom contraptions.

I had arrived at the time and date requested. However, my initial visit to her room had been cut short amid the beeps and whirring of machinery. After some brief exchanges, she began to raise herself and then asked me to summon her aide.

“Please get Dr. Reinhardt some tea while he waits for me.”

During the whole of the visit, that was the one time her eyes sparkled and she was fierce and energetic, full of bearing and dignity. That she was truly herself.

I went to the kitchen with the aide. She had already poured me some iced tea when I'd first arrived. I retrieved the glass and said, “I think she wants you to go back in and help her come out.” The aide smiled and returned to the bedroom laboratory. I found a seat on the living room couch and took small sips while she helped my friend get herself together.

It took a few minutes. Terminal lung cancer patients move slowly. When she finally came out, it was with the help of the aide and a multi-pronged cane. Trailing behind her was a machine that facilitated breathing; she was tethered to it by a clear plastic tube attached to her nose with fasteners looped around her ears. She sat down gingerly and was engulfed by a wing back chair.

As we talked, we knew it would be the last time. Adults don't have to explain these things to each other. She gave me a colorful pouch with a drawstring. It contained a small gift of remembrance for a mutual friend who was out of town: polished stone jewelry from Afghanistan. The pouch itself, made in Oman, was for me. I asked if there was anything I could do for her.

“Take me to Oregon,” she responded.

I was puzzled. So far as I knew, she didn't have any family or friends in the Pacific Northwest. Indeed, I doubted that she'd ever even been there. She was originally from Ohio, started her family and got her doctorate there. She had lived in Maryland for decades, and had conducted her research in sub-Saharan Africa. I looked at her quizzically. “Oregon?”

“They have that law there.”

It took a moment, then I understood. Physician assisted suicide. She nodded, wheezing and in pain.

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Why don’t more people kill themselves?

by Emrys Westacott

Imagine you are given the following choice:Hosptial-mexico-patients

Option A: You live 34,748 days. Your final four weeks are spent in and out of hospital, alternating between discomfort and semi-consciousness, entirely dependent on family members and health care providers for assistance with every basic function.
You die in hospital or in a nursing home. The cost of home care, hospital services, and medications over this period depletes your estate by thousands of dollars.

Option B: You live 34,720 days–that is, 28 days less. The 28 days you give up are those last four weeks just described. You die at home. The money you save helps put a grandchild (or great grandchild) through college.

To my mind, this is a no-brainer. Option B is clearly preferable. In both cases you live until you are 95, a good long life. Everything significant that you were able to enjoy or accomplish will have happened. All you miss out on if you choose Option B is a few days of humiliation, discomfort (occasionally rising to out-and-out pain), guilt about the burden you are imposing on others, and anxiety about how your final pitiable condition might affect the way you are remembered. I assume most people will share my view that B is the better option. So the question arises: Why do the final days of so many people resemble Option A rather than Option B?

This question was prompted by two very good bestselling books that I read during the recent holidays: Atul Gawande's Being Mortal, and Roz Chast's Can't we talk about something more pleasant? GawandeGawande, a physician, addresses an increasingly important problem. Due to the tremendous progress made in medicine over the last century, dying is often a much more complex and protracted process than it used to be. Doctors today have the know-how and the technology to keep us alive a lot longer after we are stricken with illness or old age. Unfortunately, says Gawande, doctors, other care-providers, and family members, often unthinkingly opt for whatever will prolong life without considering sufficiently whether what is being prolonged is really worth living from the perspective of the person who has to live it.

Our worst nursing homes are luxury hotels compared to the old workhouses and almshouses where people used to spend their final days, but they are nevertheless dreaded. Innovative assisted living arrangements make an honest attempt to eliminate some of most objectionable aspects of nursing homes, particularly the lack of independence granted to the residents. But all the same, loss of autonomy, and the blighting of even small pleasures by continual discomfort, seems to be the fate that awaits many of us if we take our time shuffling off our mortal coil.

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Suicide: An Act Of Supreme Bravery

by Evert Cilliers aka Adam Ash

WilliamsSuicide is not for cowards.

You've got to be mad brave to whack yourself. Yep, suicide takes a lot of balls. The most courage any human can ever muster. Suicides are the bravest people who ever lived, because they commit the greatest act possible — a deed against actual existence, against their very being. They say no to life itself, and then have the courage of that unbelievable conviction to end everything. Suck on the barrel of a gun or cast themselves down from a great height on to the indifference of solid ground.

And we often resent them for it. Because they say no to all of us, to all of us who persist in living. They place the idea of living in jeopardy. They undermine our pathetic belief in life. How could they? How dare they?

Why do they say no to life? Because for them, living is not worthy. Life is too crappy to merit a fart. Not up to scratch. They feel this way because they are depressed. So depressed, there is no more pleasure in being alive; only persistent, absolute pain. And no advice from the living can help.

I know about that.

I've been mortally depressed in my life, clinically depressed, and thought about committing suicide, but never got around to trying it. (I believe I saved myself from depression by exercise: as a runner all my life, I think I finally ran my topsy-turvy brain chemistry into balance: if more people exercised, we'd need fewer therapists.)

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