Going out With a Bang Instead of a Whimper

May 24, 2012

Multiple Pages
Going out With a Bang Instead of a Whimper

As I was stuck in New York’s Pennsylvania Station (“lead us not into Penn Station…”) waiting for a commuter train home and mooching vaguely around in the news outlet, the May 28 issue of New York magazine caught my eye.

Michael Wolff’s cover story concerns his aged and incapable mother living a semi-vegetable life in a “care facility.” The cover shows a 1950-ish photograph of a good-looking woman. It is captioned, in successively smaller print:

Mom, I Love You.

I Also Wish You Were Dead.

And I expect you do, too.

The article is a plea for what, depending on your metaphysical inclinations, you might call “death with dignity,” “euthanasia,” or “state-sanctioned killing of the helpless old.”

I bought the magazine to read on the train going home.

New York magazine is an unlikely purchase for me—it’s a lefty-metrosexual-fashiony thing filled with subject matter of zero interest to me and with advertisements for things I shall never buy. In some cases I do not even understand what’s being sold (“latitude and longitude cufflinks”…wha?). In other cases I actively deplore what’s being sold (“designer children’s wear”—right, let’s get the little tots on the consumerist-fashion treadmill as early as we can). This issue’s “Intelligencer” page featured an array of 36 celebrities. The only one I’d ever heard of was Angela Lansbury. I think the last time I bought an issue of New York was in some year beginning “197-.” So, no, I’m not a big reader of New York.

“The vast and ever-swelling cost of warehousing helpless, semi-demented old people cannot but become a major political issue.”

I have therefore puzzled over why that particular cover got my attention so successfully. Wolff’s topic is of no pressing personal interest to me. My own parents are long gone: Dad in 1984, aged 85, after a blessedly brief encounter with Alzheimer’s; Mum in 1998, aged 86, after a much more grueling years-long incapacitation by strokes.

I’m no spring chicken—I shall turn 67 next week—but actuarially speaking, I’m a couple of decades away from the horror zone Wolff describes, and thoughts of it do not press on me uncomfortably any more than they did when I was 47 or 27. The Angel of Death has apparently taken an interest in my little suburban log cabin recently; but that’s more in the context of a Blighty One than of the lingering, grisly, stripped-of-all-dignity, suffering geriatric helplessness Wolff describes:

When my mother’s diaper is changed she makes noises of harrowing despair—for a time, before she lost all language, you could if you concentrated make out what she was saying, repeated over and over and over again: “It’s a violation. It’s a violation. It’s a violation.”

I am a somewhat death-haunted person—not an especially uncommon personality quirk, certainly not among the English. I can remember how in early childhood I used to scandalize adults by asking them what it’s like to be dead. (One dry old uncle: “Quiet, very quiet.”) My attention is naturally snagged by stories of the various kinds of journey from this place to the other.

Wolff is writing about his mother’s journey, one that is unbearably gruesome to contemplate, intolerably prolonged, but more and more commonplace.

His article comes with a longer-than-usual comment thread, which does not surprise me. My occasional postings on this theme have always drawn numerous comments. People have strong opinions about this.

In that New York comment thread are some interesting points Wolff missed. Try this for cynicism:

Dementia Care is the new hot product on Wall Street. Far less risky that regular commercial real estate, because it’s not subject to the whims of the market. Less risky than regular residential, because the residents can’t really leave, and because their bills are paid using guaranteed money from the government. It is really a brilliant product.

Cynical as that is, I bet there’s something to it. Wolff covers in detail the fact that the vast and ever-swelling cost of warehousing helpless, semi-demented old people cannot but become a major political issue. We are heading for an almighty, steel-plate-grinding collision between traditional humanitarian ideals and fiscal possibility.

For most of us, the recurring question is: How do I avoid this fate? How do I prevent this from happening to me?

Michael Wolff gives his answer in a closing paragraph:

Meanwhile, since, like my mother, I can’t count on someone putting a pillow over my head, I’ll be trying to work out the timing and details of a do-it-yourself exit strategy. As should we all.

Perhaps we should, but given the human inclination to hope against hope—”I can’t go on. I’ll go on…”—and the possibility of a stroke or accident that deprives you even of the power of suicide, I doubt that do-it-yourself exit strategies, even if widely popularized, will move the numbers much.

Legalized euthanasia doesn’t necessarily help cases such as Mrs. Wolff’s. A report on jurisdictions where it is allowed notes that:

It appears that in “boundary cases”, such as suffering in the case of early dementia or existential suffering, there is more variance between physicians’ and patients’ perception of whether such suffering could be considered unbearable.

So there’s still some damn doctor making the decision.

The conditions endured by Mrs. Wolff and the millions like her are unconscionably cruel. The associated costs, as the numbers grow and the life-prolonging techniques multiply, will be unsustainable. Yet our inhibitions against killing remain strong, and our litigation-whipped medical profession is extremely unlikely to take a lead on the issue.

In Brave New World, as I recall, everyone lives into their early sixties, then swiftly declines and dies. That seems to me ideal if the necessary genomic tinkering can be done.

Until it is, sauve qui peut. I have a good selection of guns and have made up my mind that if it comes to diapers, I shall see myself out with a gun. I will not wear diapers—that’s the end point for me, the milestone I am determined not to pass.

I promise not to make too much of a mess. Heart, not head—like Flory in Burmese Days—and outdoors if I can make it: ideally a nice hillside in the Poconos, watching the sun go down, with a good cigar and some decent bourbon for company. But I will not wear diapers.


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