The Perks and Pitfalls of Finite Living: Atul Gawande’s Being Mortal

20161019_094117

This past weekend, John and I went camping to celebrate our four-month anniversary. When you’ve only been married four months, such milestones carry significance. A new record every day!

Despite my best efforts, though, he still doesn’t appreciate when I start conversations by asking him about his feelings towards death. I suppose I’ll have to keep my musings about Atul Gawande’s Being Mortal to myself…and the blog.

All this reading about how life ends has made me hungry to think about the life we’re living now, too. We camped on Lonely Lake, a calm, still lake situated in the middle of a wilderness lake system about an hour’s drive from our house. There are well-kept portage trails and sometimes even water trails between the lakes, and many of them are full of trout.

Our last trip to this area was early last spring, as we were contemplating our big Yukon voyage. By now, it is definitely fall. Though it was sunny, gorgeous weather, temperatures hovered around freezing throughout our overnight foray, and we had to share the tent with several dogs to keep warm. More accurately, the dogs shared the tent – in ever-decreasing portions as the night progressed – with us.

The next morning, after a breakfast and warming fire, and several cups of hot-chocolate-infused coffee, we packed up and set off for the car. Before long, our beautiful morning turned cloudy and windy – a cold, searing wind. Then we encountered the sheen of ice between one lake and a narrow, windy passage to the next. We plowed into the ice, thinking it was more fragile than it was, and as we entered the narrow passage, John’s voice came calm and steady from the front of the boat.

“We’ve got a hole in the boat. We’re taking on water.”

Indeed, I could see water rushing back towards me, under the dogs feet (we had all three with, of course) and beneath our bags. Lots of water.

“Can you plug it?”

“No, it’s a tear.”

“Can we make it to the other end of this narrow spot?”

“Nope, we need to pull over.”

“Up there?”

“Here. Right now, actually.”

And so we ended up calf-deep in a half-frozen bog, gear strewn about, smashing fragile lichens, dogs post-holing, and the boat upside down to assess the damage. I happened to notice at this point that the wind had picked up, or we were in some sort of tunnel, and the clouds looked like snow.

“I hadn’t dreamed the ice would be so thick,” I said.

Luckily, John had packed the repair kit.

“How long does it take to set?” I asked.

“Sets in 15 minutes at 90 degrees,” John read. It was about 32.

“Should we light a fire near it?” I asked. But there wasn’t any stable ground to light it on, and we didn’t want to risk burning more holes into our vessel.

Later, I’d reflect how this Pakboat canoe had carried us over 700 miles on the Yukon, through water so heavy with silt that it sloughed against the side of the boat like sandpaper. We’d run the Eleven Point river in southern Missouri in this boat and tied it up overnight while we camped in a limestone cave in the riverbank. In Bull Shoals Lake, we’d paddled past a water moccasin that was coiled on top of the water and struck at our paddles and the side of the boat as we passed. This canoe had been on our strange but beautiful trip to Tangle Lakes, where Maggie split the caribou herd in half and disappeared for hours.

As it turns out, canoes are mortal, too. We have that much in common.

In the moment of our return trip from Lonely Lake, however, we didn’t have time to mourn our canoe. We traded off having mini panic attacks about the situation and making clear-headed, practical decisions about what to do.

In the end, we triaged. We smeared our hands and the boat with the caulking glue, smoothed out the patch as best we could, and then wrapped the entire bow of the boat with some kind of waterproof firefighter tape that we had in one of our packs. We portaged our gear, dogs, and boat across the delicate edge between bog and forest-on-a-slope, and we back-loaded the canoe. I sat in front with a paddle in one hand and our one-quart coffee press in the other, ready to bail.

Though it wasn’t a permanent solution (the whole hull had been worn down enough to be easily compromised), she held. We held. The weather even cleared, and the sun warmed our wind-chapped hands a bit. It turned back into a glorious, quiet morning paddle.

When we emerged into the parking lot, we cut the tape around the bow, broke down the canoe, and packed it into the car. At least the last voyage was a true adventure, threat of freezing and all.

And though I haven’t said one word about Gawande’s book, I may have painted a similar picture of the issue of dying these days. Is it better to triage and enjoy the quality of life as it ebbs, or should we fight until the end?

In the canoe’s case, we would have been very, very cold. In the case of human life, it’s obviously far more complicated.

When is it time to “give up” on treatment and give in to the art of dying – the time we have left – and when should we cart our elderly to the hospital for each small hole in a sinking ship? Or, as Gawande put it, the “ODTAA syndrome: the syndrome of One Damn Thing After Another” (208).

I don’t know. It varies from situation to situation. Most important, I think, is honest, compassionate communication between practitioners and the terminally ill. Also important are the patient (the individual person)’s own wishes.

I have to admit that my youth (because yes, we live in a world where 30 is quite young) makes it hard for me to truly stay focused on the issue of death. Right now, it seems more likely that I would die quickly in a horrible accident than die slowly, inevitably, in a terminal decline. Both are possible, but both unlikely. I can only hope to have a few more years to ponder the above questions.  Still, as Gawande suggests in Being Mortal, they are questions worth pondering, worth working out ahead of time: before the crisis.

I need to put this sticky issue to bed for a while. Time to put the beast back in the cage. It is almost November, after all – that dark and dreary Alaskan month, the strange creep of time  – and I must find cheerier things to focus on. Or at least try.

I’ll leave you with an interesting premise that Gawande puts forward regarding end-of-life care for those ready to accept that they are dying: “The lesson seems almost Zen: you live longer only when you stop trying to live longer” (178).

Maybe the same lesson applies to happiness: maybe we are happier once we stop trying so damn hard to be happy, and just let ourselves live. And because I still haven’t let go of Annie Dillard, here’s another way of putting it:

The weasel lives in necessity and we live in choice, hating necessity and dying at the last ignobly in its talons. I would like to live as I should, as the weasel lives as he should. And I suspect that for me the way is like the weasel’s: open to time and death painlessly, choosing the given with a fierce and pointed will.

….The thing is to stalk your calling in a certain skilled and supple way, to locate the most tender and live spot and plug into that pulse. This is yielding, not fighting. A weasel doesn’t “attack” anything; a weasel lives as he’s meant to, yielding at every moment to the perfect freedom of single necessity. (“Living Like Weasels”, Teaching a Stone to Talk, 33-4)

Advertisements

2 responses to “The Perks and Pitfalls of Finite Living: Atul Gawande’s Being Mortal

    • Yeah! Gawande writes about this town in Being Mortal, and the crazy low rate of Medicare spending for its residents. Apparently there was a campaign through local healthcare managers to educate people about end-of-life decisions, and it really worked. Thanks for sharing the story – I love how the teenage daughter plans to play Bruce Springsteen at her dad’s funeral. 🙂

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s