chapter ten

Hey All

A few things.

1 Yesterday I saw something I don’t think I’ve seen before. I was outside in the late afternoon, when the vultures have just come to roost in a couple of the tall trees to the west of the meadow. I was looking up at them sunning themselves, when I saw two things that looked like leaves about ten feet away from them and the same height as they. I watched these come down and realized these were feathers. I don’t think I’ve eve watched a feather on it's whole drift down to the earth. the two feathers were contour feathers (as opposed to flight feathers or down feathers). i had to look up the term.

2 There haven’t been any bears around the last few days. I’m guessing that there’s a lot of food out there for them.

3 I edited chapter 10 more, and then decided to cut it off. One place in the chapter is a nice end. I’ve already got a good start on chapter 11. Chapter 10 is below. I’ll send chapter 11 (the start) in a couple of days. I’ve said this before, but I think it’s odd how I never ever wrote in chapters for my first many books, and then for no reason I suddenly switched for my last four. It felt natural to write all those other books as one long section and break into chapters at the end, and now it feels just as natural to break them into chapters as I write.

Thank you,

Derrick

Chapter 10

Death With Dignity

Today, something inside of me broke. And it was over such a trivial thing.

I went to my cabin to sit with the cats. I fed them, watered them, sat on the loveseat to pet them. I saw that one of them had pooped on the floor. I cleaned that up, then saw there was pee elsewhere on the floor. Then more poop, more pee.

I cleaned it up, sat down, saw one more pile. And something broke. This was one thing too many.

In my 20s, I popped a hamstring playing softball. I’d been rounding third, trying to score on a two-out single, when I heard and felt something snap in the back of my leg. Our third base coach later said he, too, heard the pop. I fell, then swam/crawled back to third base.

This felt the same, only psychologically, not physically.

When I was in high school I played a lot of pick-up basketball. Not infrequently other athletes or entertainers would practice on the sidelines or empty courts: dancers, for example, or, surprisingly frequently, jugglers. With the jugglers I noticed a clear pattern, and, even though I was only seventeen, an obvious metaphor. Most jugglers would, depending on their skill and experience, be able to juggle two, three, four, five, six, or seven objects with no problem. But when they would attempt to add one more to the mix, not only would the new item fall, but so would all of the others.

Sitting on that loveseat, I remembered those jugglers. My mom was dying, and I was doing fine. Or at least I could maintain that fiction. I was helping her basically by myself, and I was doing fine. I spent hours, days, weeks, with her in emergency rooms, and I was doing fine. I was barely sleeping, and I was doing fine. I wasn’t writing, and I was doing fine. My life as I knew it was ending, and I was doing fine. I cleaned up where the cat pooped and peed, and I was fine. I did it again, and again, and I was fine. But one more time, and I was sitting on the loveseat, broken, unmoving, unable to clean up the mess, unable even to cry, unable to stand up and do the next thing that needed to be done.

#

If there are eight billion humans on the planet, and we live an average of 80 years, then about 100 million people die every year. If the average person has two parents, and the average parent has two children, then 400 million people per year experience a parent die.

The responses to these deaths vary as widely as the relationships with the parents.

Some people don’t know their parents, and don’t know when their parents die. Prior to the invention and expansion of long-distance instantaneous communication—in my grandmother’s early lifetime, for example—anyone who emmigrated might expect to hear of a parent’s death months later, if ever. In generations before, it was notorious that if a son went to war, parents might reasonably expect to never learn what happened to their child, unless the son returned alive many years later. Even if he didn’t return, did he die, or did he meet someone and fall in love, perhaps near the site of some distant battlefield?

Some people know their parents little. I spoke with a man who’d talked to his mother on the phone a couple of times a year, whose sole response when his brother let him know their mother had died was, “She lived longer than I thought she would. She was a tough old bird.”

