death and dignity

In an interesting and poignant post, keepbreathing writes about observing a death without dignity and pathos.

Elderly women drinking coffee with a dead man and then leaving his side only when forced to by an unfortunate loss of bowel control. I hope there’s more to getting old than this.

There is a lot written, especially by medbloggers, about the futility of much of end-of-life care, and how disturbing it is to torture some poor old person just to keep their heart beating a few more tired beats. I have written about the guilt I felt when performing CPR on an individual and breaking ribs in a vain attempt to restart their "life." In much of this discussion, when we talk about dying with dignity, we seem to cherish this image of some sort of Hollywood scene where the dying individual is surrounded by loved ones who are all sniffling tastefully (with nary a makeup smudge), and they slip away with a beatific smile on their face, having said their last, heartfelt goodbyes and cleared up a few minor misunderstandings to ease the regrets of the living.

In my past life, I have played and sang for a lot of funerals. (I would far rather play for a funeral than a wedding...but I digress.) I have always been quietly amused at how everyone who dies is a perfect human being. The deceased is ALWAYS the best husband, father, mother, daughter that ever there was; who never spoke a harsh word to nobody, and who spent all their spare time volunteering in soup kitchens. No one gets up at a funeral and says, "So and so was a right bastard, who beat his children and yelled at his wife." Or even, "He was a complicated man who meant well, even though he got it wrong a lot of the time."

"Do not speak ill of the dead." There is a mythology in death that we seem to want to embrace, even when it flies in the face of reality. Is this born out of our fear of how we will be remembered?

Death, like life, is messy. It frequently involves pain, fear, blood, piss, and shit. And sometimes, it is funny as hell. I remember one memorable night several years ago when a couple of friends and I sat in our local dairy queen and laughed together for hours as they told their "dead dad stories." Both their fathers had died after long, drawn-out illnesses, and they both had some really funny stories to tell from the time they spent in the hospital being with their dying dads.

As we write and speak about the way we treat the dying, I think there is a danger of simply exchanging one horror for another; the horror of medical torture for the horror of dishonesty. Because not everyone wants the Hollywood version of death. For some, it's not appropriate. For some, it's not true to who they are. And for some, it's just not funny enough!

And while I will continue to use the phrase "death with diginity," for me it will mean more than just a slightly fake decorum that allows us to pretend that death isn't that big a deal after all. For me, "death with dignity" will be about celebrating the dignity of a person's humanity, and celebrating the journey they have been on, with all the road bumps and swerving, and swearing and detours, and break downs and speeding tickets that journey implies.

So to the little old ladies who sat with their deceased with their coffee and their laughter until one shat her pants, I say, "Way to go!" They were celebrating his life and death with their messy presence and their humour; in their own honest way they were allowing death with dignity.