It’s been a while since I’ve done a longer book review here, but one of the books I just finished, Being Mortal, by Atul Gawande, really merits a few paragraphs.
I first learned about this book when I recently saw Dr. Gawande, a surgeon, as the opening guest on Real Time With Bill Maher. I was immediately intrigued by the book he’d written and its core topic: how we take care of (or do not, as the book also points out) people who are in the last days/weeks/years of their lives. In other words, how and where we make our inevitable progression toward death. It is not necessarily as you think it might be.
Yes, this—death and dying—is an uncomfortable topic for virtually everyone to talk about, myself included. But when it is something that is going to happen to each and every one of us, shouldn’t there be more compassionate treatment and open discussion of this ultimate life truth? I think so, especially if you are going to be involved in deciding how someone else has to spend that part of their life. And, more to the point, I think that these considerations should be made far earlier than in the thorniest, most heart wrenching parts of life’s ending.
But to do this, you also have to have an idea of what the current state of affairs is. You need context for how it was, how it is, and, thankfully, how it might all be better in the future if we have a collective shift in how we treat those we love most in their final days.
Dr. Gawande does this so eloquently in this important book. He lays all of this out there, including his own choices in the process, both as son and doctor. Admittedly, he achieves this by giving the reader ample yet often heartbreaking anecdotes in the process when he recounts various stories of patients and people he’s come to know while working on this book. Truth be told, I cried at a few points during this short book. Sometimes I teared up when I related to what I am likely to encounter at some point in my own life (not my own death per se, but the deaths of my family members), but often it was just the lives being described in the book. Do not let those difficult feelings stop you from reading this book.
Here is why I think this book is important: I think many of us are completely clueless about exactly what happens and what choices do/don’t exist when we are nearing the end of our lives. I certainly had no real idea. My only knowledge was based on seeing how my and my husband’s now deceased grandparents and great grandparents progressed through that phase of their lives. Some of those situations were representative of the current state of affairs, and the others fell on either side of that dividing line, but in the end there is much that I completely failed to take into consideration or understand.
I was also ignorant about how “medicalized” it all has become, particularly in the U.S., and it is not necessarily the best road to take. I was taken aback by how much of a loss of autonomy is forced upon the elderly when they enter a nursing home or even assisted living, and the drastic effects this can have. Just the aspect of who nursing homes are often designed for and marketed toward was eye opening. Children want safety for their elderly parents, but this comes at a cost to the parents: their ability to make choices for themselves is stunted if not removed wholesale. Even something as simple as deciding when (or what) to eat is taken away, purportedly in the name of safety. Yet, can you imagine life like that for yourself? It’s hard to do. In the same vein, I was encouraged by Dr. Gawande’s mention of more progressive ways that we are, as a nation and society, rethinking how the elderly should and can spend their lives at the end. Those stories offer hope.
I learned so much from reading this book and was forced to consider, at least for a moment, how the kinds of choices that exist, and those that do not, will play a part in my life as a daughter, wife, etc. At forty-one years old, I know that those decisions, discussions, and difficulties still lie ahead for me, and goodness I hope for a long while still. Obviously no amount of preparation can really make it easy. But by starting to think about them now, I can start to knit together the various aspects that will come into play and how they might be approached. It’s a responsible, though clearly difficult, thing to do as an adult.
I wish more of us were adept at talking about death and how we go through this process with loved ones or alone, as the case may be. This book helps us start those conversations, and it does so with a keen compassion and insight.
Incidentally, though I have not yet watched it, there is a PBS/Frontline documentary based on this book. I plan to watch it once I put a little heart space between myself and the book. There is something about seeing (versus reading about) people in this situation that I am not sure I can handle at this particular moment. But here is the link if you are interested.
