I just know the man was younger than I.

And early last summer, he was healthy, or at least so he thought.

Today, I read his obituary in the paper.  He had been diagnosed with “brain cancer” (a glioblastoma, likely) six months earlier.

It gave me a moderate jolt.  These sorts of things do.

There is death, and there is death.  For those who are demented, death is a release for them and their families.  It is sad, but it is a release.  Society often doesn’t allow us to say that, but many of us think it.  When my mother-in-law died at 94, one niece cried for hours.  My wife and I just said, “It’s finally over.”  My mother-in-law had been widowed twenty years earlier, was never the same, moved out of her house to assisted living 8 years later, had become slowly demented and had been ready for death for years.

I have seen too many who did everything they could to forestall death, when it was not only going to be the outcome, it needed to be the outcome.  I wasn’t popular, but I had the respect of nurses who dealt with these issues first hand.  When I practiced, I once had eight dying patients simultaneously in an ICU.  I had to deal with eight families, each of whom had members who were dealing with a family death for the first time.  I don’t remember what I got paid for it; suffice it to say that my total bills for the entire 8 were less than an average inpatient surgery at the time.  Surgery takes skill; dealing with death?  Well, that is another story.  That’s just talking to patients or families, not taking a knife and curing them.  Talk is cheap, and talking about death isn’t paid for at all.  Remember Death Panels?  That was just paying for the discussion with people about how they wanted to die.  You’d think from the uproar that elderly people had never thought about the concept before.  I submit talking about death is far more important ultimately than a good deal of procedures Medicare does pay for.  Perhaps if it were reimbursed better, the discussions would be better, but I am out of date.

Here in Oregon, people who are competent and terminal can choose the time of their death, not passing, for passing is a euphemism that makes us think that the non-existence of a former sentient being is something other than non-existence.  About seventy-five people choose that option here every year, not many.  These individuals know full well what they are doing.  They know they are dying soon, and they don’t wish to go through the indignity, often painful, to reach the end result—death.  Some use “assisted suicide” to describe this law, but suicide has a different connotation in our language, and “planned death” is a better term.  The individual is dying soon from a disease, not a medication, and they don’t wish to go through the whole disease process to the bitter end.  There are strict controls, and people die when they are ready, having had for some time the knowledge that they could choose or not to choose to use the drugs that would allow them to die.  A third never use the drugs.

A death from a bad disease in a younger person is a particularly bad tragedy, even if it is were not preventable.  It is a message to those of us who hear about it to be sure we are doing what we want with our lives.  It is a message to end estrangements, if possible, to fight only those battles that are meaningful, to leave behind something good, to live and to be able to say to yourself or even aloud, “I am alive!!!!”

I don’t live in a perpetual state of angst about death, but I find myself discussing events in the next 1-2 decades with the caveat, “If I am still around.”  Mind you, accidents, which can occur at any age, can cause sudden, unexpected deaths.  In one’s 60s, however, there are a lot more things that can kill.  Pneumonia is suddenly not just a minor inconvenience; it is life-threatening.  One nurse told me a two years ago that a cardio-thoracic surgeon we both knew developed leukemia at age 60 and was dead 6 weeks later.  I probably had my mouth open for a couple of minutes.  Suddenly, the problems of the world don’t seem so pressing.  Indeed, Oliver Sacks, who recently admitted he has cancer metastatic to the liver, has stated just that.  He no longer watches the news.  I can’t say I blame him.  I don’t watch it much, either.  I try to deal with the things I can control, not worrying about the many over which I can’t control.  I wish I could stop worrying about the weather and climate change.  I can’t change it, but it still hurts to see it happening.

That means I support the Humane Society, but I turn off commercials and don’t look at posts that show animal abuse.  I simply do not have the time, resources or energy to deal with every needy individual in the world.  Further, the sheer volume of these requests overwhelms me and shuts me down.  I feel like a failure that I can’t fix the world. I am not going to try, and if that makes me a bad person, so be it.  I try to choose my battles, decide where my money, time, effort should go, and am glad I am in a position to do all of these.  I have my own list of things to do; another list, much shorter, are those few things I have done in life that I believe have defined me as a person who existed and which have mattered the most.  The first list is written down, not ordered.  I discuss it should people ask and make it a point to do the things on it when I can.  The second is far more private, and it is very much ordered.  I am deeply clear what those items are.  Others may have seen me as a different person, but this list describes how I see myself.

I don’t know how much time I have.  I just know that every year needs to count for something, and something on one of those two lists needs to be part of every year.

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