Sunday, June 26, 2011

The Inevitable

"Whatsoever thy hand findeth to do, do it with thy might; for there is no work, nor device, nor knowledge, nor wisdom, in the grave, whither thou goest." (Ecclesiastes 9:10)

This is an unpleasant subject. Both of my parents breathed their last in hospitals - my father after a mercifully short skirmish - rather than the usual "long battle" - with cancer; my mother after a massive stroke. I'm sure that the setting of their deaths was not what either of them would've liked. When my father was told by his doctor that his case was terminal, he motioned toward the coat rack, as if to say (he had a feeding tube down his nose and couldn't speak) "take me home." His actual dying moment took rather longer than expected, so his doctor helped him along with a large dose of valium.

George Orwell, whom tuberculosis killed at the age of 46, knew enough about people dying in hospitals to never want to end up there himself:

"As I gazed at the tiny, screwed-up face it struck me that this disgusting piece of refuse, waiting to be carted away and dumped on a slab in the dissecting room, was an example of ‘natural’ death, one of the things you pray for in the Litany. There you are, then, I thought, that's what is waiting for you, twenty, thirty, forty years hence: that is how the lucky ones die, the ones who live to be old. One wants to live, of course, indeed one only stays alive by virtue of the fear of death, but I think now, as I thought then, that it's better to die violently and not too old. People talk about the horrors of war, but what weapon has man invented that even approaches in cruelty some of the commoner diseases? ‘Natural’ death, almost by definition, means something slow, smelly and painful. . . . And it is a great thing to die in your own bed, though it is better still to die in your boots. However great the kindness and the efficiency, in every hospital death there will be some cruel, squalid detail, something perhaps too small to be told but leaving terribly painful memories behind, arising out of the haste, the crowding, the impersonality of a place where every day people are dying among strangers." ("How the Poor Die")

How Orwell would've envied the death of Albert Camus, also at the age of 46, in a car crash. Camus once wrote, "I know nothing more stupid than to die in an automobile accident." Yet, for the father of Absurdism, it was a perfectly absurd way to die. A return rail ticket, which his publisher had persuaded him not to use, was found in his pocket.

The concept of "dying with dignity" has only materialized now that people are living longer, perhaps, than they expected. Modern medicine has made it possible for us to survive our first catastrophic illnesses. Obviously it isn't prolonging life as much as forestalling death. We have even reached the point where life could go on even longer if people didn't place caveats in their medical records against further unwanted resuscitations. The feeling has always been that life under any circumstances is preferable to death. Only people who have endured long and wasting illnesses know that sometimes it is better to let go of life.

I had just showed up for work in a hospital ER in 1996. A woman was being taken upstairs to the ICU. Since the trauma room was next to my desk (I was providing armed security), I was given the woman's purse to secure in a safe. When I examined the contents for inventory, I told my partner that the woman and he had the same last name. He took one look at the purse and immediately recognized it as his mother's. She had gone to the trouble of having a "DNR" placed in her medical records, after having gone through the ordeal of resuscitation twice, and the long recoveries. Somehow, the nurses hadn't seen it in her records. My partner received heartfelt apologies from hospital staff throughout the day for saving his mother's life.

Few writers have confronted dying as an event that they will one day have to face as powerfully and as frighteningly as Philip Larkin. To read his biography, he was terrified by death, and his late (1977) poem "Aubade" certainly bears this out.

I work all day, and get half-drunk at night.
Waking at four to soundless dark, I stare.
In time the curtain-edges will grow light.
Till then I see what's really always there:
Unresting death, a whole day nearer now,
Making all thought impossible but how
And where and when I shall myself die.
Arid interrogation: yet the dread
Of dying, and being dead,
Flashes afresh to hold and horrify.
The mind blanks at the glare. Not in remorse
- The good not done, the love not given, time
Torn off unused - nor wretchedly because
An only life can take so long to climb
Clear of its wrong beginnings, and may never;
But at the total emptiness for ever,
The sure extinction that we travel to
And shall be lost in always. Not to be here,
Not to be anywhere,
And soon; nothing more terrible, nothing more true.

This is a special way of being afraid
No trick dispels. Religion used to try,
That vast, moth-eaten musical brocade
Created to pretend we never die,
And specious stuff that says No rational being
Can fear a thing it will not feel, not seeing
That this is what we fear - no sight, no sound,
No touch or taste or smell, nothing to think with,
Nothing to love or link with,
The anaesthetic from which none come round.

And so it stays just on the edge of vision,
A small, unfocused blur, a standing chill
That slows each impulse down to indecision.
Most things may never happen: this one will,
And realisation of it rages out
In furnace-fear when we are caught without
People or drink. Courage is no good:
It means not scaring others. Being brave
Lets no one off the grave.
Death is no different whined at than withstood.

Slowly light strengthens, and the room takes shape.
It stands plain as a wardrobe, what we know,
Have always known, know that we can't escape,
Yet can't accept. One side will have to go.
Meanwhile telephones crouch, getting ready to ring
In locked-up offices, and all the uncaring
Intricate rented world begins to rouse.
The sky is white as clay, with no sun.
Work has to be done.
Postmen like doctors go from house to house.

The manner of Larkin's death, from esophageal cancer in 1985, aged 63, was awful enough. His last words, to his nurse, were "I am going to the inevitable." From his last collection, High Windows (1974), the poem "The Old Fools" is chilling.

What do they think has happened, the old fools,
To make them like this? Do they somehow suppose
It's more grown-up when your mouth hangs open and drools,
And you keep on pissing yourself, and can't remember
Who called this morning? Or that, if they only chose,
They could alter things back to when they danced all night,
Or went to their wedding, or sloped arms some September?
Or do they fancy there's really been no change,
And they've always behaved as if they were crippled or tight,
Or sat through days of thin continuous dreaming
Watching the light move? If they don't (and they can't), it's strange;
Why aren't they screaming?

At death you break up: the bits that were you
Start speeding away from each other for ever
With no one to see. It's only oblivion, true:
We had it before, but then it was going to end,
And was all the time merging with a unique endeavour
To bring to bloom the million-petalled flower
Of being here. Next time you can't pretend
There'll be anything else. And these are the first signs:
Not knowing how, not hearing who, the power
Of choosing gone. Their looks show that they're for it:
Ash hair, toad hands, prune face dried into lines -
How can they ignore it?

Perhaps being old is having lighted rooms
Inside you head, and people in them, acting
People you know, yet can't quite name; each looms
Like a deep loss restored, from known doors turning,
Setting down a lamp, smiling from a stair, extracting
A known book from the shelves; or sometimes only
The rooms themselves, chairs and a fire burning,
The blown bush at the window, or the sun's
Faint friendliness on the wall some lonely
Rain-ceased midsummer evening. That is where they live:
Not here and now, but where all happened once.
This is why they give

An air of baffled absence, trying to be there
Yet being here. For the rooms grow farther, leaving
Incompetent cold, the constant wear and tear
Of taken breath, and them crouching below
Extinction's alp, the old fools, never perceiving
How near it is. This must be what keeps them quiet:
The peak that stays in view wherever we go
For them is rising ground. Can they never tell
What is dragging them back, and how it will end? Not at night?
Not when the strangers come? Never, throughout
The whole hideous inverted childhood? Well,
We shall find out.

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