Facing Into Your Mortality

These Precious Days by Anne Patchett is full of wisdom for aging and mortality.

Besides Patchett’s collection of essays, my book club has read one on The Gift of Aging, which profiled people who were enjoying their older years and living them to the fullest. Basic message: don’t dread getting older, make the most of it.

There were three books by physicians: With The End in Mind by Katherine Mannix, Atul Gawande’s Being Mortal, and The Lost Art of Dying by Lisa Dugdale. These books by docs had at least two things in common. One, they were all reflecting on their experience of death and dying in light of extensive medical practice. And two, all three were critical, often sharply so, of their own guild — physicians — and expressed a high degree of doubt about the medicalization of death, and its outcome of death now usually occurring in a hospital.

Reading their descriptions of how a natural process, dying, has been increasingly treated itself as a disease with heavy medical interventions, brought to mind the parallel of birth. In my own parents’ time, birth was medicalized. It was moved to the hospital, accompanied by sedation of the mother and exclusion of family or community. The image of the anxious father pacing, chain-smoking, in the waiting room became a kind of archetype or perhaps cartoon.

By the time my wife and I started having children, it was all about “natural child-birth.” We husbands joined our wives at childbirth and Lamaze classes, where we husbands were prepped to serve as coaches. Concurrently, the birthing room turned into something much more home-like and accessible to other family members. Now, it seems that the generation that worked back then to de-medicalize birth, is pushing for something similar for dying.

With this series under my belt I resolved to be more intentional and plan-ful for my own dying and the things that go with it (how the remains are handled, rituals at and after death, etc.). In some ways, however, such resolve is odd, in that death and dying seldom conform to our plans or schedules.

It is also a bit out of character for me to try to plan much of anything out in advance. I’ve been pretty much in the school of “letting life come to me,” as opposed to having a life-plan. So, we’ll see. Maybe I’ll make good on my intent to, if not make plans, then formulate preferences, and to share those with the ones nearest and dearest to me.

Our book-club series also included a novel, Wallace Stegner’s Crossing to Safety. It is the story of a life-long friendship between two couples, who were dissimilar in many ways. It concludes with the dying of the dominant character in the foursome, Charity. She plans her dying with efficient zeal, having resolved “to do this right.” Her story raises this question: where’s the line between making reasonable plans (putting your house in order), and trying to maintain, or exercise, complete control?

That question seems to me at the heart of the matter for many of us and for our society. It is wise to learn about dying, whether from the experience of caring for the dying, or under the tutelage of a palliative care physician like Katherine Mannix. Mannix is very helpful in showing readers that death can be, and most often is, a natural process, with certain predictable steps and stages. And most important, death can be peaceful and not gruesome. Instead of hiding death away and so coming to fear it, we can befriend death, prepare ourselves, put our house in order and make our preferences known.

But, being a modern and technologically equipped people, the tendency for us is to try and control what cannot, in the end, be controlled.

Perhaps birth again provides an analogy. None of us were in charge, in control, of our own birth. We relied on others. Those of a faith or spiritual bent might say we relied on gracious powers not our own. As at birth, may we in death, also rely on gracious powers not our own.

So, face into your mortality, plan what you can, accept what you can’t control. And for now, get on with living.