Going gentle into that good night

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

— Dylan Thomas

I have witnessed only two deaths. They were not good. My mother was whisked off against her wishes to die in a hospital and to be subject to an unnecessary autopsy she had been strongly against. We all gathered ’round to witness her struggle, her laborious gasping for yet another breath. I did not have a sense that giving her extra oxygen through her nostrils eased her passing. (This had been the sole reason my father chose to remove her from our home where she wished to die. Dying people have difficulties breathing. Duh.)

I described the recent death of my father in the previous post. It was a horrible experience for me, and infinitely more horrible for him. I would not wish it on my worst enemy. Trusting the system, or for those with caring children, trusting that they will somehow manage to give you the good death we all deep down hope for… is foolish. The only person I know who had a good death was my grandmother. Still well, she dozed off one afternoon while her daughter, my aunt, was puttering in the kitchen nearby. And then she was gone. A lucky woman. But one can hardly bet on such luck.

Those experiences jolted me into a close examination of my own wishes and eventual options. I wrote a while back about ecologically sane disposal of the body. Since then, my final choice has become clear. I walk away. If a few of my remains are found — and I would be delighted to become food for one of the noble beasts, cougars or vultures if in America, and jackals or bears if in Europe — then I want them wrapped in a simple shroud, placed in a shallow grave lined with compost, with an apple tree planted over me. This of course goes against many laws in many places, but discreet action on private land remains a viable option everywhere. (There is yet another way, much simpler. Swimming out into the ocean. But I’d rather grow into an apple than a jellyfish.:)

Or perhaps by then there will be orchard cemeteries, and if I should have the misfortune to die in bed, that too would be lovely, my body nurturing a fruit tree the living could come and enjoy. And for a funeral? A simple horse-drawn cart, with a brass band playing the songs that sent generations of my ancestors to the next world, that would be the cherry on top.

I struggled mightily with the proper disposal of the dead, but it turns out that’s a simple problem. What about the dying itself? That’s where the real complexities enter in, and that’s where this insane world we live in makes things really difficult for those who would rather skip the usual: institutionalization, prolonged misery with one’s faculties radically diminished and one’s self-determination gone, often dying amidst strangers.

There are several issues that need thinking out, well prior to one’s actual need. Pain medications in an age of moral panics about certain drugs. Reliable lethal doses and access. And then, the most difficult one of them all: how to handle the fear and existential dread that falls upon those whose mortality suddenly ceases to be, um, theoretical. When I was told twelve years ago that I was dying, I was not only grief-stricken, and maddened by the rude and callous way the doctor handled the situation, but I also suffered from the realization that I was completely unprepared for… well, for what I am now calling the good death. I did have the time. I had no resources. I called the Hemlock Society for advice. They told me that the hospice folks leave plenty of morphine behind as they care for you. This is, I suspect, no longer true. Well. As it turned out, I used the time the doctor opined should be taken up to set my affairs in order to save my life instead. But that is another story, and another post.

So I was given a second chance for a rethink. While I believe that suicide is profoundly wrong for reasons too numerous to mention, the idea offers itself that to slightly speed the scythe that is already swooping down… calling it suicide seems a misnomer. It’s more of the last act of exercising the gift of choosing we were given at our birth as human beings. Many dying people refuse to eat — and nobody calls it suicide. (But really, isn’t starving to death, well, a somewhat sub-optimal way to go? Just sayin’….) If it is a kindness to ease the suffering of animals, why must humans endure the worst, at the mercy of often unmerciful happenstance? And being childless, I cannot console myself with idyllic pictures of a loving family gathering to say their goodbyes. It seems to me that when one’s life is done, and all that remains is waiting for the grim end, the kindest thing for all concerned is to make those last months as grimless and meaningful as possible.

I have been reading Michael Pollan’s latest: How to Change Your Mind. It follows his adventures with certain currently-forbidden substances (all hallucinogens, in his case) that he missed out on as a young man. One of the things the book describes are the scientific experiments, quite well corroborated, that demonstrate how the existential dread of dying can be substantially eased or eliminated by guided psychedelic experiences, enabling the person to make a spiritual turning that reframes the death that is coming. I remember when a dear friend was slowly dying of recurrent ovarian cancer — her last year spent being abused by one failing chemo after another, then the cold announcement from the doctor, and then the endless waiting… waiting… waiting… lying in front of television, resentful of the cruel blow of fate, and of death tarrying so. Bitter, too, against the Catholic faith she felt had let her down. She could have used help. But we were clueless.

Why not, instead, refuse heroic measures that swell the GDP with their false “palliative” promises and opt for experiences that bring one’s last days full circle into the meaning of it all, in the largest possible sense? This intimation of meaning which we can only guess at, but which is, experientially, within reach? For me, roaming the wildish lands and communing with critters (human and non) I have loved all my life would come first. And second, I would wish to have available to me all the substances given to us by God-Cosmos-Gaia exactly for the purpose of easing our pain, experiencing parting pleasures, expressing the love we feel without the usual restraint, seeing the meaning of our life with fresh eyes, and finding strength to face the beckoning transformation with grace.

Which leads me off on an exploration.

• What are the best ways to deal with the pain that often accompanies one’s last months– and which, in its infinite unwisdom, this culture stigmatizes and prohibits — allowing you to walk into the proverbial hills despite your bad back and your bum ankle or the cancer gnawing at your insides? When my mother was dying, my father — being in the cancer research business — pulled some strings to obtain for her what in those days was the most effective way to deal with severe pain. This Brompton’s Cocktail (then commonly available behind the Iron Curtain) was made up of morphine, cocaine, heroin and alcohol. It is still illegal today. The mix was adjusted to the needs of the patient — he or she could choose to be more or less alert, more or less social. Why do we put up with a medical system that puts politics above patients’ needs?!
• What is the best way to speed the scythe as you can walk no more, and wait in the hills for the blessed scavengers to transform your death into new life? The internet is vague about the dosage (maybe 300 mg of morphine might be enough; but what about a person whose previous months had included plenty of pain medication?). We need expert guides who can advise. And we need doctors who will allow us to build up a cache for when the day comes, well in advance. I think I will mix mine into creme brulee…
• And finally, what is the best way to use those divine substances that grant us the mercy and vision that in normal consciousness would likely be unreachable? The peace beyond understanding. The rightness of Being. The rightness of Death. The hope for another adventure awaiting in the beyond. The deep gladness that one’s death serves life. A whole new gestalt in which the universe opens its arms to you and welcomes you home. This, as I understand it, the new generation of psychedelic researchers are focusing on. But they need not stop there! How about drugs given not to quell pain, but to suffuse with pleasure a body that no longer can do it on its own? What about pills or herbs that would bring happy, vivid dreams? What about hypnosis that would help the person relive the most meaningful days of their life?

If I am granted the foresight and the knowledge that the time has come, I will walk away into the wilderness to offer my body to the living. That too will require preparation and scouting out, depending on the season and my strength. I suspect it will take more than just putting on a backpack and heading west into the Rockies, as I had naively imagined. Maybe an old cabin might come in handy. After all, it could be winter. The very last adventure of this earthly life ought to be grand, don’t you think?

And when I am gone, the friends I have left behind will shield their eyes when a vulture or a raven flies overhead, and wonder if I am flying along.