With Open Eyes

Be utterly humble
And you will maintain your inner peace.
Be at one with all living things which,
Having arisen and flourished,
Return to the stillness they came from,
Like a healthy and vigorous plant
Falling back to its root in winter.
Quiet acceptance of this return
Is criticized by some as "fatalism".
But fatalism is an acceptance of mortality,
And to accept mortality is to face life with open eyes.
To deny mortality is to face death blindfolded.

Lao-Tsu

Last night, with my stuffy nose and a huge fever blister in the middle of my upper lip that makes me look like a pipping chick, I watched a PBS program on the problems society (and families) face as we are able to prolong life to greater and greater lengths. Living to be 100 is not so uncommon anymore, but few do it without serious decline of their physical and mental abilities.

There comes a time when life itself is a burden. Wracked by intractable pain, unable to participate in life in any meaningful way, medicine and families fight to keep elders alive who want nothing more than release.

I remember some 30 years ago, when a friend of my parents was struck with some illness that left her body a mindless shell. She existed in the twilight zone of a hospital room, kept alive by tube-feedings, and a breathing machine. Mom and Dad were in their 70s, and what they saw terrified them.

"Don't do that to us!" they pled. "Let us go should something like that happen to us."

When Mother broke her hip at 78 she had successful surgery, and appeared to be recovering, but died from a massive coronary a few days later. About 20 minutes before her heart attack she called the nurse and asked her to adjust the IV lines so that she could cross her hands over her breast.

"Why do you want to lie like that?" the nurse asked her. "That's the way they lay people out after they've died."

"Because I'm going home now." Mom answered.

The nurse ran from the bedside and called my brother. She told him to get Dad and come to the hospital immediately, as mother's death was imminent. They arrived as Mom was being taken to the ICU. The doctor told Dad he might be able to keep her alive with aggressive treatment, but he couldn't guarantee that her brain had survived intact, or what her quality of life would be. Dad asked that she be made comfortable, and be allowed to pass without being subjected to aggressive and invasive treatment. She died within the hour.

Medicine looks at death as the enemy, and so it should in people who are still productive and capable of enjoying life. But death is not the enemy when your body fails you and your only experience is pain. Then death can be a blessed release, a "falling back on the root" for a winter's season.

No one wants to die, even when they are 90, but death comes to all of us, and it's better to make your peace with your own mortality. Doing so sharpens and sweetens your days.

No one can prepare for every situation but make certain your doctors and your loved ones know how you want to be treated at the end of life, whether it's to be kept alive as long as possible, by any means available, or it is to be made comfortable and be allowed to die without the application of heroic measures. I am firmly in the "quality" measurement camp. If my life becomes a burden to myself and others I want to be allowed to face death, open-eyed.