death has a new face

All Hallow’s Eve has past. The ghoulies and ghosties, skeletons and zombies all have been put in storage and out of sight for another year.

The next day, Saturday, November 1, All Saints’ Day in the Christian calendar, death had a new face. Brittany Maynard. A widely posted family snapshot shows her in a backyard patio setting, relaxing on a chaise lounge; her attractive, brown-haired, luminous-eyed, broad-smiled countenance peering up into the photographer’s lens, the proverbial picture of health and hope.

On New Year’s Day of this year, Brittany was diagnosed with inoperable and incurable brain cancer; later being given six months to live. She and her husband, Dan Diaz, moved from their California home to Oregon, which allows terminally ill persons to choose to end their lives with physician-prescribed lethal medication. Over weeks and months, Brittany became an advocate for the expansion of aid-in-dying state legislation beyond, in addition to Oregon, Vermont and Washington.

Brittany’s death, perhaps more her choosing to die, not surprisingly, has evoked a range of responses, publicly expressed and privately stated.

Some have spoken and written of Brittany’s decision as one of courage in the offing of inevitable deterioration beyond, below any desired standard of quality of life. My friend, the Reverend Susan Mann Flanders, on Sunday, October 26, at St. Mark’s Church, preached a sermon, entitled, Love of God, Love of Neighbor, that addressed in poignant and powerful terms “suicide and assisted suicide in the decline of old age” (see www.stmarks.net > Worship > Sermons). Though Brittany was 29, given her medical diagnosis, the difference between her circumstance and that of the profoundly debilitated aged, I think, is a number.

Others, largely, but not only the staunchly religious, have questioned, some more vigorously than others, what they deem a usurpation of the purview of the deity or perhaps fate to determine the end of life. In interpreting, rightly, I think, the counsel of Psalm 39.4 (Lord, let me know my end, and what is the measure of my days; let me know how fleeting my life is) not as a desire to know the timing of death, but rather a plea for the grace to live wisely in the face of the reality of its inevitability, some would adjudge Brittany’s actions as rash, if not also faithless.

Still others, and the large majority of commentators, whether or not claiming to understand Brittany’s choices, and, even in that, confessing their conundrum if ever faced with a similar situation, express a palpable depth of lament.

As I think of Brittany and Dan, I honor them, each and both, for what I perceive as their belief in a life of love well lived, which, in the lengthening shadow of her inescapable increasing suffering and, therefore, their shared loss, led them to choose her dying day.

I also think of my mother, Lolita, nearly seventy years Brittany’s senior, who, long having journeyed into the insentient wilderness that is Alzheimer’s disease, for the past ten years has been confined to bed. My mother’s body with heartbeat strong is still with me, but her mind and her conscious awareness of her surroundings and her maternal acknowledgement of me are far away and long past. With her continued breath of life, I have come to know loss like death, provoking in me a so-far interminable, heretofore unimaginable sorrow. At times, with humor macabre – for a smile, however wan and grim, interrupts, if for an instant, my soul’s anguished weeping – I consider that my mother is well on her way to proving that she is God, for she is eternal and incomprehensible.

A week ago, a friend referred me to the book Being Mortal: Medicine and What Matters in the End. The author, Atul Gowande, M.D., M.P.H., writes eloquently of what some, I imagine, would call advances of medical science that prolong life, even in our waning days, without “a sliver’s chance of benefit.” Recently having enrolled my mother in hospice care, I find comfort in Dr. Gowande’s counsel.  I also confess, no doubt somewhat selfishly that I might engage fully my grieving, wanting to know, quite apart from the psalmist’s intent, the measure of my mother’s days.

Until that moment comes, I wait. And in this moment and forward, again, I honor Brittany and Dan.

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3 thoughts on “death has a new face

  1. I don’t know what I think of all this, which is my way of saying that I have many contradictory and conflicting thoughts. I’ve been a nurse all my life and believe in and support the American Nurses Association statement against assisted suicide and euthanasia. At the same time I also understand the wish of the terminally ill to die on their own terms.

    As a nurse, I have given morphine to patients who were actively dying, in order to alleviate pain, anxiety and respiratory distress, understanding that the morphine would have a cumulative effect and likely hasten their death by suppressing respiration. The first time I was asked to do this, I called the physician and asked for clarification. She explained to me that if I refused to give the morphine, which was my right as a nurse, my patient would die in a state of anxiety and pain, struggling for every breath. If I did give the morphine, my patient might die a little sooner, but she would die in peace, with dignity, and free from pain. I gave it.

    What is our responsibility to one another when it comes to facing our own death? Do we have a responsibility to others, or are decisions concerning our death strictly our own? What about the wishes of others? Are we obligated to fulfill those wishes simply because they’ve been made known? How much or how little do we, can we, should we, participate or not participate in the desire of another to end their life?

    I don’t know.

    I have a couple of problems with Ms. Maynard’s decision. The first is, she wasn’t actively dying. She still had time. No one knows how much time. A day? Another six months? My other problem is that Ms. Maynard appeared on the news just a couple of days before her death saying that she had changed her mind and would not end her life on November 2nd. Then she changes it again and she is gone. To me, that doesn’t seem to be the decision of someone who is mentally stable.

    I don’t know.

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  2. As soon as I saw the title of this blog post Paul, I instantly knew what it would be about.

    I too honor Brittany and Dan. And I had followed the case from the very beginning. I hadn’t talked with anyone else about this case or the implications or how I felt about it…. Until the Reverend Susan Flanders preached about it two weeks ago as you mentioned. I was verging that Sunday and when Susan arrived she shared with me the topic of her sermon so I would be prepared. But I really wasn’t prepared…. There were many tears shed during the sermon and especially as people spoke during Sermon Seminar.

    My mom hates the fact that she has dementia and has expressed it many times. I know she doesn’t want to live like this, just as I’m assuming your mom would not. My mom has said many times that no one should have to live with dementia as she does. But as you pointed out, we wait!! I believe that like your mom, my mom will live a LONG time and the uncertain future with her terrifies me.

    I’ve shared with my family since Susan’s sermon that I’d love to be as brave as Brittany and Dan and make that type of decision. Having endured years of intense physical pain in my life due to illness years ago, I clearly understood why Brittany wanted to avoid all the pain that was to come as her tumor progressed. Watching my sister die from MS in excruciating pain before Hospice arrived with the morphine to quicken the process, scarred me forever. As soon as I get my act together I am going to write my letter to my family expressing what I’ve heard my mom say many times, “please just let me die”.

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  3. Loretta, as difficult as I find…as I feel my life has become…is with no longer having (and not for many years now) my mother, I cannot imagine, knowing what I do about your life’s pilgrimage (long term illness, caring for Renee, and now Doris), the burden of sorrowing you carry. Hence, when you write, “As soon as I get my act together I am going to write my letter to my family…” I believe, know that your words reveal the most wide-eyed honesty and open-hearted conviction. As I honor Brittany and Dan, so, too, I honor you.

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