I should leave this stuff to Roy, but I recently started reading Rod Dreher’s blog again. God knows why, because he often drives me nuts, but evidently I need a certain amount of that stuff in my daily run, and Lileks isn’t doing it anymore. Today, he takes on a wrenching New York magazine piece by Michael Wolff on the long, slow decline of his mother.
It was brutal, and I couldn’t get all the way through it. The headline was brilliant: “I love you, Mom.” Sub: “I also wish you were dead.” Sub-sub: “And I expect you do, too.” If you’ve already been through this, you know the way these things go — the pain, the suffering, the indignity and, worst of all, the towering, senseless expense — $17,000 per month in nursing care for Wolff’s mother, who hasn’t been able to walk, talk or take care of herself for a year and a half. He goes on about this and that at some length before announcing he’s planning a different exit strategy for himself, and he’s pretty blunt about it:
Not long after visiting my insurance man those few weeks ago, I sent an “eyes wide open” e-mail to my children, all in their twenties, saying this was a decision, to buy long-term-care insurance or not, they should be in on: When push came to shove, my care would be their logistical and financial problem; they needed to think about what they wanted me to do and, too, what I wanted them to do. But none of them responded—I suppose it was that kind of e-mail.
Anyway, after due consideration, I decided on my own that I plainly would never want what LTC insurance buys, and, too, that this would be a bad deal. My bet is that, even in America, even as screwed up as our health care is, we baby-boomers watching our parents’ long and agonizing deaths won’t do this to ourselves. We will surely, we must surely, find a better, cheaper, quicker, kinder way out.
Meanwhile, since, like my mother, I can’t count on someone putting a pillow over my head, I’ll be trying to work out the timing and details of a do-it-yourself exit strategy. As should we all.
Dreher reads this, and sniffs: “Appalling.” He goes on to lay out his own situation, with his father:
He is 77, and in poor health, though not suffering from dementia. He’s got a bad heart, and all kinds of aches and pains, the result of a rough-and-tumble country-boy life (e.g., he used to rodeo as a young man). He is in near-constant pain in his hip, and has to use a cane to get around. I don’t know when he has last felt good. You can’t believe the medicines the poor man has to take every day, just to maintain. He’s getting too feeble to do much more than sit in his chair.
And all I could think was: Do you have any idea how easy you have it? A father with “all kinds of aches and pains” who is still lucid and ambulatory? As these things go, that’s a blessing from heaven. When my parents died, I decided the measure of a good end of life was the brevity of the interval between creaky-but-taking-care-of-yourself, that is, perpendicular to the floor, and bedridden-and-entirely-dependent-on-others, i.e., parallel to it. For my mother, this interval was five years, for my father, about two weeks. If you can have a conversation with your parent? If you aren’t smelling their pee, or if they’re still in their own house? That is wealth beyond rubies, and when the crisis comes, if you have a lucid, kind and pragmatic medical team to advise you? You are even richer. Alan’s mom spent a few months in assisted living before pitching forward onto her noggin and raising a subdural hematoma that eventually proved fatal. This still required an ambulance ride to Toledo on Christmas Day so that another medical team could state the obvious and send her home to hospice, where she died a few days later.
My point vis-a-vis Dreher being: If you could read that essay and still find the writer’s honestly stated vow to not inflict that on his own children “appalling,” well, I need to stop reading this sort of bullshit, because life is too short.
And I don’t need to remind you who we have to thank for setting common sense back a few more decades, do I? (She-Who!!!) Wolff, again:
I do not know how death panels ever got such a bad name. Perhaps they should have been called deliverance panels. What I would not do for a fair-minded body to whom I might plead for my mother’s end.
The alternative is nuts: to look forward to paying trillions and to bankrupting the nation as well as our souls as we endure the suffering of our parents and our inability to help them get where they’re going. The single greatest pressure on health care is the disproportionate resources devoted to the elderly, to not just the old, but to the old old, and yet no one says what all old children of old parents know: This is not just wrongheaded but steals the life from everyone involved.
And that is not appalling at all. It’s just the truth.
I’m not really in as bad a mood as I might seem to be. My advance medical directives are pretty clear. They say, “…and I understand these actions may result in my death.” Ego te absolvo.
While we’re there, another good read from NYMag, not so grim: An account of George Romney’s run for president in 1968 and, along the way, the beginning of the end of moderate Republicanism. My fellow Michiganders probably know all this well, but I was a mere girl then, and I didn’t know all the details, many of which are both sad and funny, as this story about the start of Romney’s campaign, in fall 1967, with a tour of ghettos in 17 cities, where the candidate talked about civil rights. That was, shall we say, a message that fell on deaf ears:
In Watts one day, Romney and Lenore were sitting in the back of a sedan, being chauffeured to the airport by a local driver, with Romney’s bodyguard riding shotgun. According to a story that circulated all through the campaign, Romney leaned forward: “Say, what is that word they keep saying to me? I don’t understand, it begins with an M…” The driver and the bodyguard racked their brains as Romney tried to pronounce it, working his western consonants around an inner-city accent. Then the driver straightened up and said, “Governor, I think what they’re saying is”—and here he let his voice get kind of ghetto—“mo’fucka.” And then, because Romney was legendarily a Mormon and these vulgarities may have been somewhat beyond him, the driver clarified: “Motherfucker, sir.” And Romney sank back into his seat, like a part of the car that had been mechanically retracted.
A great Bridge yesterday if you’re interested in the ins and outs of municipal finance, addressing the burning issue — yes! I went there! — of fire service. In some ways, firefighters are like dentists, victims of their own success at upgrading building codes and preaching prevention. Fewer fires are being fought — half as many in 2010 as there were in 1977 — but you still need a force down in the firehouse. The question is what kind, and how do you train and work them? You can hit the main Bridge link in this paragraph, or the individual stories in the RSS feed over there on the right rail.
Happy Wednesday to you.