Part VIII: Advance Directives: Dying Inside Our Big, Hairy Healthcare System

(Continued from Part VII: Advance Directives: Ours.)

Turns out there’s a huge, third party squatting in the room with us, as we wade through our advance directives. It’s our healthcare system. We didn’t realize until now what a disproportionate influence it wields on our choices about dying and I’m struggling with some real sadness about it.

We discovered that the choices we’re making today are different than the ones we’d be making if we were either very wealthy or had access to universal health care.

The unsettling truth is that we’re both opting to die a little earlier for reasons of cost and care burdens. In our current healthcare system, dying could cost so much for medical intervention and help with day-to-day care, that it could easily leave whichever of us was left destitute and/or with broken health. It’s happening every day to people just like us…middle class with decent insurance (I saw a couple of tragic examples when I worked with hospice)…and the hubster and I simply refuse to do that to one another.

I had a very hard moment the other night when I suddenly realized I wouldn’t mind so much, lying in bed for months or maybe even years, slowly declining while looking out the window at my beautiful garden, as long as I could still write and visit, study and learn, meditate and muse. It surprised me. I’d always thought if I couldn’t hike, escape to the mountains, garden and swim anymore, that I’d be done. I had no idea that I could still be happy without those things…if only the burden of care was spread across the shoulders of enough people to protect them all and care for me well. If only we were wealthy and could afford to hire them. If only our healthcare system was universal…and actually helped with home care to begin with (which it doesn’t.)

For the first time I realized I’m not so much afraid of being disabled as I am of destroying the people I love with the burdens of my care, or of being cared for negligently in an institution somewhere (I saw too many tragic examples of this), and I experienced an unexpected and poignant wave of love and deep longing for my life.

On the one hand, I’m irrationally wishing we were born in Canada, or England, or Cuba instead…some country with universal healthcare that cares about all its people equally.

On the other hand, I say irrationally because I know that if I turned Fate loose for a do-over like that, we might just as easily have been born in Bangladesh or Somalia. Some other country where dying can happen even faster.

I suppose there’s no useful purpose to be had in bemoaning destiny. The hubster and I were born in this country, we’ve lived here all our lives, and this is where we’ll die. And to tell you the truth, we don’t really want to die in another country with better healthcare anyway, even if dying here could come earlier and suck more. We’ve loved our lives here. This is our home and no country is perfect…a corrupted healthcare system just happens to be our particular Achilles heel.

So yes, all things considered, it’ll be okay if we wind up dying a little earlier here than we would if we were living in an ideal world. I guess comparing our situation to perfection isn’t the best idea.

(Next the conclusion: Part IX: Out of Town And Back Again (With Advance Directives In Tow)

One response

One of the things I’ve tried to do is to live enough adventure to pack away lots of stuff to think about, remember, and replay in my head, should I ever end up flat on my back and unable to do anything else. (My luck, my brain would be fried so all that living would be wasted anyway)

This post is a rather dreary one, I must confess. But, you know, sacrificing a few months or years at the tail end doesn’t really sound all that bad if all the years leading up to it are rich and full.

Where DO you find the marvelous images that you pair with your posts, Dia? They never fail to be absolutely spot on for your topic.