Thursday, September 27, 2012

Death and American Exceptionalism

Bill

I finished my stint in the cardiac care unit yesterday. Our 90- year old is still there. With the usual manipulations we we able to restore her to a point sufficient to remove the breathing tube. She remains mute, as she was before she entered our unit. Her nephew, who has power-of attorney, has at last agreed to dramatically decrease the level of aggression with which we are treating her, and to allow her to leave this world when the next crisis arrives, which I expect will happen soon.

I have come to see this end-of-life ritual as exactly that, a ritual, like a bar mitzvah or christening or vision quest, only at the other end of life, and in which the presiding sentiments are  grief and loss as compared to joy and celebration. There is a curious intersection between the relentless optimism of American materialism and the unshakable reality that all of us die. Her next-of-kin  seemed to think that that death for his loved one was some sort of option-in reverse that could be avoided if only more stuff was done, more tubes inserted, more buttons pushed, more tests run, more money spent. No amount amount of reasoned counseling on our part (and believe me we tried), was going to change his mind. And so of course, the tubes were inserted the buttons pushed the money ($10,000/ day) was spent, but outcome was the same. This is a scenario played out day-after-day in intensive care units and operating rooms and cancer treatment centers across the land. I tell my loved ones, "I'll know you really hate me if you ever let this happen to me"

Eli  

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