“In the end, a person doesn’t view his life as merely the average of its moments—which, after all, is mostly nothing much, plus some sleep. Life is meaningful because it is a story, and a story’s arc is determined by the moments when something happens.”
I hate Atul Gawande. Surgeon, public heath activist, writer; the man has a lot of talents. My own Gold Duke of Edinburgh Award simply does not cut it. Perhaps the most important book of this annoying polymath is called “Being Mortal”. Western societies are aging. Average life expectancy in Australia if you were born in 1870 was 34 (child mortality playing a big role in this). If you were born in 1945 it is 67. If you were born in 2020 then it is predicted to be 83. In 1901, the median Australian was aged 22. In 2022, they were aged 38. In terms of both lifespan and actual population, Australia is getting older. And it is not alone.
An acquaintance called us the “sandwich generation, dealing with kids on one end and aging parents on the other”. Our parents (and even grandparents) are older than ever. And yet we are still embarrassed to talk about death. To discuss the end feels like we have already given in, that we have consigned our elders to the grave prematurely.
But if we avoid these conversation out of shame and fear, then we risk doing our loved ones a disservice. Do not trap me in a prison of flesh because you cannot bear to say goodbye.
My father was clear in his wishes. He did not wish to hang on, a shell of his former self. When he got sick, it was the end. I share his view. When the part of me that can write things like this is gone, then I am gone. The part of me that is more than a confused soul in solitary confinement.
These are hard conversations. These are hard decisions. We cannot pretend they are otherwise. So let us have the hard conversations before it is too late. Gawade’s book spells out the form and function of these hard conversations in humane and engrossing detail.
Make sure you have a will and you give your loved ones power of attorney / enduring guardianship / whatever it is called. Make a living will. Tell them what you want and what you don’t want. Tell them what life and death mean to you. Does life mean the ability to run, does it mean eating ice cream and watching the footie? Does it mean holding a grandchild and knowing who they are?
Give them the comfort of clarity.
“Come in pedalo number 17, your time is up…”
Really enjoyed that book. Sobering reading on a day off, but one of the rare books where people, on seeing me reading it, jumped in and commented on how much they had enjoyed it.
The "lifespan vs health span" concept was a game changer for my thinking.
Thank God we have had these hard conversations in our family. When my mother died of cancer in 2019 - a mere 6 weeks after being diagnosed - then, when she suddenly became unable to talk to us, we were able to honour her wishes about palliative care and then the funeral because of those previous conversations. And it took so much stress off us. We were free to start our grieving.