by Jan Baughman
(Swans - April 11, 2005) There has been much talk about death lately, though probably no more deaths than usual have occurred -- 8,000 people die from AIDS every day; 2,740 from malaria, 24,000 from hunger; countless others from the war in Iraq -- nameless, faceless victims of the no-body count policy, and more troops dying since the mission was accomplished. Just another day in the life... These deaths rarely make the headline news; they aren't politically correct, entertaining, or good fodder for filling those 24 hours of non-news news. Once in a while a worthy case appears, as when every politician from governor to congress to the president drops everything to save a vegetable in the name of "life." This saga filled 24 hours for almost two weeks, until the death watch and appeals on behalf of the political pawn, Terri Schiavo, came to an end. The focus shifted immediately to the Pope's death watch, who then followed suit within days. Schiavo will be resurrected in the news when the autopsy report is released, the lawsuit is filed, and the politicians have cause to invoke her name (should the polls concur), and the Pope story will continue until the post is filled and the world settles back down to its unholy deeds.
Man makes a death which Nature never made.
One gets a real feel for this "culture of life" when dealing with illness and death.
While Bush and Cheney tour the country preaching to their believers on the urgency of Stock Market reform disguised as Social Security reform, and attempting to instill terrorist-level fear of destitution in the rest of us, the looming crisis of Medicare is being swept under the rug. Medicare premiums will have been raised 34 percent from 2004 to 2006, far outpacing cost-of-living increases in Social Security benefits. Additionally, there is a proposed 5.2 percent cut for physician reimbursement next year, further discouraging them to accept Medicare patients in their practice.
My siblings and sisters-in-law began investigating this Medicare maze and the options of caring for our parents many months ago. The Schiavo drama brought to the public debate the need for advanced directives, but the need goes far beyond. A Living Will deals with the near death and vegetative state issues; what happens when a person requires in-home health care, assisted living, or nursing home care is another matter of bureaucracy within the system, whose rules vary from state to state. We faced our parents' struggle with the cost of $1000 per week of in-home care providing cooking, medication support and basic hygiene; canceling it when they felt well, their health would then decline until the care would be resumed -- an endless spiral we could not put a stop to without asking them -- imposing on them -- to hand over control of their fate, precisely what they were fighting to maintain. Every month dad would calculate how much longer they could afford to live. Their vulnerability was exposed when they discovered one health worker who had generously offered to help pay bills, generously helped herself to some blank checks, forging $1700 worth, which their bank readily cashed and would not replace. That was nearly two weeks of life for them.
We looked at nursing homes, hoping to find an apartment-like, not hospital-like setting that could also provide appropriate medical care, which, in the relatively low-cost market of Houston can run $7,000 per month. That's not many months of life for a lot of elderly people, including my parents. And in many states, one is forced to run through all of one's assets, including the value of the house, before Medicare will provide support. Imagine your Depression-era parents in this vulnerable condition hearing, "once you've spent all of your money, we'll take good care of you." Sure you will.
While we focus our attention on global politics and policies, we increasingly live first-hand the day-to-day inequality from which these policies emanate -- the effects of the transfer of wealth from the poor to the wealthy, the chipping away of social services and individual rights. As we age, and our parents age, life and death choices become a daily reality, a far cry from the sensationalized stories of the chosen few whose death makes headline news or whose fate is put before the Supreme Court.
Death is not the worst evil, but rather when we
wish to die and cannot.
Last Wednesday, with no fanfare or publicity, no political intervention or papal circumstance, no CNN coverage -- my mother died, too. I think she was more than ready. Upon admission to the emergency room three weeks prior, with a remainder of dry humor and honest desire, she asked the ER physician to send her straight to the crematorium. She was politely told they weren't in that business, and instead, was between hospital and nursing home and back again, multiple chronic health problems converging at once; a growing disorientation to time and place; finally, sepsis and total system failure won the battle. She had, I was told, a peaceful expression when she died, looking just the same as the day before, when still alive. Her suffering, decades of suffering, were finally behind her. Her sightless eyes, her failed heart, bladder, and pancreas are now resting ash, their work shift complete.
My father, who doesn't share the Pope's stature in the world outside the circle of family and friends who know him, is also 84 and struggling with Parkinson's disease. He is now living in the system that has taken the best care of him so far: the home of my brother and sister-in-law.
What is in store for the very fabric of our society is unfathomable.
Doris G. Baughman (1926-2005)