The Devil MAID me do it…
This article first appeared in the Minden Times on February 15, 2023.
I think about death quite a bit these days. I find myself comparing deaths in much the same way as, in earlier days, we considered the choices people made about getting married: what kind of event was it? a quiet ceremony in an officiant’s office? A week-or-longer series of lead-up events that collectively involved a cast of hundreds and culminated in a blow-out extravaganza? An intimate and tasteful affair at an exotic location? A friends-and-family get-together that involved food, drink and a full range of reminiscences?
I’m not talking about the funerals or Celebrations of Life; I’m talking about the actual passage through the portal from life to what comes after. Because that’s what will be in my experience – the follow-up social event is for those left behind. I’m thinking and talking about it because I would like to have a Good Death for myself, but also for those I love.
So what’s a Good Death? Well, that’s the question, isn’t it? And the follow-up question is What can I do about it?
We’re probably all in agreement is that a Good Death is waking up dead the morning after completing a lovely, lively life, hopefully as a reasonably attractive corpse, not too messed up by the transition. I’d choose a massive one-time heart attack if it were on the menu: a widow-maker, they used to call that, because it was unexpected and couldn’t have had a different outcome even if any of the interventions we have come to expect to stave off death had been applied. For the left-behind, no guilt, no prolonged self-castigation about coulda-shoulda-woulda. Perhaps a Didion-type Year of Magical Thinking grieving following.
I’m much more encyclopedic about the death I do not want. I do not want a long runway that engages the full panoply of medicine and slowly chews at the lives of those who care for me. Once I realize my party is over, I want to get my coat and hat, give my thanks and say my goodbyes, and take my leave. Hmm, that sounds like Medical Assistance in Dying, MAID. Such an interesting acronym; I imagine an impeccably-mannered servant wearing a sky blue uniform with a starched white apron, presenting a work-of-art cocktail at a tasteful event at which my nearest and dearest chat intelligently and amiably with each other in my presence, practicing for my absence.
The worm in the bud, of course, the thing that may deform this beautiful blossom, is figuring out when the party is over. If I’m lucky, there’ll be a proficient and charming bar-tender with an endearing accent announcing “Time, gentlemen (I’ll forgive the genderism), please”, and I’ll finish my drink, gather what I brought with me and head out the door into a friendly and familiar night.
But what if, by then, I’m deep in my cups and can’t comprehend what he’s saying? What if I get argumentative and they need to call the bouncer and escort me out, fussing and fuming and threatening to defend my rights in the highest court in the land? What if they summarily chuck me out the door, kick me to the curb, dump me in the ditch?
I guess the best prevention for that happening is a) never lose control of your ability to comprehend your world (oh, wait, an ever-increasing segment of what makes the world go ‘round is incomprehensible to me – starting with cryptocurrency, the metaverse, even Microsoft’s newest improvement to Word, Hydro’s new billing format, and filing my taxes electronically)… and b) don’t go drinking alone. That, now, is within my ambit. If it takes a village to raise a child, it similarly takes a village to have a good death. Call it community, inclusion, a sisterhood, friends and neighbours – call it what you will, but don’t leave home without it.
Dr. Blair Bigham’s recent book, Death Interrupted: How Modern Medicine is Complicating the Way We Die, published in 2022, is making a big splash -- obviously he’s hit on the un-MAID side of this very hot topic of having some control over how you die. Bigham’s focus is the extent to which life should be prolonged when death is inevitable. Plus the underlying issue of who gets to make that decision. And ethical and humanistic concerns about taking the medical maxim of doing all that can be done to preserve life to the extent that modern medicine makes scientifically possible. Docs can do it: should they? That’s the question Bigham, a doctor who comes to the career by way of being a paramedic, explores: what’s the right way to think about and manage ‘…the grey zone caused by the ever-expanding suite of technological and pharmaceutical choices available to doctors that delay a person from being dead dead (that’s not a typo) but might do little to restore life.’
I once sat with a daughter as she gave the nod to unplugging her baby from life support, and held her while her heart slowed and the warmth seeped out of her. It was perhaps the saddest moment of my life. Sadder than having the babe be acknowledged as dead when she emerged into the world? I can’t know. But I do know unplugging life support is certainly not something I want anyone who loves me to do for me. If I’m not ended by one fell blow from the heavens, I want significant input into how I go. Ding Ding, that’s me calling the MAID.
