Over on my KHIT.org blog I’ve posted a reflection on Ann Neumann’s important book “The Good Death: an exploration of dying in America.”
Two years before he died, Dad mentioned that he was thinking of shooting himself or hanging himself out behind the shop. When things got bad, he hoped to find a painless way out. I was terrified I’d be the one to find him, his body swinging somewhere or bloody and mangled. I told this to a friend who brought me a copy of Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, the New York Times best seller first published by Derek Humphry in 1991. Humphry, a brusque and controversial figure, was a principle founder of the Hemlock Society in 1980. Final Exit outlines the ways in which a person can kill himself, without legal ramifications. I read it and read it again, then gave it to my father. I was certain that, if I ever had to make the decision to end my life, I knew exactly how I would do so (sleeping pills, turkey basting bag over the head, loose rubber band around my neck to keep the carbon dioxide in), and my father would find his way, if he wanted to. I wanted him to know that whatever he decided, I supported him. Instead, he found death, good or not, in a hospice facility far from his beloved hollow.
When I finally left Africa for home, I quickly realized that all the hurt I thought I was working out on the road was still there, where I had left it. The divorce papers, the job search, the house that Dad built — my memory’s catalog of images consistently fell open to the same one: my father, almost naked, pale, lean, and contorted. I realize that in many ways, my memory’s recall of this image was my need for what Susan Sontag called, in her 2003 book Regarding the Pain of Others, “the pleasure of flinching.” It’s an easy memory to access because it hurts so much, but also because it made me feel close to him again. Yet it was crowding out all the good memories I had from our life together, like when we’d catch each other’s eye some golden afternoon while cutting wood on the farm. Or the comforting intimacy of his voice when I’d call him out of the blue to talk about the rain. His twisted body, arranged in a way it never would have been had he been alive, was crowding out all the things I loved about him. I replayed the last hospice scenes in my head. Did everyone die this way, fighting with both arms and legs until the needles came? I wanted to know if his had been “a good death.” And if so, might it come for me the same way?
It was clearly time for me to find another way to deal with my grief. Like my decision to get out of the country after he died. But this time, instead of running away from it, I had to get closer to it. I had been unmoored by my own grief for so long that I had no alternative but to finally make sense of it, to wrestle it to the ground and know it. To function in the world again, I’d need to understand what had happened to my father, to my family, to me — to all of us. I didn’t grasp the nature of this work at the time, but I was doing what Peter Trachtenberg describes in The Book of Calamities: I was launching myself into an investigation with all the raw energies and emotions I had put into grieving. “Before suffering people can form a coherent picture of their suffering,” he writes, “they must first ask questions about it, or maybe of it. In doing so, they are performing the work of science and philosophy, interrogating their reality in order to derive a thesis about it.”
Finding a good death seemed about as likely as finding the fountain of youth. What was good about dying? I had no idea where to begin, but since my reality of death began with hospice, I became a hospice volunteer. Most anyone can volunteer, and training is fairly brief, but hospice programs are constantly in need of more willing participants. Volunteers are warmly welcomed. I learned how to sit with other peoples’ dying. And I kept going. I followed my pain-filled curiosity to conferences and clinics, to academic lectures and to grief sessions in church basements, to isolated prison cells and to pale-blue hospital wards where every hushed word could be the last. I didn’t care if it was a morbid inquiry or a vain self-improvement project. I asked questions, yes, but mostly I listened to the stories of others who were close to death, their own or a loved one’s. I pursued an expert’s knowledge of how we human beings, in this time and country, slide into death or thrash at the end, and how those of us left behind stumble around in the absence. I told myself that this investigation was something that my father, who never let a loose chair leg or a broken appliance go unfixed, would have appreciated, if not encouraged. Something was rattling around, and I was going to set it right…
Neumann, Ann (2016–02–16). The Good Death: An Exploration of Dying in America (pp. 17–19). Beacon Press. Kindle Edition.
I subsequently tweeted
…A larger understanding was necessary: of why we die the way we do today; of the development of medicine and concepts of choice, autonomy, informed consent; of how hospice and hospital cultures were formed and perpetuated; and of what our regard for the dying has become in broader society. Too, the laws that regulate what is available to the dying had to be considered, along with their purpose and origin. As well, the financial systems that had locked us into the untenable way we currently die. Religious and other cultural forces also play a role in how we die. I had to ask myself how all of these interactions influenced end-of-life care. By focusing on individual lives and deaths, it became clear to me that changing the way we die would be a project of depth and breadth, one that involved loving care for patients as well as a fearless examination of the social, legal, and institutional systems that governed the end of our lives [ibid, p. 20].
