My Word's Worth: a weekly column by Marylaine Block

vol. 2, #14, September, 1996

DR. DEATH

So, Dr. Death has done it again. As of this writing, it's 40 patients and counting that Dr. Jack Kevorkian has assisted in dying, 40 desperate, terminally ill people, unable to face their doctors' determination to prolong their lives. When he first started doing this, many of us thought the man was simply trying to make a point, and that, having done so, he would stop. But no, he just keeps going and going and going. He's been tried three times for murder, and acquitted three times. When he recently "assisted" four people in one week, it seemed to a lot of us, that this was really a bit over the top, that maybe the man should just quit for a while, give his lawyer a chance to take care of his other clients.

And yet...

We don't want to find him guilty of murder. We do want him, or someone like him, to be available to us, in case of need.

One reason is that we are afraid of pain. Not the ordinary, bearable pain that our flimsy human frames are subject to--the headaches and backaches, the pain of broken bones and childbirth and whiplash injuries and open wounds. These are time-limited sorts of pain. Our minds help us through them by assuring us that the pain will go away, maybe not immediately, but sometime. We can deal with almost anything if we know it will end. It's like the monster in the horror movies--when we see it, we say, "O.K., a forty foot tall gorilla--I can handle that." It's the monster we don't see, the monster we can only imagine, the monster we know only by its effects, that scares us most.

But thanks to the advances of medicine, and our doctors' merciless devotion to preserving life--whether we want them to or not--we all know that we may spend our lives in unremitting pain, as cancers spread their way through our bodies, consuming us. We know that this process can be slow, inexorable, excruciating. We know that the doctors, though unable to cure us, will be able to keep our pain-wracked flesh alive a lot longer. Infinite pain without hope is what frightens us.

The other thing that terrifies us is Alzheimer's--a disease that steals your memory but lets your body live on.

Think about that for a moment. Take away your memory, and what's left? Is there anything else to be distinctively you? Anything, that is, but the shell your mind is wrapped in?

I know that the essence of my personality lies in my memory. It's a peculiarly sticky sort of memory. I pick up bizarre little pieces of information, from God knows where. I pick up well-turned phrases from the people I read and listen to, friends, poets, rock music, books, magazines. I tuck away my own experiences, my friends' experiences, bits and pieces of conversations. I remember what my son's favorite rock groups are, what my friends are worrying about, who the characters are in the various books I've read, what topics various students are researching, what new journal titles we will be subscribing to.

You know, nothing I think, nothing I write in these columns is really original. All I really do is let these bits and pieces from my memory jumble and tumble around in my head, like so much laundry in a spin dryer, and they come out linked together in some very odd ways. And then I think about them, and try to organize them into coherent, logical essays.

And if my memory goes, there's no me left anymore.

I have watched, from a distance, as this happened to someone I loved, as he descended into a memoriless haze. He seemed cheerful enough, as far as we could tell, though his medication left him with a continuous headache, but he couldn't tell us anything that was going on in his mind. He got up everyday, got dressed, (if he remembered to), smiled vaguely at people he no longer remembered, wandered around aimlessly, living a life without point or connectedness. Maybe he was happy--there's no way we could tell.

But it was hell for the people who loved him. And this is what most of us do not ever want to inflict on our families. I want my son to love who I am, not who I used to be. I want him to visit me because he wants to chat and enjoy my company, not because I have to be fed and watered. I don't ever want him to say, "Well, it's Saturday, time to go visit the turnip."

I hope never to need a Jack Kevorkian. I've told my son to shoot me if my mind starts to go. But that's not really what I want, because that kind of guilt would be terrible for him to live with. What I would wish is that, in one of those periods when my mind was present and accounted for, he would tell me what was happening to me, and show me where the sleeping pills are. That way, the decision, and the act, would be mine, not his.

But what I really wish is that we didn't have to worry about dying this way. I wish the doctors would learn when to stop. The Hippocratic oath was not composed in an era when machines could do our breathing and eating for us. I wish the doctors would just stop pumping air in and out of bodies whose minds and maybe souls have already left--it's hard to see the difference between this and infinitely filling a leaky air mattress. To the doctors who say that letting people die is playing God, I say, forcing people to live is also playing God. Death is as natural as birth, and as necessary. It is not always an enemy.

To the doctors, and to those sincere religious people who value life above all, who are horrified by Dr. Kevorkian, I ask that you read Dr. Sherwin Nuland's book, The Way We Die. He shows us at length the absence of fit between the doctors and their terminal patients, the doctors who make decisions based on the abstract value of life, and the patients who want to be allowed to live, to die, and to make choices, as individuals. The book will do much to explain why, uncomfortable though the ghoulish Dr. Kevorkian makes us, we want him there.

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