Some are relieved when their parents die. I knew a woman whose father died at 81, having been married to her mother since they were seniors in high school. I thought she and especially her mother would be devastated, but her mother felt joy and release, and my friend felt mainly relief, as when a terrible headache finally goes away.

I said, “They were married so long.”

She said, “It was hell. He never hit either of us, but he was domineering, and squashed every bit of my mother’s creativity and joy. My mom was old-school and could never divorce, but now for the first time she’s looking forward to the rest of her life. He made her quit her art, so she’s going to finally take up painting and pottery.”

My mother and one of my sisters were glad when the old man died. My mother was glad to live on a planet where she never again had to worry about him somehow again abusing her. And my sister said seeing him as a shrunken old man, and then dead, made her less fearful to live in the world. I didn’t feel much when he died. My main decrease of dread had come when I moved out of Colorado and no longer had to worry about running into him at the grocery store.

And for some people, losing a parent creates a fracture, a fissure: not merely a crevasse into which a part of their own self falls forever, but an unbridgeable chasm that separates the life they had and who they were before from the life they have and who they are after.

#

In the early 1990s, I interviewed Richard Manning, whose book Last Stand, about clearcutting, had just come out. During this interview, he said part of the reason this culture hates wild nature is when you go into a forest, grassland, marsh, or anywhere else natural, you realize pretty quickly that the whole place runs on death. Everywhere you look you see death: dead trees (dead trees are at least as important to forests as are live trees), other dead plants, dead animals. Wild places remind us of the necessity of death, and of our own mortality.

The afternoon of my breaking over the extra pile of cat poop, I walk through the forest, from my cabin to my mom’s house to get back to taking care of her—needs must, “once more unto the breach, my friends,” and all that—and I reflect on what Manning said. It’s true: the forest floor basically is dead matter. And it’s also true that the forest floor is alive—full of tiny plants, animals, fungi, bacteria, viruses, and so many others—because life feeds off life. Life requires death. Death is the fuel for life. As much as the forest floor is death, it is life, and death, and life.

#

I wonder if the forest knows or cares about my mom’s impending death. I’m guessing that with a few exceptions, the forest doesn’t notice, and most of those trees or others who do notice don’t generally care. I’m guessing the feelings of the trees and others is not unlike my feelings toward the big Douglas fir next to the path, who was girdled by bears twenty years ago: I was sad for the tree when I walked by and thought about it, but when I wasn’t walking by I didn’t think about the tree much at all. Most of the trees in the forest, alive or dead, I never notice. And I only notice the shrews, slugs, or beetles who happen to die on the path. I notice none of the others. I don’t think about flies caught by spiders, except those whose frantic buzzing catches my attention.

It is revealing of the depths to which human supremacism suffuses this culture, suffuses me, that even after I wrote a book decrying human supremacism, I still want the forest to care more about my mom’s death than I care about the multitude of deaths that are the daily life of a forest, lives that are just as precious to those who live them as mine is to me and yours is to you.

#

My mother wrote each of my siblings a letter telling them she was dying. She had one final request, which was not that they help her die, since she knew they wouldn’t. It was, because she had always been a profoundly private person, that my siblings respect her preference that my mother be in charge of who knew she was dying. In other words, not to pass around the news to anyone without asking her.

My brother did not respond to the note at all. Our mother never again heard from him.

One sister respected this request, and also continued to have regular phone conversations with our mom.

So far as my other sister, just a week after our mom sent the letter, our mom received a phone call from a third party who had just been told she was dying. . . .

#

The catheter in her side finally led my mother to slightly change her mind about allowing herself to be helped only by family (by blood and by friendship). She permitted a caretaker, arranged by Jeannette—her GP’s nurse—to come three times per week to help her shower, and to drain her pleural cavity. From the other room, each time I could hear my mom moaning as the nurse sucked the dregs of the pleural fluid from the cavity.

#

I went to see Jeannette, who, like John, represents everything good about the medical field.

