Category Archives: death and dying

Practicing for the Afterlife

(Some people never learn. My new hobby is submitting to the New Yorker’s Shouts and Murmurs. The following piece was promptly rejected so I’m posting it here. Stay tuned for future rejected “humor.”) 

I. Go to your favorite social media site. Not the one that limits the number of words you can use. Go to the site where you can use all the words. Find a topic that interests you. Write a long heartfelt reply to a post, a reply that will save humanity. Delete it without posting because nothing you say matters, and no one can hear you when you’re dead.

II. At the end of yoga class when everyone is lying down in shavasana and the teacher announces you are all welcome to stay there as long as you’d like, stay there as long as you can. How long? Start with a few minutes a day and work up to forever.

III. Shhhhh. Stay silent at social events and all other opportunities. Do not speak except to avoid “the drama.”  Passively take in what others say.. Make only the slightest nods and gestures, and these only so the person speaking will feel heard and not say, “Dude, are you even listening?”  Do not display emotion. Be like Spock.  You are a tree or better a stone, a slab that people would stare into at a graveyard barely taking in the letters etched in the middle as they ramble to their dear departed.

IV. Declutter: Your stuff is not coming with you.  Burn it, bury it, throw it away, or give it to someone who will use or enjoy it.  Note: The person who will enjoy it is NOT your neighbor, Shirley. She is a hoarder!  Leaving it for her is just cruel. Just put it in the dumpster and maybe on the way, knock on Shirley’s door and ask if she has anything you can take for her. 

V. Move into a small modest dwelling, preferably made of wood or something biodegradable. Do not furnish: Okay, you can get one IKEA cube – no hacks, unless you put fancy boxes in so it looks like above-ground vaults. Sleep on a futon mattress close to the ground.  No pillows! Maybe a little pillow that raises your head at a slight angle as it would in an open casket burial, but only if you are into that sort of thing. 

VI. Live as simply as you can. Eat and drink only enough to survive. No processed foods — and then cut back until you note a look of terror in the eyes of your co-workers. Avoid alcohol but most especially avoid frivolous alcoholic drinks with double-entendre names and frilly umbrellas. There are no “wet pussy shots” on the other side!

VII. Try turning the other cheek. Not in a sectarian way, but because when have you seen a corpse throw a punch?  Don’t just avoid physical confrontation, avoid all confrontation and conflict. You really don’t have to yell at the asshole who is shaking a fist at you for stopping short, so you wouldn’t hit the meth head in the wheelchair pushing a shopping cart followed by a dog on a rope.  You are all meat puppets who will be desiccated bodies soon enough including the dog.  Note: Do not remind the asshole of this or you will be a desiccated body sooner. Besides, God spelled backwards is dog, and you never know, so good on you for not running over a possible deity!  Also you’re the one with the broken tail light.  And why do you still even own a car?

VIII. Move again to an even more modest dwelling or possibly, wander to practice for when your ashes are scattered if that’s your wish.  Leave no forwarding address.  Do this regardless of whether or not the asshole whose car you bumped is still stalking you.  Give your cash away. Cut up your credit cards. Take only what is offered and never ask for anything because the dead ask for nothing.

IX. Make a written account of all the motherfuckers who have screwed you over and you want to tell off. Include everyone from the random lady who wouldn’t move her bag and let you sit on the A train that time you were really tired, to your siblings, exes, and friends. Burn the list without confronting anyone. Be content in the knowledge that they, like you, are going to die.  Really, is there anything you have to say that’s more of a zinger than living under the wrath of a capricious God who could strike anyone down at any moment? Dying is easier when you simply no longer give a fuck, which is the point of these exercises. Cultivating not caring  is the best preparation for a peaceful eternal rest. If you’re still not over your rage at how you were betrayed, abused, lied to, disrespected, and definitely not mom’s favorite,  try ranting in front of a mirror. Don’t you look tough! That was sarcasm. You look like a crazy person. Throw some cold water on your face, shut up about everything forever, and move on. 

X. Now that you have cultivated the nonchalance of a cadaver, turn off the lights (if you still have electricity) and lie down on your futon or directly on the ground.  Rest your hands over your chest, take a deep breath like it was your last, and have a nice nap. If you’re lucky, you won’t ever have to get up! 

Murder on the Subway

Honestly, I wasn’t going to write about this. I was going to write a post about the obvious fix that is needed to make the JFK Airtrain functional. But it’s insane now to write a post about first-world-problems — getting to and from the airport — while vigilantes are murdering homeless people on the trains.

