Image by Erik McLean on Unsplash
I’ve been on many long, cross-country drives. Sometimes you’re so tired you have to force yourself to stay awake. All you can think of is finding your exit and finding your motel in the dark, and you hope like hell they didn’t lose your reservation.
And sometimes you see signs, “Last exit in Nowheresville.” If you miss that exit, you’ll be driving for a while.
When you’re in a hospital or “care facility,” you could reach a point when you’re ready to stop. There’s no point in going on. You won’t make it to the next town. You want to grab that last exit. Of course, the kindly medical people want to keep you on the road, half-zonked and wholly miserable. You’re ready to take that exit and never get back on the road again.
That’s how I envision the end-of-life experience. You’re tired. You’ve been driving for a long time. You’re ready to crash somewhere and rest.
You don’t need someone to say, “But don’t you want to keep going? Get a few more miles before you call it a night.”
Those next few miles will be sheer misery. And if you don’t stop now, the ending might be a lot more ugly.
The best book on the subject comes from Susan Jacoby (Never Say Die). People who have no way to enjoy a meaningful life on their own terms should be allowed to leave on their own terms.
Jacoby tells the story of a man who was forced to replace “living alone” with “living with a caretaker.” One day the man stole the caretaker’s car keys, drove to the nearest bridge, and jumped.
It’s not suicide, says Jacoby. It’s a rational choice. He shouldn’t have been forced to jump off a bridge. Some people would have been happy with his life, but he wasn’t. He was ready to go. No amount of therapy or medications could change him.
In today’s world, you aren’t always protected by a DNR or advance directive.
ER doctors have been known to follow procedures first and ask questions later. Nobody knows how many of those “give me everything!” people were responding to exaggerated promises: “A few days and you’ll be back to normal.”
Somebody’s got to be there advocating for you — and in some cases, advocating pretty aggressively. It’s not enough to have that paper in your file. Your designated medical proxy is on vacation in Bali and you’re in New York? Too bad for you.
Here’s my proposal for achieving a comfortable End of Life.
First, you get to record your DNR as a tattoo or bracelet. Why should you need an in-person proxy when someone can link to your digital records? The IRS already has records of our past lives: you’ll be asked to remember where you lived twenty years ago when you’re claiming your refund. A tattoo could be a URL or a QR code linked to your living will.
Then, as mentioned earlier, the day you become eligible for Medicare and Social Security, you would be allowed to request your very own cyanide pill, to use as you like, whenever you like, no questions asked.
You would also be offered a gift certificate to a hitman in the nearest Mafia enclave. It’s quick and final. And for a little extra cash, your death will get written up as an accident or unsolved murder. For those who worry about their family’s guilt, this solution works perfectly.
As a marketing pro, I’d argue that giving out cyanide pills could end up making the elderly life worth living. If we could choose to die before we got to the nursing home, the homes would be empty. And the “care managers would be motivated to find a way to fill them up again.
Imagine the ad: “No need to take your cyanide pill! Come to Magnificent Manor.”
Of course, some of us would take the pill anyway. But I bet a lot of things would get a lot better.
NOTE: This is taken directly from my book on aging.
