Occam's Razor

The inescapable implication of being alive is that you will die. Most of us accept our mortality in a kind of abstract way. We are aware of it but choose not to dwell on it. Fortunately, life offers us plenty of reasons to ignore it. For most of us, simply surviving is a full time struggle. Contemplating your eventual death is easier to ignore when you are young but less so as you age.

Retirement is one way I grapple indirectly with death. I am fortunate enough to be able to retire this year at age 55 if I choose to do so. I coped with this fact by assuming I would pick up some other job. It so happened that an instructor position opened up at the community college where I teach as an adjunct. However, when they finally offered me an interview, I turned them down. I had my reasons but one of them was that I wasn’t ready to kiss a demanding but enjoyable full time job I love goodbye, at least not quite yet. Retiring, even if it is to another job, made me feel old. Being employed and well moneyed makes me feel needed and validated.

A terminal illness should make you confront your mortality at last. My mother in law was diagnosed as terminally ill last week. She has stage-four lung cancer and her prognosis is four to 6 more months of living. There is some hope that a $6000 pill might extend her life another year, but its success rate is marginal. Operating is out of the question. Her heart is operating at twenty percent of normal and she had part of her left lung removed a few years ago in a previous attempt to get rid of lung cancer.  She still gets around but now needs supplemental oxygen day and night. Her blood oxygen levels are now so low that she will need a blood transfusion this week.

She seemed to have an inkling that the biopsy would give her this terminal news. Even without the lung cancer, her life is precarious because of her heart disease. A combination of factors that come with age and poor choices earlier in life (like smoking) have caught up with her. However, she has managed to live into her eighties. Given her health history, this in itself is remarkable.

Long time readers know that I lost my mother in 2005, but spent about five years witnessing her decline. The whole experience was wrenching for me, my family and of course my mother. (Her eulogy however has proven to be immortal, since six years later it is my most frequently read post, averaging about thirty five page views per day.) Now I get to watch the process indirectly and somewhat more dispassionately, as she is my wife’s mother, not mine and she lives two thousand miles away instead of thirty miles away.

My wife is discovering that it makes a difference when your own parent is the one who is dying. To say the least she is distressed and feels pulled many ways. Should she immediately fly to Phoenix where her mother lives? What would she do there that is not already being done? For now she has the lifeline of the telephone, an imperfect way of communicating concern, until she figures out an optimal time to fly across the country to see her. So far they have not really talked about the elephant in the room.

What can you really say to someone who is dying that does any good? There is really nothing you can say or do that will change the fact that her death is staring her in the face. You can say you love her, which is undeniably true, but love by itself is not strong enough to repel death. You ache with all your heart to take this millstone off her neck, but there is no way to do so. You want to be a positive presence in her life but at the same time you are wracked with turmoil. It’s useless to pretend otherwise, but some amount of pretense seems to be required in order to keep you from becoming a weeping, sobbing mess. If you are brave enough, particularly in their last weeks, you hover by their deathbed as they slowly slip from this world and maybe hold their hand and stroke their forehead as they pass.

That comes at the very end. Meanwhile there are months of a slow decline, with small triumphs and setbacks. The whole family stays on edge. Tempers are likely to flair; this is our mother we are talking about. And yet there are conversations that need to happen. Is there a living will? Has Power of Attorney been granted? Where does she want to be buried? Is she okay with cremation? It seems uncharitable to bring up these topics, but they really need to be discussed. The American way of dying is often laborious and filled with paperwork.

My wife won’t go alone to Phoenix, at least not for all of her visits. I plan to visit at least once, likely as she moves closer to death. Just as my wife’s perspective of my mother was vastly different than my own, so is my perspective of my mother in law different than my wife’s. To me, she was mostly a kind-hearted sweetheart, deserving of my love and respect. From the day of our marriage I called her “Mom”, for she became an honorary mother in my life as well as something of a substitute mother after my own mother died. I enjoyed calling her on Mothers Day, and chatting with her on the phone and even sending her cards on birthdays and holidays, particularly after my mother was gone. It was easy to do and heartfelt. Before she dies she certainly deserves to hear from my own mouth my love for her, and my appreciation for having her in my life. To the extent she wants me and I have time available, I can be near her and simply listen to her. My role may be invaluable, because I do not come with the baggage of a biological relationship. I can serve as an independent reference of her self worth and validate her existence on this planet. In short, I can act sort of as a minister and will be glad to do so. And should she want to confess her fears and failures to me, I will be glad to listen with an open heart.

My own mother departed this world with some baggage not resolved between us. She alluded to it before she died but we never quite had the conversation we should have had. We all must meet death, but death must be a little sweeter and easier to endure if your heart is not troubled by sorrow for past mistakes.

In the end, helping her reach this stage honestly is probably the best use of my time, and hers.