Riding Shotgun: We All Gonna Die!

Let me start off by saying that if I am in a persistent vegetative state for 15 years, please smother me with a fucking pillow. Thank you.

Let me start off by saying that if I am in a persistent vegetative state for 15 years, please smother me with a fucking pillow. Thank you.

I was going to take this space to write my first technology review. A review of my brand spanking new iPod Shuffle that I affectionately named “Bubba.” That didn’t work out.

Then, I was going to write a review of Apple’s warranty service, but that might take a few too many months. Lesson learned: If you buy the cheapest product on the market, you still get what you pay for, even if it’s got a shiny stylized Apple sticker slapped on its ass.

And then Terri Schiavo died the other week in Florida, putting an end to one of the most poignant and pointlessly protracted national controversies in recent memory. Finally.

Except, no, it’s not going to end. The discussion isn’t going to end (probably a good thing, depending on who’s involved), and this case isn’t going to end because politicians can still make political hay out of it. Tom DeLay, the Republican House majority leader, has promised that the judges who made the court decisions that led to Mrs. Schiavo’s feeding tube being removed will “answer for their behavior, but not today.” I don’t know what this means, but I don’t think it involves DeLay showing up on their doorsteps with a bandoleer of grenades and an M-16.

It means that somewhere down the line he and Senate Majority Leader Bill Frist (I’m sorry, Dr. Frist) will introduce legislation to, I don’t know, take away the rights of spouses to make care decisions for their incapacitated partners, give Congress the ability to bypass the federal court system, or just give Tom the power to walk into any hospital and shove tubes down throats, pull the plug, steal our Jell-O — whatever he wants.

It won’t pass (I say with bated breath and fingers crossed), but it will look good to the conservative Christian base that, while not the largest voting bloc in the Republican party anymore, is certainly the loudest and most organized. And it’s always a safe political bet to shun the strong husband and side with the mother if she’s willing to wail on national TV.

If there is a God (or at the very least an otherworldly complaint department), Tom DeLay will be found in the Senate cloakroom, his spinal cord snapped from a misguided autofellatio attempt. His fellow party legislators will vote to keep him alive, propped up in the lobby of the Dirksen Senate Building as a reminder to all of this nation’s commitment to a culture of life.

They’ll do it, too. These are the people that let Strom Thurmond keep his seat three years after he passed away. Finally … well, Febreeze only does so much.

Seriously though, this incident should bring about a national discussion. The problem is, taking into consideration the people who are speaking the loudest right now, it will be the wrong discussion. They’ll make parallels to abortion. They’ll make parallels to assisted suicide. They’ll discuss the role of government in dictating medical care. They’ll use Terri Schiavo to make any argument they want in favor of anything they want because she couldn’t speak for herself before and she certainly can’t now.

And these are all things that certainly deserve to be talked about. Saying that federal judges “thumbed their noses at Congress and the president,” just because they didn’t agree with you? Threatening retribution? It’s just … it’s stunning. Honestly, what is it with phrases that begin with “Separation of …” that make Republicans piss themselves and shove corncobs in their ears?

So, these things need to and will be talked about. But the big thing — the discussion that should be the no-brainer — is getting passed by.

I had the opportunity not too long ago to attend a conference at the National Institutes of Health on the state of palliative care in this country. Palliative care is also known as “end-of-life” care. It’s the care you get when there is no more treatment; there’s just keeping you comfortable and alive until you stop being either.

The problem, according to many physicians, is that nobody wants to talk about palliative care. Everybody wants to talk about treatment, about the next step, about the last-ditch cure, but nobody wants to think about what happens when the cupboards are bare and there’s nothing left to do. Do they want to go to a nursing home? Do they want at-home care? Are there family members that can take care of them or do they need a part-time or full-time nurse? Do they want to make a living will?

This discussion becomes extremely important for men and women who have been diagnosed with Alzheimer’s, or some other progressive dementia. They need to talk about this, to think about this, while they are still capable of making decisions for themselves.

But no one wants to have that conversation. It’s bad luck, bad juju. Talk about Death and he’s gonna get ya. Let’s see if we can put off that discussion until the last minute, like when payments begin on the coffin. But remember, Terri Schiavo was 26 when she had a stroke and entered the now world-famous persistent vegetative state. Don’t put it off too long.

People are living longer, and while medicine advances further every day, most of those people are not going to be in the best of health when they go. Gone are the days when it’s safe for a man to say that he’ll drop off from a heart attack while chopping firewood.

He’ll have the heart attack, get rushed to the hospital, get his heart working again, get started on a regimen of blood pressure medication while they prep him for a dual-bypass, maybe a transplant, that will leave him so that he can’t chop firewood anymore, but he’ll eventually give it a whirl and end up having another heart attack that will leave him unable to go up a flight of stairs without collapsing.

So, he and his wife move into a one-level house and he figures he’s got another 20 years if he takes it easy, but the combination of the heart surgery and the medication have left him susceptible to stroke, so he gets a blood clot in the brain and now he can’t move half of his body or talk. He’s confined to a couch and a wheelchair and eventually another mini-stroke puts him in the hospital for good and the doctors ask his wife what they should do — should they send him home; should they send him to a care facility; has he signed a DNR; does he have a living will? Should they call Congress?

So … no, not so much with the chopping firewood.

We’re afraid of death. That’s okay. It’s to be expected. It’s the great unknown. We’re afraid of it, and we don’t want to talk about it. Even those people who strongly believe that there is some better life afterwards are scared of it — otherwise they might have told the Schiavos to let her go be with God rather than beg Florida Gov. Jeb Bush to shove a feeding tube down her throat.

Maybe we’re not mature enough as a species to talk about death. Maybe we’re not mature enough as a species for a lot of things. A doctor will say that death is just part of life, but we can’t even decide what “life” is, so what the fuck do they know?

But this case should have at least taught us that we have to talk about the end of life. They may not be the best years, but they’re still our years. I’ve seen way too many people waste away and die — some swiftly, some not so — to believe that these kinds of decisions are best left in the hands of people who don’t know what you want.

It’s just something we’ve got to talk about. We don’t even have to call it “death.” We’ll call it “brunch,” if that makes you feel better.

“I’d like to spend my time before brunch at home.”

“Please do everything you can to keep me from going to brunch.”

“If it’s a choice between brunch and 15 years spent motionless and unaware being used a surrogate mother/lover/Diana figure by every politician or pundit with a microphone … I’ll have the eggs Benedict.”

See, not so hard after all.

Article © 2005 by Steve Spotswood