Copyright (c) 2015 Kristen M. Ploetz
I don’t think about my status as an atheist or non-believer very much. Certainly not on a day to day basis. Sure, here and there it comes up in discussion at home with my husband or daughter, or occasionally with a couple of friends (believers and non-believers alike), but generally my point of view just rests mutely in the back of my mind. I suppose this happens when there is no regular gathering, such as on Saturdays or Sundays, to ponder the wonder of a collective non-belief. I’m also not very interested in proselytizing (who has the time!?). Ah, well. I feel no ambivalence about the conclusions I’ve reasoned and reached, so this is just like any other aspect of what makes me “me”, like my affinity for coffee or my messy sock drawer.
Still, despite my comfort level, over the past month or so there’s been a quiet bubbling to the surface of the one aspect of many religions’ belief systems that makes me wonder whether parenting is slightly easier for the believing majority: the promise or idea of an afterlife or heaven. I think there were two specific things that got me mulling this over more than usual.
The first was listening to a portion of the NPR series, “What Comes Next? Conversations on the Afterlife”, featured on All Things Considered. Granted, so far I have only heard one full interview (the rabbi) and bits of others, but it was a jolt of thought long held at bay for me. Listening to some of these folks made me pause and think, “they’ve got it good because they almost get a second bite at the apple with their loved ones by holding this view.” It also made me recall a passage from the book Life of Pi, by Yann Martel (which I read more than a decade ago), where the question was posed by Pi, which is the better story that he had recounted: the one with the animals or the one without? The answer was the story with the animals because it gave the beauty and brutality we face in life more divine context. Pi’s response was something to the effect of, “and so it is with God.” In other words, if you can believe one of two stories, why not choose the more comforting and beautiful one. Yet, despite the obvious comfort it offers in the context of death, I’ve personally never been able to make that leap of faith.
The other event was attending a funeral earlier this month. There were some religious readings, including a mention of heaven and the idea that we—that is, those of us still alive—will one day see the deceased again and that we will be looked upon from on high. The previous funeral I attended before this one was while I was pregnant with M in 2007, thus I was not yet fully immersed in the role of parent and lacked the different perspective I now carry about mortality and the fragility of life. As cold or as crass as some might think it is, I don’t believe there is an afterlife or special place that our “spiritual” selves go or reunite with others. In my mind, the physical end is the ultimate end. Yet it is this finality that makes me feel that perhaps believers may have the upper hand, at least insofar as being a parent is concerned.
Let me paint the picture this way. When you become a parent, you’ve essentially been given season tickets to a deeply moving, life-changing improv show. It’s a wonderful mix of comedy, drama and suspense. In the beginning, you see everything, from the behind the scenes tasks and toil to the front of the house standing ovation after a particularly good performance. No two acts, let alone performances, are alike. You are equal parts producer, director, supporting actor, acting coach and audience, though these roles ebb and flow throughout the season. Over time, you see less and less of the performance onstage, but you certainly have a handle on what’s been taking place by hearing the reviews. You are immersed. You are spellbound. Yet this is the one show that you do not want to see the end of. This is because to see the last performance would mean that the life of the main character—your child—would have to end before yours. No parent wants that. So instead, we usually duck out sometime before the final curtain call.
Of course, of course, saying goodbye to our children, whether it be because of our death or theirs, is hard for each and every single parent, no matter when it happens and no matter what your belief system is. But what I wonder is if there is some small, even if infinitesimal, advantage to the knowledge, if you’re a believer in the afterlife, that you will have an opportunity to come together again one day. I have to think that there is, if only because there is the promised benefit of seeing, albeit from a different plane, the end of the show as well as a soulful backstage reunion.
As an atheist, I do not operate under that premise. It sometimes moves me to tears that there are so many things that I will ultimately not get to see in M’s life solely because of the natural order of our mortality, which usually has offspring living well beyond their parents. The physical world and the finite running time of the show is all I expect. It is the ultimate “fear of missing out.” This is the handicap of an atheist parent, at least for me. It is often difficult to move through life knowing this, and makes me envious of those who can adopt a belief in something more after this physical world.
