Tuesday, May 7, 2013

The End Game

Knowing people’s ages has always been of interest to me.  Early on it was a question of knowing what a person could do at any certain age.  How old do you need to be before you can do that?  Whenever I went to a baseball game I checked the ages of all of the players in my score card; I recall that Wayne “Red” Garrett (third base) of the Mets was the first player that I ever saw play a major league baseball game that was younger than me at the time.  I felt like I had reached a milestone.

This checking of ages changed character as I got older.  By now it’s more of a question of cataloging the ages at which certain things move from being statistically conceivable to something much more likely.  Things like strokes; Parkinson’s disease; hip replacements; heart attacks; various cancers; Lou Gehrig’s disease; and the very considerable “etc” of such things.  These things begin to seem almost inevitable at some point if we are lucky enough to live through our reckless and accident prone early years. 

So we begin to wonder: how old was that stroke victim?  A lot older than we are, it is to be hoped.  We are seeking evidence that we have a few good years left in us.  If the math is right it provides us, at best, with a false hope, but even a false hope is some comfort.  Many of us begin to check the obituaries with greater interest as time goes on.  For those poor souls, the record has been cut in stone, and we seek whatever statistical comfort that we may find. 

I was interested in the process of getting older even before I knew about getting old.  I’m so old now that I am becoming curious about the direction that all of this mess is pointing to. 

The Process Of Dying  

I have always counseled that we do not die all at once.  Dying is a process that for most of us begins around the age of forty.  Prior to age forty (or so) we are on the flood tide, strong muscles, strong immune systems, it’s all systems go, you might as well smoke cigarettes.  After forty everything begins to wear out, slowly at first, almost imperceptibly if we are lucky.  You may begin to notice little things.  I recall the first time I ran up some stairs and felt my jowls move up and down.  I was about forty-four.  Now, of course, the idea of running up stairs is itself out of the question.  You’d hear my knees go “pop” a mile away. 

By age fifty, the message is clear, something is happening.  For a fifty year old, even playing a game of soft ball is a challenge.  For purposes of this essay, I’m going to leave it at the mention of soft ball.  To discuss the effects of aging on sexual function would be too depressing. 

When I was about fifty a lawyer friend of mine turned thirty-eight, and he was not happy about it.  He felt old.  I told him that he was actually quite young, and that he should enjoy it while he could.  “I’d pay good money to be thirty-eight again for just one weekend,” I said. 

The End Game

The game becomes very one-sided at the end.  The team in the black uniforms always wins.  It’s like a game of Three Card Monte, in the end we all realize that there is no queen to be found.  

Not all end games are the same.  Consider chess.  For some the end comes suddenly, with complete surprise, like that fellow who lost “The Great Game” to Paul Morphy.  He never saw what hit him.  For others, it’s more like a bishop and a knight chasing a king around the board for dozens of moves.  The process can be inevitable and yet strangely interminable. 

Some of us are definitely luckier than others, and this is not the kind of luck that you can manufacture in advance, although many people try.  Poor Andy Kaufman was very careful in life, no smoking, no drinking, he ate only health foods.  Struck down, he was, by lung cancer at about thirty-eight.  Those cancer deaths can really stretch out too, not very lucky at all, and no return on Andy’s investment. 

My Aunt Mary, on the other hand, had the greatest result possible, the Royal Flush in Spades of end life possibilities, and almost as rare as that poker hand.  The end came when she was eighty-five, an unanticipated heart attack in her sleep.  If she suffered momentary distress there was no evidence of it.  Very lucky indeed, healthy to the end (in a manner of speaking).  She had never done anything to invest in this result either, hers had never been a life of forbearance.   She was a fan of cruises right up to the end.  One time I asked her if she was afraid to come down with one of the strange maladies that seemed like frequent problems on cruises.  “Oh no,” she said, “not me, I never drink anything but scotch.”  She figured that the problem was the water, and she took the W.C. Fields approach to drinking water.  (“I’m thirsty, not dirty.”)

The Reason I Bring This Up

As I sit here today, all of this is much on my mind.  A close friend of mine is in the final stages of dying from breast cancer.  She’s only fifty, and she felt that first telltale lump eight years ago. 

She has always been a tough woman in many ways.  She had three older brothers growing up, and she mostly played with the boys of the neighborhood.  She played games with them, she climbed trees with them, and she fought with all of them too.  She was always a strong, athletic and very attractive girl.  She's very tough minded, even now she has a will to live that you can easily see from a distance.

This month will probably be it, and it’s definitely safe to cross her off the Christmas card list.  It’s terrible to see.  I’ve never been this close to the process before.  This time I’m on the caretaker team.  My job allows me some time to do good deeds, although I rarely avail myself.  This time it’s personal, so I’m on the team.  She’s at home, hospice care and nursing homes are very rare and very, very expensive in Thailand.  It’s more of a die-at-home kind of place.  So I’m learning things.

When the default position of the patient’s eyes is rolled back in the head; when the eyes begin to lose their focus and their shine; when they begin to operate independently of one another; these are very bad signs.  When the patient’s voice becomes the faintest croak bearing little or no indication of the words that were intended, that is a bad sign.  There are many other physical signs that I could mention, but I won’t right now, as a matter of delicacy.  Let’s afford the woman some dignity. 

Did I say “tough minded?”  She was beginning to suspect that she wouldn’t live out the month so she told her family to schedule her funeral about a week from now, WHILE SHE IS STILL ALIVE.  She has arranged to have her body donated to the teaching hospital of Chulalongkorn University.  She wants them to get it immediately upon her death, so everything is fresh.  She’s afraid that most of it is kind of a wreck by now, but maybe somebody is out there waiting for her corneas.

Three Cheers

So let’s hear it for my brave friend.  Three cheers and a fair-thee-well.  We’ll all be joining you soon, sweetie, but not too soon I hope.  “For whom the bell tolls,” indeed.  My friends, you may be sure that when we cry at funerals , we cry for ourselves. 

“It tolls for thee.”   

1 comment:

marc aurel said...

Ever since I first heard George Harrison singing "The Art of Dying", I have been intrigued by the process of my last moments. Later I became a sort of fringe Buddhist and now I am certain that I want to die fully conscious, holding on to active awareness of everything leading up to death. I sometimes practice this as I fall asleep.