She gave me a hug, as she normally does at the start of an appointment, and asked, also as she normally does, “How are you doing, Sweetheart?”

I shrugged, and wobbled my head noncommittally.

“I understand,” she said.

How often, I thought, is this really all we want: to feel that someone understands at least a little of what we’re going through?

We dealt with my minor health issue, then sat in chairs facing each other across the small examining room, also as we normally do, and as we especially did during the time of my mother’s dying.

After a couple of false starts, I said, “My mom just wants to die with dignity.”

She looked at me, silent. I knew she wasn’t considering what to say, but how to say it. In my experience she has always been both relentlessly honest and relentlessly compassionate. Again, the best of the medical field. Finally she said, “One way or another, I think that’s what we all want. But the sad truth is that very few of us ever get that.”

#

Until that moment, I’d never considered the phrase death with dignity. Oh, sure, I’d read it, heard people say it, said it myself, wished it for my mother, wished it for myself, wished it for almost everyone I didn’t despise. But it was just a cliché. No matter how many times with how many people I’d had great long conversations about death with dignity, I’d never thought about the phrase, and I suspected most people with whom I’d discussed it hadn’t either.

What does it mean?

My first thought was to ask what if, all those years ago, the semi-load of plywood hadn’t flipped—we’d rolled a four, five, or six on the die of fate, instead of a one, two, or three—and my mom and I had both been decapitated. It wouldn’t have been a bad way to go, in terms of not having had time for fear. And even if the stories were true that my junior high friends and I told each other around campfires—about Reign of Terror executioners holding up their victims’ severed heads, the victims’ eyes blinking and looking around for a couple of dozen seconds—I presumed from my experience of the accident that at least we would have been hallucinating and as unafraid as Peyton Farquar in Incident at Owl Creek Bridge. So it probably wouldn’t have been a scary death. But dignified? Having one’s head pop off, perhaps fly out the no-longer-extant windshield, land, roll across the wet highway, drop off the shoulder, and come to rest, eyes blinking and rolling, between rocks at river’s edge? Fast: yes. Painless: yes. Unusual: yes. Making a story witnesses will never forget: yes. Dignified: not particularly.

And would dignity even have mattered to us? We would have been dead.

My second thought was that most animals die from predation (with most of this predation by other animals, as opposed to micro-predators like bacteria, viruses, and so on), which means the majority of animals die running from a wolf, stumbling, rolling, and getting caught by the throat; or flying and being snatched by a bat; or swimming and being swallowed along with 40 million of your friends and neighbors by a blue whale.

But at least in nature most of them are free of the tortured, lingering deaths in nursing homes—waiting stations for the return to forever—where those who once had lives as beloved and unique to them as yours or mine are to each of us; and now sit side-by-side in wheelchairs, faces blank and frozen, eyes staring at walls, when they’re not in hospital beds, staring at other walls or at best, televisions, desperately wishing they were dead and just as desperately clinging to life.

In nature, if you’re as sick and incapacitated and miserable as the people I met in nursing homes all those decades ago, there’s almost certainly someone nearby who will help you die. Wolf, coyote, hawk, eagle, tiger, jaguar. Just a few moments of fear—or hallucination—a few quick bites, and the pain is over.

Recall the story of the rat who approached me, my two dogs, and three cats, in an abortive assisted suicide attempt

#

For me, at least, the question of what is “death with dignity” gets complicated pretty quickly. When I think of the phrase, the first people (literary or real) who come to mind are Sydney Carton, Lord Jim, King Charles I, and Teddy Sheean.

Sydney Carton, of course, is the cynical, self-loathing lawyer in Charles Dickens’s A Tale of Two Cities, who redeems his wasted life by surreptitiously and selflessly substituting himself for someone about to be guillotined, and whose final act is to comfort a young seamstress also about to be killed. Dickens suggests Carton’s final words, had he time to articulate them, could have been, “It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to than I have ever known.”

