Conscious Aging: Figuring It Out

A friend remarked in an email that I seem to have aging figured out — an affirmation that I welcome and appreciate, although I suspect I often look much more confident and coherent than I actually feel. Her comment moved me to wonder how stable what we have figured out is, in the long run. I’m prompted to wonder that because of Minga.

Minga’s kidneys have been failing for several years, and she knew long ago that at a point she’d be told she needed dialysis. She and I had several brutally honest conversations about what she would do in that moment. She said very clearly that she did not want dialysis, did not want to spend time in Panama City getting it, did not fear death, and that she felt at peace knowing her mother and the Virgin Mary would be there to greet her at the moment she died. She had it all figured out, one might say.

Then death moved into her home, into her bed, and surrounded her with its cold arms. She was, she said, very fearful. She wanted to go to the hospital. She wanted help, even if that help meant dialysis. She is willing, now, to spend most of her time at her daughter Ita’s house in the city order to have that 10pm dialysis slot in an urban ambulatory treatment center.

I think we all get to change our minds about anything at any point — that isn’t what causes me to ponder. What I’m wondering is whether we can ever truly anticipate something as momentous as death, and formulate stable plans. Drafting health care directives assumes we can. Minga’s experience suggests we can’t, or that it’s unlikely.

I’d welcome your thoughts.

4 thoughts on “Conscious Aging: Figuring It Out

  1. I think until you’re in the situation you can’t really know. I base this on the experience we went through with my mother about a year and a half ago when she had 4 major heart attacks. We were in the cardiac ICU meeting with the thoracic surgeon and we were all scared. My mother told the surgeon she was not going to consent for the double bypass surgery she needed. I am her health care proxy and if she is incapacitated I have to decide. I evaluated her mental capacity at that moment as she had just survived a fourth major heart attack in a few short days. I looked at her and told her that it was her right to make that choice and we would all live with it if she decided that but we didn’t have to agree and that I wanted her to really understand what she was choosing, that she was choosing to die and she likely wouldn’t live for another week. She was going to miss seeing all of her grandchildren grow up and graduate and get married, possibly great-grandchildren too. I felt like a cad as I was saying all of this to her but at the moment I felt as though, even though she had the capacity to make a decision she didn’t fully understand the gravity of the decision she was making. The surgeon was giving me a look of almost disgust that I would speak to my mother in that manner. She responded indicating that she hadn’t actually thought about it in that manner and no that wasn’t what she wanted, she wanted to live, she wasn’t ready to give up fighting, she wasn’t ready to die and if the bypass surgery was her only hope then she was going to have to be brave and do it as she wasn’t ready to die. The surgeon’s look changed to one of respect with my mother’s response, he had not realized although he had thoroughly explained that to my mother in different terms in her fear she hadn’t heard or comprehended what he had said to us. I think imminent death isn’t actually real until you are actually in that position.

  2. After reading Being Mortal, I decided that if I were diagnosed with something like pancreatic cancer, I would refuse treatment and enjoy the few months I had left. But I also know that maybe when the doctor said those fateful words, I would have a totally different reaction and grasp at every straw. None of us knows until that moment.

  3. for Bryna: This is a powerful and profound comment. I think the reason you were able to break through your mother’s fear of surgery and her feeling that she couldn’t withstand it is your loving relationship with her, which is visible to all and admirable. Speaking as Sheia’s sister-in-law, I think she is a remarkable mother and grandmother. I’m so glad she made the decision to keep fighting and is still with us. I’m glad that you were willing and had the courage to push back on what seemed her final decision. Kudos all around.

  4. for Ada: Yes and yes. I read Being Mortal too, and have always felt that given a really bad prognosis, I’d want to be as comfortable as possible but not try experimental treatments and suffer their dismal side effects — which I’ve seen with too many of my friends. But Minga’s experience is illustrative for me. I think in the moment, it all looks different.

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