So short and simple and with some links:

I challenge anyone reading eyewitness  reports of what happened on the train and looking at the photo of the chokehold to say that Neely wasn’t murdered. I’m not saying it was first degree murder, but the chokehold was wreckless, and any REASONABLE PERSON would know that. I say this as someone who is now often frightened on mass transit. The mass shooting in Brooklyn, and the more recent shooting of a single passenger — a man on his way to meet his brother for brunch —  are terrifying. Deaths caused by people pushed onto trains are terrifying. But you don’t react to fear by pouncing on an emotionally disturbed person with no gun, no knife, making no threat because he throws down a jacket, and then putting him a CHOKEHOLD which a reasonable person would know is deadly force. In photos it’s clear the marine was bigger than him and could have subdued him — not his job — without deadly force. Whatever his intent was, he was wreckless, and of course he should be charged.
Updating to add: Just found this, a statement by the alleged murderer’s lawyer: “Daniel never intended to harm Mr. Neely and could not have foreseen his untimely death,” the law firm of Raiser and Kenniff, P.C. said in a statement. “We hope that out of this awful tragedy will come a new commitment by our elected officials to address the mental health crisis on our streets and subways.”
Again, Man A puts man in a chokehold. Man B in chokehold passes out.  Man A continues to choke him.  A reasonable person would have foreseen the victim’s “untimely death.”  And yes, NYC prosecutors if you don’t overcharge, you will find a jury willing to convict on the evidence, and convicting a murderer is your job. Doing your job won’t cost you the election.
Updated to add:  Caught a NYTimes article contrasting the lives of the victim and his assailant. The mental health system (and other systems) failed Jordan Neely before his murder, but some of the failure wasn’t due to money or a need for “stronger” involuntary commitment laws. Some of the failure was simply the failure to track humans within the mental health and law enforcement system. There was a warrant for his arrest because he had left a program that he’d agreed to in court because of charges against him. He could have and should have been arrested and sent back to that program instead of simply being thrown out of the subway by cops — who didn’t check for warrants — weeks before.  Why didn’t the police check for warrants?
That failure will be exploited by his killer’s defense team  (if he’s ever charged) — as it should be because that is the defense team’s job. Ultimately, that failure didn’t cause Neely’s death,  but it is an example of one of many things that could have prevented the encounter from ever happening.
While I don’t think it is the job of NYPD to be psychiatrists or mental health workers, it is certainly their job when called in by mental health workers to CHECK FOR OUTSTANDING WARRANTS.

Earthbound Angels in Need of Decent Wages

(On my my twitter feed this morning, Pankhearst, an uppity collective of independent women writers, twitted about something on the Bitch Magazine blog. How is it that I had never heard of Bitch Magazine before?  In what Nick Cave have I been living? I checked it out and saw a post about home health workers. This being Bitch, it referenced a 30 Rock episode.  As this is a topic, close to my I heart, I wound up posting an overlong comment. You really should check out Bitch, and Pankhearst while you’re at it, but I’m also re-posting a slightly edited version of my comment below:)

In 2005, after electing not to treat his final bout with cancer, my father was able to get “home hospice” services. Like most elderly in the US who have insurance, he had “managed care.” He was encouraged to have an home health aide (HHA)  in the house to help with daily tasks. He and my mother reluctantly agreed. This was all arranged through the hospice services, which are part of a bigger hospital-affiliated health service. Several HHAs were sent. Some my parents had issues with, including theft. One finally stuck.

Continue reading Earthbound Angels in Need of Decent Wages

Romney/Ryan to the Elderly, “Drop Dead”

“Although few of us want to admit it, once we (or our parents) become old and chronically ill, we (or they) will likely end up in a nursing home with care paid for by Medicaid.

— Tom Curry, NBC News national affairs writer

The above quote comes from Tom Curry, NBC News national affairs writer in a blog-post published 8/17/2012 on NBC Politics on Ryan’s plan for releasing Medicaid from federal protections and regulations and turning it over to the states, allowing them to set their own agendas for who qualifies because that’s worked so well for them with voter suppression.

Curry misses the mark on what most people fear or even what’s “likely” to happen to most people.  Dying in a nursing home on Medicaid is not the fate of most people. Many people in the middle-class have worked hard to keep that from being their fate.  My mother worked hard, not only raising her children, but also as a teacher (in the union) and had a decent pension as well as a combination of health insurance from her job and Medicare (managed care).   Her savings and the sale of her home helped pay the rent after my father died and she moved into an apartment in a senior living facility.  That facility wasn’t technically “assisted living” but offered her the services she needed to remain independent.  Facilities like that are private and for the most part fees are not covered by insurance, Medicare or Medicaid. Her managed care helped when she had a fall or other health crisis and needed hospitalization, physical rehabilitation and/or temporary nursing home care.  In a sense she was racing the clock, trying to remain as healthy as she could for as long as she could so that whatever happened would be covered by the managed care she had.  All the rules around what is covered and what isn’t in terms of nursing home care, home attendant services, etc are very complex.  In the current system, the issue is when people’s long-term needs exceed what is covered by managed care.  That’s when savings are needed and after they are depleted or transferred, Medicaid kicks in.

