Back when I was on dialysis the nurses once wheeled in a patient who scared all of us. Ella was dead white, looked about a hundred and five, lay on a stretcher with her mouth open, and stared at nothing.
"What the...?" I looked around the room and saw the same appalled astonishment on every other patient's face. Were we going to have to watch this woman die right in front of us?
No, actually. We watched her get well. Three or four dialysis treatments brought her color back. She sat up. In a week or two her eyes began to sparkle and she started up conversations.
Ella had an old lady's wicked, go-to-hell sense of humor. She had just been fitted for a colostomy. The average fundamental sigh, or passing of gas, amounts to perhaps 20 cubic centimeters. A colostomy bag tends to accumulate gas over the course of hours. It was Ella's delight -- "There! That'll show 'em!" -- to wait until her bag had grown drum-tight.
And then to prick it with a pin. Probably 10-20 times the normal human amount of accumulated methane suffused the dialysis ward. It could make your eyes blur.
I don't think Ella even bothered to cackle. But I always thought she was getting even with us for those appalled looks in our eyes when the staff first wheeled her in.
The situation isn't funny, of course. People make so-called "living wills" to anticipate being unable to express their own wishes about the medical treatment. It has always strike me as not so much a living will as a dying one, specifying the circumstances under which a wife, mother, father, child, could decide to end treatment for someone else.
Our news covers these situations in ghoulish detail. Terri Schiavo's case becomes a soap opera over her mostly inert body while the state legal establishment of Florida decides whether or not to "pull the plug" -- in this case, to remove her feeding tube. Even someone minimally aware, it seems to me, should not be subject to involuntary starvation and dehydration.
And one of this year's Oscar-winning movies depicts a supposedly "heroic" struggle wherein a crippled young female boxer persuades her wise, homely old trainer to...kill her. No, I haven't gone to see it, and won't. I've been too close.
Back in 1975, when my native kidneys failed, I got horribly sick all at once, not unusual with kidney failure. I had percarditis, couldn't walk well, had lost mental focus, had recently gone through a series of grand mal seizures related to an infection, can't remember what all, and it's probably just as well.
I found myself seriously considering whether or not to end it all -- to the extent that I was contemplating methods. Grace intervened, however, and I realized that people who think that way really aren't sane, and I asked to see a therapist. It hardly mattered who I talked to, but it did work.
Three things I remember from when my friends came to visit me in the hospital. One thing they all said later: "I thought you were going to die." To which I used to say, "If I ever get out of here, I'm going to get a motorcycle."
And the other was waking up at various times in my hospital bed, seeing my mother, always faithfully there, no matter what.
It is too damned easy to be cavalier and heroic about "dying with dignity" when somebody else is doing the dying.
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