Letting go of the rope

A dear friend of my family is dying. Inexorably, painfully, hopelessly dying. Some days are better. Some are hard to bear. But the eventual outcome is not in doubt.

Along the way, he will have spent a double-digit number of weeks in the hospital, an unknown number of days in a rehab facility, uncounted hours being shuffled between the two, and no time in his own bed. He is finished eating, walking or going to the bathroom unassisted. He has so far engaged eight or ten specialists, and not a single general practitioner.* It will -- has already -- cost a fortune.

This is a man who was a proverbial captain of industry only a few years ago. An actual son of a share-cropper, he worked tirelessly to improve his lot and provide for his family for most of the previous century. He created a thriving business, became a pillar of his church, and a force in political discourse. A generation ago, he's a man who would have died unexpectedly in his sleep, or pitched over into his dessert after a big steak dinner and a couple of martinis. Today, he is a frail, frightened shell of his former self, his body struggling to maintain the minimum requirements for continued existence.

It is the way of life, and American medicine, that many of us will live our final days undergoing every procedure, and receiving every medication, for which our insurance will reimburse the medical corporations whose representatives are working so hard to bring our vital signs back into the range where they may consider the course of treatment complete. There is no talk of cure, or even of going home. Address the current issue, get the patient stable, discharge them from your service, and hope for the best, seems to be the only strategy.

I think the end of life is like water-skiiing. When you feel your balance slipping, you can try to right yourself, or let go of the rope and glide to a stop, more or less under control. The trick is in knowing when to let go. Release your grip too soon, and you may miss a chance to correct and ski on. Hang on too long, and you end up dragged face first through the water, sometimes with your swimsuit floating in the water behind you. It's not exactly drowning -- assuming you let go eventually -- but no one would call it fun.

I've reached the age where I think about these things. Not because I want to, or because I think they are interesting, or significant, or cool.  I think about them because they are happening to people close to me. And because I can feel it in my future, the way we once saw graduation, or marriage, or a new car, just over the horizon. It's all the same journey, but the scenery gets darker towards the end.

Ultimately, hanging on or letting go is a personal decision. Maybe the most personal we ever make. I'm not surprised my friend chose to hang on. It is his nature to struggle, and I always assumed that he would not be one to go gentle into that good night.

For myself, I hope I can be less Dylan Thomas and a little more William Cullen Bryant. Of all the ways we can measure the quality of a life, length is not high on my list. Every story has an ending, and I hate stories that go on too long.

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* Because we don't have those anymore.