What makes life worth living?
For me, that question was the most important take-away from Atul Gawande’s Being Mortal—a must-read for anyone who is aging or has aging parents. And it’s a question that is increasingly on my mind.
According to Gawande, it’s also a question that every physicians should ask patients during end-of-life treatment, when treatments themselves often take a toll, assuming that quantity trumps quality. You need to ask yourself, at what point does quality trump quantity? No one else can answer.
It’s hard to say what makes life worth living when it’s full of the daily tasks, joys, and sorrows that keep us engaged with our own passions and the people around us. But when illness pushes the boundaries of that life closer and closer, the question begins to loom large. A stand-out from Gawande’s book was the man who was happy to prolong his life as long as he could watch football on TV and eat chocolate ice cream. I think I’d want more—but I’m not there.
Neither is Jack, yet. But he’s beginning to struggle with the question as the cancer, which began in his kidneys three and a half years ago, takes up residence in his brain. He’s had a good, better-than-expected, three years. “I can’t complain,” he says, refusing to feel sorry for himself. But now, he is too often tired. He has trouble concentrating. He finds eating an ordeal. He can still spend a few hours a day in his pottery studio, but his passion for the craft is gone. He’s still passionate about his kids and grandkids—I don’t think that will ever go away. He’s still engaged with the world, which is providing no end of intrigue in this most horrific of years. He’s still playing on-line scrabble—though he says he’s losing more than he used to.
What of those things is enough to make life worth living in the face of gradual decline? When does quality set limits on quantity? I’d like to help him with an answer, but even 54 years of marriage doesn’t give me that right.
It probably is the toughest question ever, and no one else can answer it.
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Even when you’ve discussed it, even when you’re sure, you’re not at all sure when it comes down to it. I was Power of Attorney for my best friend of 44 years. She spent seven weeks in the hospital, from early April of this year until the end of May. It was a rollercoaster of “We’re cautiously optimistic,” to “There is no hope,” and back again. I can’t count the number of doctors who asked, “What would she want?” Her Power of Attorney document said she wanted everything, so I felt I had to go with that, authorizing treatment that I’ll never be sure I should have. I was only allowed to see her three times, and one of those was to authorize letting her go. You can only do your best, for yourself and others.
The ultimate quandary. Beautifully stated. Thank you for sharing.
Thank you so much for this post. I’m ordering that book! Such an important perspective.
I loves that book, as did my husband. We have recommended it to all relatives and friends who are of similar age. Some think they don’t want to read it, which is why I think they should.