Death

City of Hope requests that upon admission we present my notarized advanced directive and durable power of attorney for healthcare, and so on Thursday night we met with our friend Mike, who is an attorney, to get some advice on how best to express my wishes with regard to end-of-life decisions. Even though we had a lovely dinner, the work we came together to do was not fun. This is serious business, and boy, of all the documents I have completed in my lifetime, this is one I really want to get right. And so I have been wading through questions about life-saving measures, organ donation, coma, brain death, and my personal definition of life.

In addition, we also discussed a living will and the ways I would want my life insurance, retirement and home equity dispersed upon my death; the contact my children would have with my family once their father had sole custody; and the ways in which Steve and his children would be able to continue their relationships with my children if I were to die.

For those of you who have not yet dealt with these questions, let me tell you: it is impossible to keep a solely cognitive focus. Emotional detachment is not a possibility. And so I have been thinking quite a lot lately about death, namely my own, and I'm a little afraid. I'm sure a contributing factor is the fear I feel as I think about my surgery next week, and what that will involve: the anesthesia, the cutting, the sawing, the shaving. Will someone make a mistake? In addition, I think about my recovery. Will it be a smooth one? Will I suffer mental or neurological deficits? Will a seemingly benign tumor actually turn out to be malignant?

I could drive myself crazy with these questions. Sometimes I think I'm already a little crazy. I'm moody and temperamental at home. I lack focus and initiative at work. I've begun sleeping with a light on because of the terrible dreams I am having, dreams of being chased or having to flee or searching through the night. I wake up exhausted from the exertion of sleeping.

So of course I have to continue to remind myself that I am not in control. I have no control. Even Dr. Badie, my surgeon, ultimately will not be responsible for my life or my death. In her book My Grandfather's Blessings, Rachel Naomi Remen tells a story about her elderly mother, very ill with heart disease, who came to live with her after her first of many cardiac arrests, still responsible for managing all of her many daily medications. She writes, "I was horrified. At eighty-five, my mother was, to say the least, absentminded. What if she forgot to take a pill or became confused and took two? What then?"

And so she began, as casually as possible, to manage her mother's regimen. "Remember the blue one, Mom," she would say at breakfast. This went on and on, with Rachel's care becoming more intrustive, until one day her mother finally stopped her in her tracks. She told her grown daughter, "Rachel, do you know that I will die when it is my time? Not one second before and not one second after. And when that happens, you will probably tell yourself some sort of a story: 'It was because she forgot the yellow one or because she took two blue ones.' But that will not be the reason at all."

Rachel's mother held out to her a handful of colored pills and said, "You don't think that these things can outwit God, do you?" In the modern world, we often think this. The technology that will be used to conduct my surgery, to keep my heart beating and my brain functioning while I am deeply anesthetized, is unknowable to me. The imaging system that will be used to precisely locate my tumor, unseen to doctors from the outside, is a wonder. And we fool ourselves into thinking that our technology has some sort of power that, truth be told, it simply does not possess. Even the operators of this equipment, the surgeons, the anesthesiologists, and the radiologists, hold no real power.

On the day I die, it will not be because of the faulty turn of a dial or a surgeon's slip of a knife. It will be because my life on earth is over. Because God's plan, his purpose for my life, has been accomplished. On the one hand, believing this takes great faith. However, it also brings great comfort. I do not have to fear my death. For it is in God's hands, just as my life has always been. Psalm 139 reminds me:

You know me inside and out,
you know every bone in my body;
You know exactly how I was made, bit by bit,
how I was sculpted from nothing into something.
Like an open book, you watched me grow from conception to birth;
all the stages of my life were spread out before you,
The days of my life all prepared
before I'd even lived one day.

So because I believe that I was created by God to do the work, to know the people, to become the person he intended for me to be, I can place my medical needs into the hands of others. For God has ordained when I will die, not man, and I choose to trust God. As Remen writes in her book, Tibetan wisdom teaches that "we die, not because we are ill but because we are complete." So true.