A must-read, IMO.
There is no good death, I now know. It always hurts, both the dying and the left behind. But there is a good enough death. It is possible to look it in the face, to know how it will come, to accept its inevitability. Knowing death makes facing it bearable. There are many kinds of good enough death, each specific to the person dying. As they wish, as best they can. And there is really one kind of bad death, characterized by the same bad facts: pain, denial, prolongation, loneliness [ibid, pg 210].
“I realized that I was [now] in a club: those who knew what it was like to see the death of a loved one up close…I had not imagined what was coming. I had never taken care of a dying person before. I had never even seen someone who was dying.” [ibid, pp 6–7].
On July 1st, 1998, I held my first-born child as she “awoke” briefly from her days-long morphine pump haze “death rattle” and lurched up in her deathbed in Brotman Medical Center in Culver City, the culmination of 26 months of cancer hell. “It’s OK, Sissy, we love you, you can let go…”
A decade later, in May of 2008 I raced from a live music photoshoot I was doing at The Palms to the nursing home in Las Vegas shortly after midnight, only to arrive shortly after my dementia-addled 92 year old Dad fizzled out from what the death certificate would subsequently list as “end-stage debility.”
A month later my musician friends and I gathered at the apartment of our dear friend, Cuban-born bassist Adrian Garcia, who was dying of colon cancer that day. I still have his phone number in my iPhone eight years later. Just can’t delete it.
Three years hence, in November of 2011, I placed shavings of my Mom’s beloved dark chocolate on her tongue as she departed after four years in long-term care, just shy of her 90th birthday.
2018 UPDATE: We’ve been struck yet again. See “A tale of two sisters.” Unreal.
I’ve never been in the military, nor have I ever been around lethal crimes (with one exception noted below), so my direct experience with the deaths of unrelated others is limited to two incidents. First, in 1963 while in high school, as I was returning home one afternoon on the two-lane Route 206 in Hillsborough NJ with my mother, the driver directly in front of us impatiently and abruptly pulled out to pass the car in front of him, and promptly collided with the rear of a semi tractor truck hurtling up the other way pulling an empty flatbed trailer, knocking the aft wheels array out. The trailer wheels careened down the highway toward us at first, then bounced wildly off into the adjacent field. The victim’s car spun violently and crashed headlong into a ditch on the other side of the road.
I was first to the scene. The engine compartment was fully smashed back to the firewall. I frantically pulled at the crunched driver’s side door. It took several hard pulls to get it to creak open.
This man was obviously dead or shortly to be formally so. Impaled on the steering wheel shaft. Blood and saliva oozing down out of his mouth, unseeing eyes open, “staring” down. Wow.
Then in 1966 in Chicago, where I was playing guitar in a road band during my second year out of high school, we were hanging out sitting at the large second story window of our Near North Side hotel room one afternoon, just watching the day’s random auto and foot traffic.
A scruffy fellow ambled stumblingly across the intersection at the light change — a “drunkard’s walk,” it seemed. A wad of what looked to be crumpled dollar bills in his left hand.
Another man raced up from behind and snatched the money out of his grip. The robbery victim shouted incoherently and gave halting chase. He tripped on the curb and hurtled headlong across the sidewalk, through the plate glass window of the store on the corner.
Yikes! Holy Shit!”
We raced down and ran across the street. A crowd of gawkers quickly assembled. “Damn, man, look at that! Those are his brains, man.”
Indeed. A shard of heavy window glass had pentrated and pried open his skull at his right temple. A river of blood flowed across the sidewalk and into the gutter.
Police and an ambulance arrived forthwith. There would be no saving this hapless fellow. He was quickly loaded up and hauled away. A store employee came out straight away and hosed the blood and brain tissue into the gutter and down the sewer drain as the crowd drifted off.
An hour later you couldn’t tell anything had ever happened, except for the quickly boarded-up storeront window.
That’s it for me. More than enough.
Do yourself a favor. Buy and study Ann Neumann’s excellent book.
Speaking of death…