The Distinguished Thing: A Colloquy

1. Although my Grandma made it to ninety-eight, and I have her body—long arms, weak stomach, ornery hair—lately, I’ve been thinking about Mortality.

2. I saw each of my parents die.

3. I’m already eight years ahead of the global average life-span of sixty-seven.  During those average sixty-seven years, the heart beats an average three billion beats, the lungs expand an average half a billion breaths, and the eyes blink an average 500 million blinks.  Such richesse! 

4. And yet, We live the time that a match flickers—Robert Louis Stevenson, who knew what he was talking about, living his entire life in 44 years.

5. There’s also a richesse of ways to die. Heart disease and strokes, the perennial one-two favorites, but also death by hippo—100 to 300 people a year in Africa, or death by coconut bonking of the head—2.5% of all deaths in Papua, New Guinea. Closer to home, by vending machine—37 a year in the US, or perhaps cruelest of all, by chocolate—not the dessert—the falling into a vat of, as did Vincent Smith II in 2009.  

6. My father died a nine-month death of lung cancer, my mother a six-month death of brain cancer.  He was 69, she 78.

7. Nearly everyone is afraid of death.  The thought of non-existence—Keats: When I have fears that I may cease to be— and death is usually described as a bad actor, a snatcher, a kidnapper, the ultimate serial killer.  Only Henry James called death the distinguished thing.

8. Fear of death, however, is lop-sided, a problem identified by Lucretius as “temporal asymmetry” and irrational since death is the mirror half of the time before birth, the “prior abyss.”

9. Nabokov, appreciating Lucretius’ metaphor: The cradle rocks above an abyss, and common sense tells us that our existence is but a brief crack of light between two identities of darkness.  Who dreads the time before they existed? Who does that?

10. Both of my parents knew they were dying, were terrified, and could not speak of it.

11. Paul Zweig, on hearing the news he had cancer, felt like someone who had been thrown against an electric fence.

12. We had an electric fence at home around the horse pasture. My dad often took what he called his “constitutional” after supper.  One night he came back looking both sheepish and startled, having peed on the electric fence.

13. One part of the fear of being dead is the fear of not being really dead.

14. Lear regarding Cordelia: Lend me a looking glass; if that her breath will mist or stain the stone, why then she lives.

15. Jacques Benigne Winslow, twice mistakenly declared dead as a child and twice waking up in a coffin, became an anatomist, understandably obsessed with finding a foolproof method to diagnose death.  In 1746 he declared the uncertainty of the signs of death and the danger of “Precipitate Internments and Dissections,” insisting that putrefaction was the only sure sign of death, breathing or not.

16. When my father died the first time, he was in his brown recliner watching Wheel of Fortune.  I had just said, Vanna’s looking good tonight, and he had just said, Yeah, looking good, when he hiccupped and stopped breathing.

17. In 1959 two French neurologists, Pierre Molleret and Maurice Goulon made a further attempt to definitively define death’s criteria: a) individual not able to breathe independently. b) no normal reflexes c) very low blood pressure d) loss of control over urine output e) flat EEG.  They called it a state beyond coma—le coma depose—proving even death sounds better in French.

18. When I lifted my six-foot father from the recliner, his scrawny body felt like a long bundle of kindling.

19. In 1968 Harvard weighed in with its death definition, the Harvard Criteria, which added to le coma depose that the individual must demonstrate no spontaneous muscle movement and must meet the criteria twice in 24 hours.

20. In 1981 the Presidential Commission for Study of Ethical Problems in Medicine, Biomedical and Behavioral Research, under pressure because of organ procurement issues, said pretty much the same thing.

21. In 2008 another presidential commission added that the “innate drive to interact with the environment must be missing” and came suspiciously close to suggesting the existence of a soul.

22. I forgot my father had dentures.  I told the EMTs I wasn’t sure I had an airway.  The compressions felt like crunching little branches giving way again and again.

23. Months later my mother said, You shouldn’t have done that CPR.

24. Probably, she was right.

25. He lingered four days.

26. One strategy to deal with the problem of defining death is to pose its opposite—what is life?  Stevenson had little patience for such metaphysical musing and said rather crankily, There is not a man on earth who has flown so high into abstraction as to have any practical guess at the meaning of the word life…philosophy has the honor of laying before us, with modest pride, her contribution toward the subject: that life is a Permanent Possibility of Sensation. Truly a fine result! A man may very well love beef, or hunting, or a woman; but surely, surely, not a Permanent Possibility of Sensation.

27. The end of my father’s life was a slow fade, a weakening fatigue, a slipping unto death.

28. The end of my mother’s life was operatic. The glioblastoma that invaded her brain was like the screw-worm larva that invades and devours the flesh of cattle.  As soon as it hatches, the larva burrows perpendicular—like a screw—and eats as it goes.  

29. Unlike the screw-worm larva, a glioblastoma doesn’t eventually drop out and move on to pupate. Instead, the ravenous tumor grew bigger and ever more larcenous, stealing first her memory, then her personality, replacing it with a hostility that was itself ravenous.  I don’t have to listen to you, she told her beloved Jim whom she raised from age 8, you’re just a half-brother. When I went to visit her, she greeted me with I should have kicked your ass out long ago.  

30. Well, actually, she had, but that’s another story.

31. At the end, mobility went, then speech. It became harder and harder to know when or if she was in pain.  Swallowing difficult, she ate less and less as the final wasting set in.  As if she were time-traveling backwards, her face grew thin and fine-boned as the girl she was in her pictures before marriage and babies.  

32. Then she refused to eat at all. An IV kept her hydrated.  The nurses asked to meet with me to discuss “discontinuance of hydration.” I suspected they wanted to speed things up before the next shift took over. 

33. I told them I would have to think about it.

34. There was no water in the chicken-coop I used as a stable for the horse I had as a girl.  I hauled the water in five-gallon pails twice a day from the house.  One night I forgot to do it.  Shame on you, my mother said, shame on you.

35. The nurses countered by saying there was good evidence continued hydration during the “end stage” put pressure on the brain, probably causing “significant pain.”

36. I told them to take out the IV.

37. One strategy for dealing with death’s reality is simple avoidance.  In 1665, Pepys, worried about his own smell after seeing houses marked with red crosses—the sign of the plague—hurried to buy some roll tobacco to smell and chaw, which took away the apprehension.

38. I went back to her house, walked the dog and went to sleep.  

39. Then I got up, walked the dog and went back to her bedside.

40. The nurses said, She’s brain stem breathing. She waited for you. 

41. I smoothed out the afghan on her bed, the brown and orange one Sonia crocheted for her, sat down on the bed, held her hand.

42. Supposedly, hearing is the last sense to go.

43. I did not know what to say.

44. Then I lied and said she was safe and not alone.

45. The rest of the time I said names. Sometimes I repeated the same ones.

46. Names of people she loved: Donald, Herman, Tomas, Alvina, Sonia, Jim, Adeline, Jesse, Miriam, David, Tom, Donald, Diane….

47. Some were living, some not.  

 

—previously published in the Mississippi Review, 2018—