Friday, November 4, 2011

And Should I Die Before I Wake...

Today I had my annual physical.

I always very much enjoy these, partly because I use it as an occasion for reflection, not just on my state of physical health but on my state of spiritual health as well.  I like that my doctor asks me very broad questions -- about how things are going at home, with my spouse and our foster son, my activities, my diet, my emotional state.  He asks me about eating enough veggies and brushing my teeth and wearing seat belts and bike helmets.  He asks me about sex.  He wants to know how I feel about myself, my sense of self-worth.  I like that he's not just taking blood and urine and feeling my lymph nodes, but that he sees my health as being interconnected with everything I do and am in life.

It's the closest I get to anything like a worthiness interview.  As I reflected on the questions my doctor asked me, I found me asking myself some worthiness-type questions.  I found myself reflecting on my state of spiritual health.  Lately I have found myself wishing I could have formal Church worthiness interviews.  If an annual or bi-annual physical is a good idea, why not an annual or bi-annual spiritual?  I guess it's assumed -- at least from the point of view of Church policy -- that because I am in a committed same-sex relationship there's no point in ever checking in on my state of spiritual welfare.  (It's hard to avoid feeling like that's a statement that I'm hopeless/worthless/not worth the time and trouble, as long as I'm in a same-sex relationship?  As a point of spiritual health, I try not to dwell on thoughts like that.)  But that certainly puts it on me to conduct regular self-exams, I guess.

But I digress...

Today, as the nurse was taking blood and urine samples, she asked me if I had a written "Health Care Directive."  I asked her what this was, and she said it was a written statement about what kind of treatment I would like in the event that I am unconscious or unable to communicate or unable to make decisions for myself.

I told her that, no, I didn't have a written Health Care Directive. 

She asked me if I'd like more information about preparing one, and I said I did.  So now I'm looking at this form that asks a bunch of really hard questions.

Now, part of the problem answering these questions is that I would be basing my answers on a lot of suppositions about an experience that I simply have never had.  It's fine and good for me to say now, "If I have a terminal illness, I don't want you to take any measures to revive me if I have a heart attack."  I can say that now, but how can I possibly know that's how I will feel when I'm actually in that situation?  Wouldn't it be possible -- likely even! -- that no matter how I actually feel about this in some vague philosophical sense now, that once I'm actually in that situation I might have a completely different perspective of the problem, and change my mind?

I remember having conversations with my mom about this when I was a kid.  My mom was a nurse for many years, and a very good one.  She actually worked in a kid's terminal ward at one point.  And she's witnessed people of all ages passing away.  And so I felt like she had some special insight about this.  From my mom I've inherited the conviction that when God is ready for me to die, there are no special measures that anyone will be able to take to prevent me from dying.  I will die.  But in the meantime, if God has put the knowledge and means at our disposal to preserve life, we should take them no matter what.

I also spent a fair amount of time with my grandmother in the last years of her life.  Grandma lived to what we generally think of as extreme old age.  She died at the age of 102.  And even though it was difficult for her to communicate toward the end, the time I spent with her was a gift.  Her life was a gift to her whole family, right up until the very end.  And I came away from that feeling that life is always a good thing, even under diminished circumstances.

But then, I wasn't in Grandma's shoes.  I wasn't on a feeding tube and oxygen.  I know it was extremely difficult for her.  I know she missed Grandpa, and was really anxious to rejoin him on the other side of the veil.  And I know how important physical activity and exercise were to her, and how difficult it was for her in those last months when she couldn't even walk.  She was getting lung infections from the feeding tube, and I know at least one family member who thought we should have taken her off it.

I don't know.

I'll be thinking about these questions in the next days and weeks, and probably putting together a written health directive.  I'm curious if others have thought about this, and if any of you have any ideas...  I'm open here, trying to figure things out.  Any insights that anyone has would be much appreciated...


Matthew said...

My mom had an aneurism several years ago. The ICU doctor put it best, I think. He told us we could keep her alive, try to operate, and if successful, she would live without most of her faculties. Then he told us that death was a natural part of life, and sometimes it is just time to let go.

We let go, and it was a powerfully spiritual experience that, while heartbreaking, also was absolutely the right thing to do.

For myself, I value quality of life too much to be willing to be brought back at all costs. Death comes to us all, and I look at it as a return home rather than an ending.

Just my thoughts, hope you find them helpful.

J G-W said...

Thanks, Matthew. That is helpful.

I think I am very much at peace with the idea of dying. So I don't feel the need to be brought back at all costs.

As I've continued to reflect on this question, however, I'm slowly coming to the conclusion that maybe I can't really leave hard fast instructions behind.

Maybe the thing to do is simply to leave behind my written intentions that I want my loved ones to prayerfully make a decision based on the circumstances. I can let them know that I'm at peace with dying, if that seems the best course; but that I also value life, and hope that if there's a reasonable chance of me being revived with most of my faculties, that those efforts will be made...

Matthew said...

"Maybe the thing to do is simply to leave behind my written intentions that I want my loved ones to prayerfully make a decision based on the circumstances."

This sounds like a really good idea - I hadn't thought of it before. It gives the option of resuscitation without making it required, allowing for adaptation to various circumstances.

J G-W said...

Yeah, maybe it's kind of a cop out... That's what my family/loved ones would end up having to do anyway... Prayerfully/thoughtfully make their own decision about what to do.

But maybe it would help them/reassure them/comfort them to have a record about my thoughts regarding life and death, and my reflections on what being in that kind of a situation might mean to me.