It was very early on a Saturday morning: somewhere between 6:00 and 6:30. A mug of green tea sat steaming on the coffee table. I had the laptop open, resting (as its name suggests it should) on my lap. I was waking my still-drowsy brain with an online game of Spider Solitaire when Facebook Messenger fired up out of the blue with a tinny ping.
It was my son, Rob.
Rob and his Kiwi wife Sheila live in the small town of Nelson at the north end of New Zealand’s South Island. Sheila was pregnant with their first child and was over a week overdue, so the first words in Rob’s message woke me with a jolt. “I’ve got some bad news.”
Was it Sheila or the baby? Childbirth is fraught with risk. I knew they were determined to have the baby at home. Had something gone wrong? I felt as if a huge void had opened up in my chest.
“Stephen died today.” Stephen was Sheila’s father, a hale and healthy 58 year old who loved to walk New Zealand’s nature trails. It seemed so unlikely, shocking even. He wasn’t even ill.
Rob didn’t have any more details to tell me. The news was still so fresh. Just that Stephen had gone out for a walk, had texted Joan his wife from the top, and five minutes later had sent her a picture of the view from the peak. Five minutes after that he’d been found, presumed dead, by another hiker, or a runner.
Mixed in with the shock and sadness, a sliver of guilt. It was Stephen, not Sheila, or the baby. I hated myself that the thought should even occur to me but how could it not in the conditions?
Then, a little over a week later my wife awoke to more tragedy. Jane, one of her best friends, a former colleague, had died the previous night. Friends were posting the news on their Facebook pages (strange how quickly Facebook has become the medium through which such news is transmitted). She was only 42 years old. Though we’d lost touch with her in the past few years she hadn’t been ill as far as we knew.
We discovered a little more in the days that followed. Jane had always liked a drink, but after being laid off in a round of cuts she hit the bottle hard. She moved in with her father and enrolled in various rehab programs to try to beat it, but the damage she’d done in her drinking years was too much for her body to bear.
Two deaths, one on top of the other. Both sudden and unexpected (at least to us).
Which surely puts them outside the remit of this blog, doesn’t it? Sudden death is shocking and traumatic, but teaches us nothing about the dying process. Its very abruptness robs us of our ability to respond, to prepare, to plan.
Which is exactly why I wanted to write this piece. It’s by way of an introduction, too, to tomorrow’s post, by guest author Naomi Mesbur.
Because sudden unexpected death throws all the responsibility for decisions (burial or cremation? Funeral service or memorial service? Flowers, donations, eulogies, dress codes, venues, etc. etc.) on those who may be least able to make them: the wife or the father of the one who died in these cases.
It speaks to the need for what is known in the palliative care world as advance care planning. The need to let our loved one know in advance what we want should we fall ill (for example), and how we would like to be remembered after our death.
Some people see this as morbid. They’d rather defer the consideration of these details until they actually need to make the decisions. But sometimes it’s too late for that. Sometimes death visits us with a shocking suddenness, and the time we thought we had to discuss those details is gone.
Jane and Stephen’s stories help to illustrate the stresses our loved ones have to endure (“did I do the right thing?”, “what would they have wanted?”) when they are forced to make decisions for us by proxy.
Naomi’s story illustrates a far more difficult decision. What if our loved one is not dead, but on life support? What if the machine they are hooked up to is the only thing keeping them alive? When they come to ask us if they should turn it off, how will we answer? Do we know what our partner, or mother or son would want in those conditions? What quality of life they would be prepared to tolerate?
Some physicians point out that “living will” provisions and advance care planning mandates are often revisited by patients when they are actually in the situation. And it’s true, they do. We adjust to new realities, and sometimes what we imagined we would not be able to tolerate is more tolerable than the alternative, when we get there. Which is fine if we still have our faculties.
If we don’t, and there has been no discussion of our wishes, the decision will have to be made by a wife, a husband, or our closest living relative. It’s an agonizing situation to be put in.
As Naomi’s story will illustrate tomorrow.
Please note: The names in this piece have been changed to protect the privacy of the individuals mentioned.