Lord Jim, the titular character in a novel by Joseph Conrad, is an honorable man who, under stress, commits an unforgivably craven act, then spends the rest of the book attempting to atone. At the end, he has the opportunity to re-make his earlier decision, and acts with courage, knowing it will cost him his life.

Charles I was King of England, Scotland, and Ireland, during the English Civil War. His side lost. The day of his execution was frigid, and he asked to wear two shirts, so he would not shiver from cold, which, he said, “some observers may imagine proceeds from fear.”

Australian seaman Edward “Teddy” Sheean was eighteen in 1942 when his ship, HMAS Armidale, was, off the coast of Timor, struck by two Japanese air-launched torpedoes. The Armidale began to list hard to port, and the order was given to abandon ship. After helping to free a life-raft, Sheean was struck in the back and chest by bullets from strafing fighters. Instead of joining his fellow crew in their life-rafts, he scrambled across the deck, strapped himself to an anti-aircraft gun, and began firing. He took down one bomber, damaged two more aircraft, and forced the others to withdraw, thus saving his shipmates. The ship’s stern went under. He kept firing. The water came up to his feet. He kept firing. The water came up to his waist. He kept firing. The water went over his head. He kept firing. The last anyone saw of him were tracers emerging from under the water.

There’s a sense in which these people—real or not—acted with a dignity to which I can only hope to aspire. But, and I feel pedantic writing this, are these really “deaths with dignity”; or are they acts of dignity immediately preceding death, acts of dignity in the face of death? Is there a difference? What of the deaths themselves? In the first and third cases decapitation, in the second case a gunshot wound to the chest, and in the final case drowning after having been shot twice.

#

I looked up “death with dignity” on the Internet, and it has nothing to do with dignified acts as such, nothing even to do with shooting enemy airplanes as your ship is sinking: it’s a political slogan created and promoted by those lobbying for assisted suicide, medical aid in dying, physician-assisted death, whatever you want to call it, and was first used in the 1990s in the campaign to pass Oregon legislation governing the prescribing of life-ending medications to eligible people.

I’ve obviously got nothing against medical aid in dying, but, after my conversation with Jeannette and this cursory research, I found myself growing daily more confused about both what death with dignity is, and what it means.

Looking up the etymology of dignity didn’t help much. Dignity comes from the Latin dignitas, which means “worthiness,” “merit,” or “honor.” Evidently, most Romans used dignitas only in its merit sense. Merit comes from the Latin meritum, a noun referring to both rewards and punishments; or the related mereō, a verb meaning “to earn, deserve.” Which means, I suppose, that in Roman times, a nasty death for a nasty person could have been a death with dignity, that is, a death merited, a death earned.

If we follow merit further back to its Proto-Indo-European root *(*s)mer-, we arrive at the concept of assigning or allotting something, which is related to words like portion, fate, and share, as in what one is entitled to or assigned: if you and I each do half of the work, each of us should be entitled to our portion or share of the merit, or credit. But also, since everyone who lives is assigned to die, everyone merits death, which kind of means all of us die with dignity.

We are not, however, living in ancient Rome or before, so it doesn’t really matter what Romans would have thought of a phrase invented more than 1500 years after the collapse of their western empire.

Smarter people than I have defined four kinds of dignity in the modern world: dignity as in behaving with poise or grace, or composure in the face of duress (Sheean, for example); or more generally living up to certain standards of character and conduct; or holding a social position (a dignified office); or universal human dignity, the status that all humans are believed to share, simply for existing.

For most of human history, this latter has not been common even as an aspiration. Stoic philosophers in ancient Greece articulated it, which didn’t stop their society from being based on slavery. And Judaism and Christianity hold that because humans are created in the image of God we all have inherent worth, which didn’t stop Christians from going forth and conquering under the sign of the cross.

