So Dr. Tucker and I talk of kidney failure, uncontrolled diabetes mellitus, and depression, then he says, “But your blog . . .” Ah, yes. My blogs. I explain to him that writing my blogs is the only thing I have left, and I don’t understand it but it’s the one thing that still works for me. I can barely get out of bed, and my mind is mooshier (this is not the medical term) than people realize, but I can still write. It is the gift God has given me and it is still in place.
We continue our talking. Amelia comes over and sits on the floor beside me. I note that I am alone twenty-two hours a day and Amelia is the only person who comes into my home. One scenario I want to avoid at all cost is Amelia finding me in bed soaked in urine or dead on the floor. Before she went to work for Peace, she was a forestry student, not a trained medical worker, and it’s not right for her to have to deal with this. So at some point I say, “Hospice” and Dr. Tucker says, “That’s what I was just thinking,” and we talk about Hospice and Francis House.
Hospice is supposed to step in and help with the dying business but I have heard that if you live alone then they may not take your case. Apparently they exist to help the living, not the dying; they take the weight off the primary caregiver. Hospice does not maintain any residences. Francis House is the only local facility designed to provide live-in service for people who are dying. I have visited Francis House and I remember it as a very quiet place with bedrooms that have color—they are not hospital-white. Hospice does not run Francis House but most of Francis House’s patients are receiving Hospice care.
For both Hospice and Francis House, you have to renounce all medical interventions except “palliative,” i.e., pain-killing, and a physician has to declare that you won’t live longer than six months. I cheerfully tell Dr. Tucker that I promise to die within five months and three weeks. We have a few more moments of conversation and then it’s a done deal: Dr. Tucker will do a referral to Hospice. He has, a couple of times, referred to death as “the catastrophe,” which makes me sad.
Sex and death are the two most natural and powerful factors in human life: why don’t we accept death the way we accept sex? Why don’t we plan for death? (Excuse me, I do plan for it—why doesn’t the medical profession?) Dr. Tucker and I talk a little about how the medical profession should embrace the full cycle of life. We all die; what’s the big deal? I already have noted that I believe that I have an eternal soul and that the soul inhabits a succession of bodies that it sheds as a snake sheds its skin, and my soul is now ready to shed this body and move on.
Why, I ask Dr. Tucker, isn’t a physician’s final referral to spiritual care? Medicare should be paying for spiritual care because that’s the final stage. One-third of all Medicare payments are incurred in the patient’s last three months of life, i.e., when the medical industry—with or without the patient’s consent—is fighting inevitable death. I don’t understand why the medical profession has become so fixated on preventing death. There’s a time to let go, and they are obstinately fighting it.
A very, very long time ago, my great-grandfather had a stroke while home alone with the housekeeper, who had him taken to the hospital. Strokes were common in the family and the family knew there were strokes you lived with and strokes you died from. When my grandmother and her brother arrived at the hospital, they met at their father’s bedside with the doctor, who declared that they needn’t worry. He would use heroic methods and he would not let their father die!
Grandma said to her brother, “Tom, you and I need to have a talk with this young man.” They withdrew to the hallway for a small, private conversation and Grandfather Hope died quietly in his sleep that night. There was a time when family made decisions and doctors followed orders. Dr. Tucker is one of the few remaining physicians who see their job as one of service, and he and I have neatly finished our business. In half an hour, we’ve looked at reality, made a decision, and are ready to move on.
In the car, on the way home, I am almost giddy with relief. After my mom went into hospice care, she signed the check to pre-pay her funeral expenses. I asked her how that was for her and she replied, “It was a relief.” There comes a time when carrying the burden of physical life becomes too great and it is a relief to set it down.
For the past couple weeks, I had been divesting myself of some of my stuff—shoes, clothes, jewelry, houseplants, paperwork—and it felt wonderful. Many years ago, I owned stuff—a dining room set, a six-foot sofa, a double bed (heaven help me, I even owned a sewing machine). I was renting a house with three other people who announced to me that they didn’t do “chores” (they were medical students) so I canceled the lease and had a yard sale in which I sold all that heavy stuff.
Then I bought a really classy sofa bed and moved to an efficiency apartment on the 17th floor of one of the most exclusive buildings in the city. I had to get rid of all that stuff in order to be light enough to rise up to where the view was long. That’s how I felt on the car ride home: relieved of the burden and free to rise. In getting rid of my stuff, I felt no regret, sadness or sense of loss—only relief.