Let's talk about dying ...just shoot me is not a plan

According to a 2014 Dying with Dignity Ipsos-Reid Survey, 84% of Canadians agree “a doctor should be able to help someone end their life if the person is a competent adult who is terminally ill, suffering unbearably and repeatedly asks for assistance to die”.  While the push to legalize physician-assisted suicide has Canadians passionately debating the right to die and what it means to die with dignity, the debate has had little effect in motivating those who are healthy to prepare for their own eventual date with the Grim Reaper.

We communicate our fear of dying in subconscious ways

Research indicates that most people are fearful of suffering during the dying process. I think we communicate this fear subconsciously through actions that let us believe we can cheat death. These actions are not necessarily bad for us, and may even motivate us to continue living life to our fullest, but they do nothing to ease the way into death or make our dying easier for those we love.

One way we may communicate our fear of dying is to pretend that we are not getting older, obsessing over aging, or jealously guarding our independence, symbolized in our reluctance to surrender our driver’s license, or downsize our home.

We avoid taking practical steps to make our death and dying easier for others. Only 56% of adult Canadians have a signed will, and less than 29% have appointed a power of attorney; fewer have designated a substitute decision-maker for personal care and health matters.  We are highly unlikely to preplan our funeral, even though 75% of us believe doing so would make things easier for our family.

Even our spiritual preparation for death can be limited to our last days when our families seek out the priest to hear our deathbed confession and administer the last rites. 

We think we have lots of time to prepare ourselves to meet our maker and to get our affairs in order, even though death is the one certainty in life and the Grim Reaper lurks in the shadows.

Creating an Advanced Care Plan

The Canadian Hospice Palliative Care Association, partly in response to the public discussion about euthanasia and physician-assisted suicide, wants to shift the public conversation towards the importance of quality hospice palliative care and away from some of the more negative views of death, which, in my view, have played a significant role in shaping Canadian support for physician-assisted suicide. The organization has a suggestion that can help us prepare for our own death and dying.

It recommends that we start talking about end-of-life issues with our family, friends and health-care providers, and suggests that individuals create an Advanced Care Plan (ACP) that will provide direction for our care when the time comes. An ACP can guide us in articulating our personal beliefs and values, and can help us clarify our own attitude about dying and what constitutes a good death. It gets the discussion moving about the types of medical interventions that we would accept or reject if faced with a chronic illness, or a life-threatening illness or injury. And, it provides information on the legal requirements and documents that will enable others to act on our behalf.  An ACP is not a sign-up sheet for physician-assisted suicide or euthanasia; it is a comprehensive plan that can help us live out our life until its natural end.

While the public discourse has Canadians talking about the death and dying of a small minority, most of us skirt around the topic of our own mortality. We avoid planning for that unavoidable dance with the Grim Reaper.

The Grim Reaper can be a motivating image

The Grim Reaper, incidentally, became embedded in the European psyche during the bubonic plague of the 14^th century, when no one could forget the reality of death. It was sometimes depicted in an embrace with a young woman to symbolize that death is an integral part of life. Rather than frighten us, it is an image that can remind us to live well, to never give up on the journey towards wholeness and holiness, and to follow confidently in the footsteps of Jesus who embraced the world from the cross and shows us the way through suffering.

The conversations I have with others about death are largely superficial because the topic can become morbid and depressing. We talk about avoiding suffering, and we would prefer to die in our sleep after a long, healthy and happy life. And, should we become decrepit or senile, we joke about telling our kids to “just shoot me”, which really is not much of a plan when it comes to preparing for death and dying.

"Lest we forget"

"It may be more accurate to say, “Lest we block it out” when we speak of the necessity of remembering..." 

By chance, I met a Holocaust survivor

I met a Holocaust survivor on a warm August day in Chamonix, France as we were doing the tourist thing, wandering about in the shadow of Mont Blanc, and searching for a place to eat.

We finally decided upon a bustling café that had a large outdoor terrace. As my mother took her seat amongst the cramped tables, she accidentally knocked her fork onto the ground A soft-spoken older gentleman at the table beside us reached down to pick it up, politely suggesting that she might like to ask the server for a clean one.  A conversation ensued. 

We learned that the man lived in Paris, and was visiting Chamonix with his grandson, who had taken the gondola up one of the mountains.  As the conversation progressed, we learned that the man was Polish. Two years before the end of World War II, the Nazis had imprisoned him in a concentration camp. He was fourteen years old at the time. Of the twenty-nine members of his family sent to the death camp, only he and his father survived.  He mentioned this horrific period of his life in passing.  Seventy years later, the power of the memory caused his eyes to fill with tears, and he fell silent, lost for a moment in the past.

"Jewish families with bundles of belongings during deportation from the Kovno ghetto to Riga in neighboring Latvia. Kovno, Lithuania, 1942."

Photo Source: US Holocaust Memorial Museum

http://www.ushmm.org/wlc/en/media_ph.php?MediaId=1883

Some memories never heal

When I think about this gentle man, wearing a long sleeved shirt on a warm August day, perhaps to conceal a number tattooed into his flesh, my mind wanders to the past, to a dark period in human history that I had previously encountered only in books and film. Then, with a jolt, my mind returns to the present, and I think of the son of a friend, who served as a peacekeeper in Kosovo and did duty in Afghanistan, and whose experiences in those places have changed him and his family forever.

I think of the gentle souls, for whom some memories will never heal, and I wonder at the words “lest we forget”, that, here in Canada, we associate with red poppies and the act of remembrance.  For, as my chance encounter with the man at Chamonix illustrates, war is impossible to forget for those who live through it. It may be more accurate to say, “Lest we block it out” when we speak of the necessity of remembering and the importance of passing down those stories that can orient our hearts towards peace.

“Lest we forget” makes me think of an old veteran that I once saw interviewed around Remembrance Day. For the first time in his life, he spoke about his wartime experience. He broke down on national television as he expressed his feelings of guilt for having survived when most of his comrades had died.  He must have spent a lifetime trying to forget; and although he had tried to block the experience, it hovered over his life threatening to destroy the normalcy he feigned.

There was a time when society expected this old veteran, like so many others, to block the bad memories, when being a man meant ignoring the trauma and getting on with life. Today, we recognize post-traumatic stress disorder, and we are learning that unhealed memoires can reoccur at the most unexpected times and at the slightest provocation – a sight, a sound, a smell, or even a chance encounter with strangers at a café.

The broad strokes of man's inhumanity to man are layered with detail

On Remembrance Day, I will stand with others at the cenotaph, not because there is any danger of forgetting, but because it is important to remember. The broad strokes of man's inhumanity to man are layered with detail. As I stand in silence remembering, I will see, on the canvas of war, a gentle man who bent down to pick up a fork, and touched our hearts that day in Chamonix.