To this day universal human dignity remains more aspiration—or maybe advertising tagline—than reality. Even using a strict definition of slavery, there are more chattel slaves in the world today than came across on the Middle Passage. These modern slaves are so cheap to buy that one anti-slavery writer wrote a book about them called Disposable People. And pornography is a primary use of the Internet: 30 percent of all data transferred across the Internet is porn, and the largest four porn sites receive far more monthly visits than there are humans on the planet, more traffic than Amazon, LinkedIn, Netflix, Zoom, and eBay combined. How can we speak of death with dignity when so many people don’t have a realistic possibility of living with dignity?

This is only to speak of humans. We collectively do not perceive nonhumans to have inherent dignity or worth in life or death, or we could not perpetrate clearcuts, factory trawlers, factory farms, pesticides, or the current mass extinction.

We’ve talked about my mom’s love of, and long relationship with, bears. Bears have complex communication abilities. Mothers cluck at their babies to tell them it is safe to descend trees; babies bawl back at their mothers; all bears sigh in gratitude; and they chuff in frustration, fear, or anger. They will moan at each other when unhappy. I was once attempting to describe this sound to a friend, and searched for “bears moaning” on the Internet. Never do this. Instead of finding a video of bears moaning at each other to say “Get out of my space, you big lug,” I saw links to scores hundreds of videos of hunters recording the death moans of bears they’d just shot. Who does that? Who would mortally wound an animal, then not only not immediately kill it, but film its suffering, and broadcast this suffering for other people to watch. And who would intentionally watch such a thing?

Death with dignity. Who gets to die with dignity?

What if I had died when I was 24, on the operating table for Crohn’s disease? Would that have been death with dignity? What if I had died earlier that evening when I passed out on the toilet from loss of blood? Would that have been death with dignity? What of Union soldiers at the battle of Cold Harbor in the Civil War who pinned their names and addresses on their shirts before they charged the Confederate lines, because they knew they were going to die, and wanted to leave some way for their bodies to be identified so their families could be told? What of the soldiers who got shot there, then died of sepsis five days later? What of the soldiers in the Civil War who died of dysentery (in the Civil War more people died from diarrhea than of battle wounds)? What of all the people who’ve died of smallpox? What of the deer taken down by wolves? What of the wolves taken down by other wolves? Would it have been death with dignity had my mom taken nembutal and killed herself?

When I find myself confused like this, often it’s because I’m asking the wrong question, in this case, “What is death with dignity?” Often when I’m asking the wrong question, it’s because one or more of my words—in this case dignity—is too abstract. In order to find some of the right questions, I often find it helpful to list what I know.

We all die.

We all know that we all die.

We all know—in the most general sense—the time range of when we will die. In my case, sometime between now and 25 years from now.

We all know that each day we are one day closer to death.

Most of us—human, nonhuman animal, plant, fungi, and so on—have little say in the general circumstances that will kill us. Most of us have little say in when we will die. Most of us will have little say in the direct cause of our death.

Most of us have some say in how we live in much of the time before we die.

Some of us have no say in how we live when death is imminent—between our possible perception of its imminence, and its arrival—e.g., had we died in the car wreck or had I died in surgery for Crohn’s.

Some of us have some say in how we live in the time between our perception of death’s imminence and its arrival, .e.g., Teddy Sheean.

None of us knows what—if anything—we experience after death.

I know that my mother wants to die at home.

I know that she wants to be taken care of only by family (plus John).

I know that for decades she has said she would rather die than be incapacitated to where she cannot use the toilet by herself, and where someone has to wipe her bottom.

I also know that I have never been so exhausted in my life.

This is what I know.

#

I shared my questions about death with dignity with a friend, who responded, “It’s such a vague notion it can be attached to whatever someone is selling, and as such it seems to be the best way to define death with dignity is to point out what it isn’t. And there’s a lot that isn’t. When my grandmother was in the fourth year after her cancer diagnosis (she had been given two years to live), by the end she was vomiting feces. That was not dignified. I think we start from there and work our way backwards, at each step saying, ‘Nope, that’s not dignified’ and take another step back.”

