SexyPrime, a blog by Susan Crain Bakos: DYING, THE END GAME, Part Fourteen: The Quality of Life

Image credit: "High Flying Bird" by Walter ver Meulen

“So, what can I say ? Most of the people who are close to death (and I was) know how speaking or writing about this subject is hard, quite hard for others to understand.

“Speaking about death is considered in our modern society as very anti-conformist, almost provocative, subversive action. Often, it can provoque very bad and violent reactions.

“When we are all made to believe we can live longer, better, younger—writing such words is a real challenge!

“Susan, I really did appreciate what I've read. It's like ‘a force tranquille’, a sweet and powerful strength,” Oliver, a French reader.

Thank you, Oliver. What a beautiful compliment. I love having my writing described as a “force tranquille.”

Another reader sent a warm note with a link to "How Doctors Die", by Ken Murray on LiveScience.

What an eye-opening piece of writing. It should be a call to action for everyone. In Part Five, Money, I wrote about the unconscionable waste inherent in our current way of dying. Millions are poured into end-of-life treatments that add nothing to the patient’s quality of life—in fact, the opposite: Treatment when the odds of remission, let alone cure, range from little to none all but guarantees the patient will die a painful, lingering death.

Dr Murray writes,

“…doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

"Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits…”

Murray writes about “futile care” and the “anguish” of administering treatments that will cause suffering because the patient requests “everything be done” or family members demand it—none of them with any real understanding of what “everything” entails. He acknowledges that doctors are rarely good at explaining all the options, including the option of refusing all treatment but palliative care—and patients and family members are just as bad at asking the right questions. Given the high cost of health care in this country and the real possibility of medical rationing one day, doctors and patients must develop these skills.

The two big questions:

What will this treatment cost me in terms of pain and suffering?
What will it gain me in quality of life?

When you have the answers to those questions, you can realistically weigh your options. I hope and believe that the readers accompanying me on my journey will know the questions to ask for self and family members. Death comes to all of us, often sooner than we think it will. We are hostage to a brutal medical system because we are in cultural denial about death. That system denies us the spiritual and emotional journey that is dying.

I am grateful that I've had the quality time to savor experiences like walking in New York City on an early fall day or having lunch with an old friend in a familiar place like Punch, to say my good-byes, be nurtured by loving friends--and reach out to so many people around the world.

But if you want to keep the blinders on: Focus solely on positive articles about aging; don’t think, read or talk about dying; refuse to contemplate living with some form of senility as half who pass their 80^th birthday will do—and spout slogans like, “Age is just a number (or state of mind)” and “60 is the new 40.”

Dying is one of the three big taboos, subjects we don’t discuss in polite company, along with sex (honestly) and non-socially-acceptable mental illness—the sorts of problems that can’t be “treated” by anti-depressants and mood elevators. Depression is trendy; personality disorders, not. I’m weary of the language of cancer—“fight,” “battle,” “wage war on”—wherein quality of the cancer victim’s life is simply collateral damage.

But I do love kicking taboos in the ass with a fine stiletto-shod foot.

IF YOU'VE MISSED THE PREVIOUS POSTS--

Dying, The End Game, Part One: The First Day of the End of My Life

Dying, The End Game, Part Two: I Gave Them Something To Talk About

Dying, The End Game, Part Three: What About Sex?

Dying, The End Game, Part Four: Secrets, Lies & The Relevance of Truth

Dying, The End Game, Part Five: Money

Dying, The End Game, Part Six: A Quickie on Questions People Ask

Dying, the End Game, Part Seven: The Power and Glory of Breasts

Dying, The End Game, Part Eight: Ghosts, Spirits & Totems

Dying, The End Game, Part Nine: Why I Don't Want A Funeral?

Dying, The End Game, Part Ten: In The Wee Small Hours of the Morning