In my mother’s case, her savings paid her “rent” and her “rent” increased when she needed more services that weren’t covered by managed care such as having the facility hand her her meds instead of having her self-manage that.  At the end, she had a stroke and died in the hospital a few days later.  Had she lived, and needed full time, long-term care, I don’t know how much managed care would have covered, and because she still held most of her money, it would have been a while before she would have been eligible for Medicaid. If we imagine a scenario where Medicaid is out or unreliable altogether, then we are imagining a time when people die when they run out of money, period.  In my mother’s case, in addition to life-long thrift, she benefitted enormously from her pure luck in having bought and held onto a home whose value had increased greatly by the time she sold it at the peak of a housing boom.

If she hadn’t had the savings to afford her “rent,” then I’m not sure how we would have coped. She was frail for the last few years of her life, and once my father — who had been the stronger one — passed away, she could not have lived on her own. She would have required family care that would have kept at least one of her adult children or other relatives from working full time for a number of years, as not only would shopping, cooking, cleaning and ferrying her to doctors have been required, but also keeping an eye out to make sure she was safe.  While she would not have needed to be in a nursing home, she would have needed to live somewhere with modifications such as stair-lifts and other safety modifications.

Most people’s fate is not the nuclear meltdown of depleting all their resources, needing Medicaid and dying in a nursing home. People may fear that because under the current system it’s certainly a possibility, but it’s not the most likely one.  Most people fear the erosion of protections for the middle class that would keep all that from happening.  This includes the destruction of unions that help negotiate for decent health care plans, the destruction of things like home mortgage deductions that help make home ownership (the biggest and best investment for most of us) possible, the erosion of Medicare, and the overhaul of the Affordable Care Act which will help us keep the insurance we have and keep the insurance companies from throwing us off plans.  In short, most people (at least in the middle class) fear or have reason to fear, the entire Republican agenda.

This is not to say the current system is perfect. Most people, even in the middle class, are already losing what they had a few years ago.  Benefits, like the ones my mother had, have already been slashed, and the nuclear scenario is still real when long-term care is needed and managed care benefits have been exceeded.  What’s needed isn’t simply keeping Medicaid available, what’s needed is more healthcare reform that will help us with preventative care so more of us will stay healthier longer. What’s needed is more reform, including cost-control, so if long-term care is needed people don’t need to become virtual wards of the state to pay for it.

A Matter of Life and Death

Email to a friend:

Hi Susan,

Are you in Colorado?  Happy New Year.  Hope the snow is fresh and the crowds are reasonable.   Just wanted to update you on my whacky life.  So last Friday (a week ago), Maizie had a seizure, which I wrote you about. Then the second one the following day which was 12/24, again complete with eye-rolling, collapsing, peeing, and getting up a couple of minutes later and looking around like, “Huh? What? Where’d this puddle come from and why is my backside wet?  Shit. I hope Mommy doesn’t yell at me for this.”

Craig was ready to put her down that day, and if Dr. Dan (the new vet that my nephew works for) had been in, we would have.  But he wasn’t, and we made the appointment for Thursday, as that was the first early morning one we could get, and Craig wanted to go to work afterwards (and not go home and brood).  But Sunday morning, when he took her out, she was all “jaunty” and continuing to want to kill her frenemies, and to want affection, and to get all excited around meal time, and signal to go out to troll, etc.  By Monday, Craig was having doubts.

I just couldn’t take it.  At that point, I still wanted to kill my dog.  I was thinking of my Dad, after his cancer returned and he kept talking about how he just wished a piano would fall on his head.  I was thinking about Craig’s cat, Big Red, and how he waited too long, didn’t even notice how much weight he was losing because he saw him everyday, and finally Craig was supposed to travel for work and I was going to take care of Big Red, but when I went over a few days before Craig left,  I realized he was dying and  we had to put him down sooner.   I was thinking about Maizie’s inevitable decline, and the stoicism of dogs, and how we should just get off this emotional roller coaster, and how it would be me, working from home, more likely to see the next seizure, more likely to be the one taking her in when she finally couldn’t get back up on her hind legs, carrying her to the car.