I’m not going to go as far and say that perhaps because of this vantage point that atheists have a stronger appreciation for life, and certainly not categorically so. No, to do so would be arrogant and presumptuous. But it certainly does beg the question of how one’s position about the possibility (or not) of the afterlife shapes the paths and emotions we face while alive.
Copyright (c) 2013 Kristen M. Ploetz
Have you ever tasted a blue potato? There’s just something special about them. In July, when they are first ready to be eaten as new potatoes, they add a beautiful ray of color to the spectrum of grilled vegetables, their crispy skins crackling in your mouth. Let them mature a bit, and they become a conversation piece, boldly proclaiming their indigo hues within the humble late summer potato salad. And, if you’re lucky, a few will sometimes remain through the early fall, best enjoyed simply with a bit of butter and chives.
When you grow blue potatoes, they are the crown jewel of the garden.
But they take time. Late season potatoes, as they are known. They take 90-120 days to grow, give or take a couple of weeks (or dry spells . . . or beetle infestations . . . or poorly draining soil). Finding a spot for them in the garden takes some advance planning, because they are not going anywhere for a while and there are future fall crops to consider, not to mention those lovely short stature perennials that peak in the garden just when the two-foot high potatoes do. I love the potatoes, I do, but I want to give the lupines a chance to shine too. Once the lovely little flowers on the potato plants die off, the bushy plants are not much to look at for the bulk of the time they are growing. They certainly don’t deserve center stage.
When you plant things, especially food, you do it with a mixed sense of excitement (Yes! This means summer is here, and all the good food that goes with it!), wonder (How is it that this one inch piece of potato will yield 7 or 8 larger potatoes in the span of just months? Is there anything more stunning than the blue that emanates from these potatoes?), and some amount of trepidation (Will they be as prolific as last year? Will those beetles give us more trouble this year? I hope this does not become a wasted effort!). Because food is synonymous with life, growing plants that feed us takes on an almost survivalist tenor for me, awakening the latent genes of our infinitely more self-sufficient ancestors, though I realize that with grocery stores less than a mile away my humble potatoes are not exactly the reason I’m still around. With each season you grow plants, you take on new perspectives about the endeavor. You develop a deeper appreciation for the factors you can control, and those you cannot. You learn to live within the cycles provided by Mother Nature, do your part when you can, and then just step back and watch the show.
The box of seed potatoes arrived last week. The weather was going to be perfect for planting on Monday. So, under the glorious sunny day, M and I planted potatoes together after I prepared the soil in the chosen bed. Though we have been planting vegetables since before M was born more than five years ago, and she has helped out in bits here and there, this is certainly the first year that she volunteered to help—and with genuine, unwavering “let me do it all by myself” enthusiasm, no less. I was completely moved by her desire to be there, with me, in the dirt planting. It was a day I do not think I will ever forget. As a family, we did a few hours worth of spring planting and outdoor tidying up that day, completely immersed in our own little world, with bees, birds and breezes at our backs.
And bombs. We had no idea what was simultaneously happening in Boston, just a dozen miles away. Our phones and social media had been filling up with inquiries and posts from near and afar about whether we were all OK. This all took place completely unbeknownst to us because we had been outside and turned off the TV earlier in the day once the women’s first place runner finished. The first I learned what had happened was when my husband came home from his quick trip to the ice cream shop and silently showed me the headline on his phone when he walked in. We didn’t want M to know what was happening so we kept it between us. If it were not for the need to get those potatoes in the ground, we might have very well still been watching the Marathon on TV while events unfolded.
She ate ice cream while I surreptitiously looked for information on my phone and responded to those checking in with us. She ate ice cream while I swelled inside with anger and sadness, initially on behalf of those friends of mine who did not get to see the finish line they had worked so hard to cross, then more progressively into something much deeper. She ate ice cream while I tried to keep anxiety at bay, rationalized.
