Madeline knew her mind was slipping. After a long and successful career, renowned in her field, she knew her brain — and knew it was no longer working as it always had. Never a forgetful woman, Madeline now misplaced important items — and, more distressing, her thoughts. She spent days talking with her doctors and searching the internet for understanding. Then she would forget why she had gone to that website.
After weeks of worry, weeks of increasing confusion, Madeline had a moment of absolute clarity: she wanted to end her life now, before she became unable to make her own decisions. So she told her family she was choosing to stop eating or drinking. Not everyone in the family agreed or empathized, but her husband said he would support her. She recently enrolled in hospice care and is carefully, comfortably spending her final days in peace.
Here’s an upside to the current COVID-19 pandemic: We are talking, daily, about dying. We the people of the USA. And not just in the abstract: “I’ve already completed my Advance Directives . . .” but in very personal terms: “If I die, what choices can I have about that?”
This may not seem very Up for an upside. The personal terms too often involve a parent or spouse who died alone in a cold hospital room, a elderly cousin or a beloved friend suffering alone and isolated. Suddenly we’re not talking about forms to complete or distant events, we’re talking about potentially imminent death, our own mortality. Madeline’s husband said one thing that had helped their family accept this difficult decision was that people everywhere are facing life-and-death decisions, confronting their own mortality.
We are confronting it in a multitude of ways. This writer, age 87, is among a bunch of other geezers I know who posted explicit no-ventilator instructions with our end-of-life documents six or seven months ago. A tiny bit of our motivation was altruistic because ventilators were in short supply; but to be honest, most of us just prefer a quick death — at home, skip the hospital altogether please — to days or weeks spent isolated and comatose followed by death in an unfamiliar ICU. COVID-19 has helped uncover a near-universal truth: we mortals would choose to be in control of our final days and weeks — the end of our mortality.
One place where this is becoming clear is my favorite nonprofit, End of Life Choices California. Madeline is a client of EOLCCA. Calls to the EOLCCA phone line have roughly doubled since the beginning of the pandemic. People call EOLCCA because they (or sometimes a loved one) are terminally ill and considering using the CA End of Life Option Act to control when and how they die. This is never an easy or casual decision — but COVID has helped bring it into the mainstream. We the People have watched as our fellow citizens died — close to 220,000 of them so far. We’ve read their stories, extraordinary stories of ordinary people just like us. We’ve seen the wrenching videos of final goodbyes said via cellphone from a cold hospital room.
So it’s heartening to consider another story: Madeline quietly dying at home, on her own terms. COVID has taken a lot from us, but it’s given us the gift of insight.