Craig thought it was my being obsessive, and it was Italy, our planned anniversary trip, coming up in two weeks — the first time we’d be in Europe together, and to a country neither of us had visited.    Maybe something to that, because we both agreed that if we didn’t put her down, leaving her in a kennel for 10 days, even a nice one, was probably not a good idea.

On Tuesday, we went out to dinner with the cousins.  They aren’t fans of the Maize, having a bad impression based on an unfortunate dinner incident.  But Daniel (the smartest man in any room) brought up the seizure thing. Did Craig really want to wait for the third seizure?  The answer was no, but….

The next day, Craig  checked with the airline.  No refund, of course, but $200 to change the dates.  My sister happened to call and I updated her.  I reminded her of my father’s piano line.  She didn’t think it was that simple.  She pointed out how much he’d held on at the end.

“Nobody wants to die,” she said.

She reminded me that even my mother, who was unconscious those last few days, seemed on some level, not willing to let go, although she had said earlier, after her stroke but before she faded away when the subject of a feeding tube was broached, “If I can’t eat ice-cream, what’s the point?”

But Maizie, based on what I was telling her, hadn’t reached that point yet.  And I realized she was right.

Craig cancelled the appointment.  We were still figuring out Italy. We rationalized that before the seizures we’d been planned to board her, and what had really changed?  Yes, she might take a turn while we were away, and we’d feel terrible, but more likely it would be a slow decline, another seizure maybe, maybe two, but not a crisis.

We wouldn’t leave her at the place we usually left her.  They’d screwed up last time, not monitoring her closely or contacting us when she seemed to be reacting badly to the meds she was then on for her Cushing’s.  There was another place we’d taken her a couple of times, swankier, more expensive, less convenient to get to.  We thought we’d try there, but also see if my nephew would consider dog sitting.  He couldn’t.  His workshifts are too long and she’d be alone too much.  My sister had mentioned a son of a friend’s, a musician in need of a day job, raised in an animal loving household as a possibility, but Craig thought given Maizie’s special “behavioral” issues, a stranger who wasn’t a professional might not be a good idea. We called the swanky place.  Before I’d had a chance to explain much, they reacted to the words, “Geriatric” and “frail” and told me straight out that a dog in that condition should never be boarded.

That hit us like a gut-punch.  Not only were we terrible human beings for considering killing our dog, we were terrible human beings for wanting to go away.

We wondered what would happen if there were an emergency and we’d both have to travel.  Or what if Craig got one of those good business gigs to Africa and I could join him after?  The answer to the first case, was we’d leave her at the vets, for as short  a time as possible.  In the second case, I’d stay home

Today, Craig reported Maizie seemed a little out of it on their walk.  She’s sleeping now.  She sleeps mostly.  Italy is probably off the table for a while, unless she takes a turn for the worst in the next few days.  We might ask the musician if he’s interested in the gig, not for Italy, but generally, if she lives a while, and come spring we want to use those tickets.

This is it.  There aren’t a lot of choices.  Putting down an animal is never easy.  But it probably helps if it’s already too late, if their suffering is obvious. In some dispassionate way, I don’t think it would be a big deal to deprive her of continuing a journey that is almost at its end, and may involve a steep uphill slog.  That’s in the abstract.  In reality, I couldn’t see getting her into the car, which often signals trouble but sometimes signals fun, driving her to Dr. Dan’s, where she’ll greet my nephew like a friend and then look at it me like I’ve betrayed her when she remembers it’s a doctor’s office. I couldn’t imagine my husband, lifting a now shaking dog onto the table as Dr. Dan gets the needle ready, and feeling for the rest of our lives that we deprived her of something, even though I’m not exactly sure what.

UPDATE:  1/12/12: We canceled Italy. The good news is I may go to see a show on Saturday, have tickets to see Al Green, Lin-Manual Miranda and POTUS at the Apollo on 1/19, and the better half and I will be taking some time off to celebrate doing New Yorky things.  Maizie seems to be doing better.  We went to the vet just to check in and because she was licking herself a lot.  He said it was a probably just an irritation from lying all day on a hard spot.  He said she looked great for a dog her age, even for one who doesn’t have cushings.  No seizures since the ones that almost caused her executions. We decided not to put our lives on hold and called up a bunch of kennels.  We found that some wanted to put her in a “special care” doggy nursing home where she would be tended to way more than she would ever want.   We now have two potential reasonably priced places that we think will work and will check both of them out.  Maizie will definitely do a test run of two days to make sure she can tolerate the boarding.