She ate ice cream and I looked down at my dirty knees, still wearing jeans since I was distracted by the news before changing. My thoughts drifted to the potatoes. 90 to 120 days. Mid-July to mid-August. Thoughts became fractals. What will the potatoes look like then? What will the garden look like? What will our neighborhood look like? What will Boston look like? Will we know who did this, and why? What will the rest of our world look like then? Will there be more of the same? Will we grow, as humans, during that time?
In gardening, as with all else, nothing is certain. This truth I now see perhaps far more clearly than ever before. There are simply too many variables and inputs that we cannot control. Given the known cycles of life, given my understanding of how things generally flow, I know it will inevitably be filled with weeds and woe, but also beauty and bounty. With this knowledge, I will try to reconcile and keep perspective about what happened on April 15th and living in the larger world that exists beyond my garden fence. This balm does not always heal deep wounds, but it certainly soothes some of the stings we get along the way. And so, with that knowledge, I keep my trowel handy, ready to harvest those blue orbs of hope in 90 to 120 days. I am sure this year’s bounty will taste the best.
My deepest admiration for all those who ran on Monday, my deepest sorrow for those who have suffered from this tragedy.
Copyright (c) 2013 Kristen M. Ploetz
Maybe because it is November. Maybe because it reminds me of just how deeply M thinks sometimes and how things affect her in a way that often seems profound. Maybe because I am acutely aware these past few weeks about how lucky we are as parents today with all that is at our fingertips to make life easier, healthier for our children. Maybe just because I loved the light when I took the photos. No matter, I share with this you because I am feeling thankful right now.
We live in a city that has a great presence of history all around us. There are few places you can go in the heart of the city that is not tied some hundreds of years to the past. About two months ago, our trip to the library resulted in us walking by a very old cemetery where some of the earliest settlers and descendants of the John Adams family are buried. M was intrigued by this place and wanted to walk around.
M has been in here before, though she certainly wouldn’t remember it. Stroller rides with her dad, seemingly light years in the past. She’s been in similar places in recent memory too when we took a trip that had us walking around historic Charleston, South Carolina.
We’ve talked about death in the past, so it didn’t bother me to take her in. Plus, as M pointed out, it is a beautiful quiet spot in an otherwise noisy part of the city. She told me that she thought it would be a good place to do homework someday. So we walked in together to explore who was there.
I didn’t expect to see so many graves for children. Very young children. Of course, now that hindsight is in my favor, it makes sense given that we’re talking about people who were buried in the late 1600’s until the early 1800’s. I thought this fact would remain fairly absent to my precocious pre-reader, so I didn’t think much of it.
That is, until she starting asking me what the names were. And how old were they when they died. She seemed perplexed by the number of young children. Sensing that she was likely thinking that this might be a similar early fate for her, I quickly assured her that those were times where healthy food, good handwashing habits and medicine were not as available as they are to us today. That seemed to put her at ease.
We did some research on the name and this particular young girl. Turns out she was one of 20 siblings born in that family over a span of just 24 years. Many of them had died less than a year old. The mother named three different sons Edward. Only the third one lived past a year old. It struck me as heartbreaking to name subsequent children with the same name. But maybe that was common back then…I don’t know. As a mother, it is impossible to imagine raising children during those times.
It also led to a few pretty long discussions about death and dying. All initiated by her. She has expressed her wishes about how she would like to be remembered after she dies. She seems quite concerned about being remembered. This is why, she tells me, she wants to visit Thankful. Because no one else does anymore since it has been more than 320 years since she died. I am keenly aware that these are not thoughts that a five year old should be having, and thankfully, they are fleeting and rare. My heart cannot take it. My heart swells and aches at the same time when she wants to figure this complicated knot out.
We’ve been back a few times. Each time she wants to go to that gravestone first. She knows exactly where it is, right in front of the biggest tree. She wants to bring Thankful flowers on her birthday next August. I wonder if she will remember. Knowing M, I bet she will.
Be thankful for what you have. It’s all so fleeting.
Copyright (c) 2012 by Kristen M. Ploetz.
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