Death by Choice

FeaturedDeath by Choice

What’s a crucifix doing on the wall?

The nurse told me I was in a Catholic hospital. I could have figured that out. I checked into Amita Health Saint Joseph, after all. I assumed Amita appropriated the name for brand continuity. Ok, it’s Catholic, but do they have to display a crucifix on my wall?

A friend came by and said there’s a cross on the wall. 

“That’s a crucifix, not a cross, “ I said.

She shrugged as if it makes no difference. But maybe she just didn’t know the difference. 

“It’s a Catholic hospital,” I said, “only Catholics hang crucifixes. Protestants hang crosses.”

“What’s the difference?” she asked. 

In the late afternoon, the overhead fluorescent from the hallway shed enough light on the crucifix for me to see it from my bed. I said a few words.

Thank you god for replacing my decaying hip with a shiny new titanium rod and ball and clean ceramic joint. 

He didn’t answer. That’s ok. He never does. Specificity was key in my gratitude. I needed to state out loud exactly what just happened to me, to visualize the medical miracle of supplanting the largest joint in my body. 

Jesus’ body hanging there with nails through his wrists and in his crossed feet started to take on a living drama. The nerve block and painkillers from my surgery were wearing off. We were in agony together. I fumbled through the sheets for the control button and banged on it to call a nurse. 

She came. Later than I’d hoped.

“I’m in a lotta pain,” I cried out.

“I have your painkiller. Oh look, your ice pack slipped to the floor. I’ll refill it. Be right back.”

I looked at Jesus.

How could you bear this? I can’t stand it.

I later opened my eyes to Sister Leticia peering down at me. After introductions and medical pleasantries, she fumbled through a sheaf of papers until she pulled out the Do Not Resuscitate form. 

“I’m here to talk to you about your papers. Do you have one of these?” 

“Oh yeah, I have a POLST.”

“You do?”

She thumbed through her pile and pulled out a blank POLST, “Does it look like this?”

“Yes, I’ve got a copy here in my purse.”

We spread my papers out on the bed—what I’d brought and those accumulated a few hours earlier when I checked into the hospital. 

“There it is!” exclaimed Sister Leticia. She found the holy POLST among Amita brochures and post-op instructions.

POLST stands for PRACTITIONER ORDER FOR LIFE-SUSTAINING TREATMENT. It’s a DNR signed by a doctor and witnessed by a third party. Some say it’s too final, a death warrant. Sister clucked with excitement at the sight of my POLST. She could then forego the talk on the tender subject of medical interventions to save my life if I stopped breathing or slipped into unconsciousness. 

Sister Leticia ducked out of sight before I could ask if she, as a Catholic, approves of my choice about my body.

I looked at Jesus. 

He seemed ok with it.

Fear of Dying Without Dignity

Fear of Dying Without Dignity

The facilitator outlined the steps to execute a health care power-of-attorney, letting us know every state is different. I knew we were about to go off the rails when a class member asked about Florida laws. We were in Chicago. But the real turning point came when a woman announced her parents died of Alzheimer’s.

”I just want to know where to get the pills” she said, “and how will I know when to take them?”

She was talking about suicide.

I’ve been schooled on end-of-life living wills, advance directives and “practitioner orders for life-sustaining treatment” (POLST). These documents allow us to describe our wishes POLSTat the end, and to designate someone to decide medical treatment when we can’t speak for ourselves. All my papers are in order. For all the Death Cafes, Journey Care and Compassion & Choice discussion groups I’ve attended, never have I been in a roomful of people who turned the conversation so fast and openly to how and when to commit hari-kari before they couldn’t speak for themselves.

The Conversation Project® is yet another public engagement initiative with a goal to have every person’s wishes for end-of-life care expressed and respected. Representatives from the Project don’t come armed with facts on assisted-suicide, or how to identify that one perfect moment before you lose your marbles completely. They do, however, listen. And in my group, person after person expressed fear of not being able to off themselves in time.

One man told us he holds the health care power-of-attorney for his mother, that her instructions are explicit, but he can’t bring himself to pull the plug.

“I’m afraid my siblings will all get mad at me,” he said.

Everyone gasped. It’s what we all fear the most.

I never thought of the possibility that I’d be kept alive beyond my sell-by date. I’m not afraid to die. I’ve thought about it my entire sentient life. Huddled under my first-grade desk waiting for an atomic bomb to drop, I knew I’d be going to heaven to see Jesus (my best friend at the time). What’s to fear? I even tried it out once. I took eighty sleeping pills when I was twenty-four because I knew there was a better place than Point Pleasant Beach, New Jersey, in the cold grey winter.

The idea of my body curling up to a breathing machine and a feeding tube without my consent or knowledge is new. Each and every daybreak now I wake with fear, unable to face the day. I use Anne LaMotte’s simple prayer, “Help me. Help me. Help me,” just to get out of bed.th

On a recent temperate morning I walked Henry on our tree-lined motionless street. A
gust of wind came along suddenly and blew the fall leaves off an overhead honey locust. We stood in a yellow-leafed shower, swaddled in fluorescent care. And the fear of dying without dignity moved off into the gutter for the day.


Death Cafe

Illinois POLST

Conversation Project

Journey Care