Life Matters Media
Start the most difficult conversation American isn’t having- the conversation about our end of life preferences

Death With Chocolate

My friends and I are at the age at which sickness and death face us every day. They appear in the mirror when we see our mothers and fathers reflected back. They show up in the news as more of the celebrities whose deaths make the front page are of our generation, not that of our parents.We feel the loss, we feel the fear, and we ask ourselves: “Who will go next? When will I die?”

News of someone we know– or know– of ­­being diagnosed with an eventually fatal disease comes with regularity. He’s got ALS; she’s got stage four ­cancer spread to where it cannot be stopped. He got Parkinson’s, she got a stent, he’s on insulin and she’s got a colostomy. The list grows longer and longer, the tide gets closer and closer to me.

Image via Creative Commons and Flickr's Joyosity
Creative Commons

The conversation started the other day when a friend came to visit. Somehow, the talk got around to someone newly diagnosed with one of the big scary diseases; at least it’s one of my big scary ones.

“If I got that I would kill myself,” she said.

I replied, “No you wouldn’t.”

“Yes, I would,” she repeated with even more conviction.

“How?” I asked, really curious.

Her quick response was, “Pills.”

“You won’t be able to. By the time you are ready to die, you won’t be able to do it yourself,” I reminded her.

She thought a minute, and then said softly: “Everyone’s talking about this. What to do when the end gets hard. I want pills. What about you?”

Taking a deep breath, I admitted that I think about it, too. I’ve seen so many people die in so many different settings that I have some idea about how I would handle one of the Big Scary Ones.

“I’ve thought of walking into the lake, but I definitely don’t want to die cold and wet. I’m afraid of heights, so I’ll never jump. I feel sick driving fast, so it won’t be a high­speed crash into a wall. Nothing violent at home, I couldn’t put someone through the trauma of finding me. As for pills, I’d probably wait until I couldn’t eat so many.”

She squirmed, “You have thought about this.”

“Oh, yeah,” I replied. “I’ve seen enough people die to know how I want to die: sick for a month, old and happy, no pain, in my own bed, surrounded by people who love me, getting massaged, listening to soft classical music, seeing the sky and trees out my window, and with chocolate ice cream in my mouth.”

She laughed. I poured more tea.

“One thing for sure, talking about it—even like this—makes it real and that gives me time to accept death and prepare for it,” I said. “What I know for sure is that I need to have a designated proxy to speak for me in the hospital if I can’t speak for myself, and I need to put it in writing in a Power of Attorney for Healthcare.”

“We did ours last year with our estate plan,” she bubbled.

“Who’d you choose?” I asked.

“My husband,” she smiled. “But I know it’ll be hard for him to pull the plug.”

I cringed, “That’s a terrible expression. It makes withdrawing life support sound simple. Pull a plug. It’s horrible to have to decide to leave someone on a machine living dead, or take them off a machine to get dead. We’d be so much better off if we never got plugged in.”

I could see she was getting uncomfortable so I added, “Hospice is the key, but so many people wait until it’s too late to get the benefit. We use hospice as a last resort when it’s a last reward. The best ends I’ve seen happened for those who had hospice at home for weeks or months­ not only days before they died. If you can’t die at home, a hospice unit is like being in a fancy hotel suite with five star service.”

She let me go on.

“Hospice patients can get good pain management, and the family and caregivers have phone support 24/7. Dying is hard, and it can be messy and offensive. None of us gets any practice dancing with death. We need to lean on specialists, and those hospice people are special.”

She sipped her tea, smiling, and then said, “You’re right. I’d rather die naturally and surrounded by people who love me than alone with a cocktail of drugs for a finale. I’m glad we talked about this. I actually feel better.”

“That’s exactly the point of talking about death—to appreciate life!” We tapped our cups and shouted, “L’chaim!” We hugged tightly, and then went on to the next topic: desserts.