#

I shared my questions with another friend, who said, “My son was, until frankly miraculous medical intervention, very near death. He knew he wouldn’t last more than a few more hours. He later told me that as he was dying, his main thought, apart from how difficult it was to draw each breath, was, ‘No matter what happens, I don’t want to shit the bed.’ For him, that was his requirement for dying with dignity.”

She continued, not entirely seriously, “Based on these stories, from your mom not wanting anyone to have to wipe her, to the cancer victim vomiting feces, to my son thinking only about how many more breaths and I don’t want to poop, one could be forgiven for concluding that death with dignity means not losing control of your bowels before you’re actually dead. Dignity equals no poop issues.”

Suddenly somber, she said, “But this does raise important issues about shame. Perhaps dignity might be partly an absence of shame. When I was a child, my mother and father let our townhouse devolve into a hoarded mess with no working plumbing or heat. And lots of old New York Times newspapers being saved for ‘later.’ The hardest part for me was not the lack of a working bathroom or lack of heat in winter, but the fact that I didn’t want anyone to know. Shame.

“Perhaps,” she concluded, “there’s a certain shame associated with loss of bodily function, and the larger loss of control that is the dying process.”

She’s right. Insofar as possible, we should individually and collectively do everything we can to reduce potential shame on the part of the dying. Later, I did wipe my mother’s bottom, and I also gave her a suppository. I made her feel as if it were nothing, which was in a sense true since the actions were nothing compared to her dying. But my trying to make her feel it’s nothing is not the same as her feeling nothing. There is vulnerability in having so little control over your fecal hygiene—and that’s a stand-in for many other processes one can no longer do for oneself, and for which someone must depend on another.

Shame sometimes can be and is a social phenomenon—e.g., we shame a pedophile or a batterer because he has violated social contracts and codes and relationships whose violation we as a society have deemed (rightly) to be shameful.

There exists a substantial social movement these days to eradicate all shaming. In this movement it’s considered bad—shameful—to under any circumstances shame someone (except it’s acceptable to shame someone for shaming someone). I think, however, that if someone’s behavior is shameful—a person is a pedophile or a batterer, or commits other equally heinous acts—that person deserves to be shamed.

I am grateful to my mother for instilling in me a strong sense of what is honorable, great, good, acceptable, unacceptable, bad, terrible, and shameful.

All of those involve voluntary behaviors. Taking care of a dying parent is generally an honorable thing to do. Sexualizing or sexually abusing a child is a shameful thing to do.

Being an adult who wears a diaper because you have a diaper fetish (they’re called ABDL: Adult Baby Diaper Lovers) is shameful. Being an adult who wears a diaper because you have one or more of any number of medical conditions is not shameful.

Nothing about one’s loss of function through physical conditions is shameful.

Which doesn’t alter the fact that my mother did not want to be cleaned up by me, and my friend’s son did not want to shit the bed. I think this is at least somewhat inherent. I have had dogs who have manifested a sense of shame when they soil themselves. And I had one dog who was stroking out and dying, lying on the floor visibly suffering while I held and stroked him (on a Saturday, which meant I couldn’t take him to the vet to help him die, and I didn’t have the courage to shoot him in the head), and just before he died he struggled to his feet, hurled himself across the room on legs no longer working, stumbled out the door, and had explosive diarrhea before staggering a couple more steps and collapsing on the wild grasses. His last act was to not soil himself.

In that sense, he died with dignity.

#

I shared my thoughts with yet another friend, who responded, “Almost everyone wants to die at home, but few are able to. If you happen to have three or more daughters or daughters-in-law, your chance of dying at home is elevated to 50 percent. Otherwise, at least in the United States, it is extremely low. The vast majority of Americans die in miserable institutions, like nursing homes, with strangers.”

This does not seem the right way to die.

#

Die with dignity? Who gets to die with dignity?