Chapter Introduction
448
CHAPTER 15
Death and Dying
CHAPTER OUTLINE
Setting the Context
A Short History of Death
Cultural Variations on a Theme
The Dying Person
Kübler-
The More Realistic View: Many Different Emotions; Wanting Life to Go On
EXPERIENCING THE LIFESPAN: Hospice Hopes
In Search of a Good Death
HOT IN DEVELOPMENTAL SCIENCE: Evolving Ideas About Grieving
A Small, Final Note on Mourning a Child
The Health-Care System
What’s Wrong with Traditional Hospital Care for the Dying?
INTERVENTIONS: Providing Superior Palliative Care
Unhooking Death from Doctors and Hospitals: Hospice Care
EXPERIENCING THE LIFESPAN: Hospice Team
The Dying Person: Taking Control of How We Die
Giving Instructions: Advance Directives
Deciding When to Die: Active Euthanasia and Physician-
A Looming Social Issue: Age-
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I was getting in the car to drive to work when Amy screamed, “Stewart! Come listen to the news!” We figured out pretty quickly that it came in right about the floor where she worked, the 96th. By the time the tower came down, we knew for sure that she died. With a normal death, you prepare for the grieving process. With a shocking death, it hits you by surprise. My wife was about to give birth to our first child, and my mother had plane tickets to come down on Friday. You get into the part of it where you mentally play back the events. Mom (typical, for her) had gone into work early so she could leave for a dentist appointment. If she’d been a less responsible person, she would not have been there at 8:46. The other weird part of it is, like, the whole country feels they own pieces of this tragedy and need to constantly remind you about it. So it doesn’t go away.
My mom didn’t have young children, but she was looking forward to retirement, to being a grandmother, and so she was cheated of all those things. Not only did she die in this horrible way—
. . .
In his seventies, my father seemed immortal. While he often joked about being an “old man,” he had no major infirmities. At age 81, mortality hit. For a few months, Dad had been listless—
Because medicine never admits defeat, the plan was three rounds of chemotherapy, punctuated by “recovery” at home. The doctor said, “Maybe we can lick this thing,” but the treatments were agonizing. Worse yet, recovery never happened. My father got weaker. After a few months, he could barely walk. Then, before going into the hospital for the third round, my mother called: “Last night we cried together and decided not to continue. We’re calling in hospice. I think it’s time for you to come down.” My father had two more weeks to live.
A day or two before you die, you slip into a coma. It’s the preceding week or two that lasts for years. Everyone has been summoned to bustle around a train that cannot be derailed. Yes, you can talk, but what do you say? My father was never a verbal man. Then, as if on cue, the disease picks up speed. From the wheelchair to becoming bedridden, the voice that mutates into a whisper, followed by waiting . . . for what? You force yourself to be at the bedside when the breathing gets slow and rattled, but you are terrified. You have never seen a dying person. You don’t know how things will go. Above all, you hope that things go quickly. You can’t stand to see your father suffer anymore.
My father died in the “normal” late-