LIVING AT WAKE ROBIN, I have become familiar with different ways of dying. A long-stemmed red rose announces a death. It is placed on a small table with a photograph in the foyer where it can’t be missed. Residents stop and look and ask, “Who died?”
Dick Walters chose his own way to die. John and I visited him twenty-six hours before he was to take the drink that would kill him. He was watching television with the sound off. His wife, Ginny, sat beside him. They held hands like two teenagers. Was she, like him, ready to let go? They had done everything together, including lobbying for ten years for the passage of the Patient Choice and Control at the End of Life Act. They stood together next to the governor when he signed the act into law.
“Congratulations, Dick!” the crowd shouted in a chorus.
And now it was Dick’s time to die by the hand that he had scripted. Two o’clock the next day, he would be in his room, surrounded by his family. He did not look as if he was at death’s threshold. He was, by any measure, a happy man. He was ninety but could pass for seventy-five except for the oxygen tube plugged into his nose and curled down into his lap. Lung cancer was the culprit.
I observed Dick in his final hours. He behaved like a busy person in his office, answering his phone and responding to emails. I detected euphoria in his glittery eyes. He had determined that his time had come. It was a rude defeat for the devil. Dick would have the last word.
We had entered the apartment quietly. Dick gestured to us. “Come and sit down over here.”
Everybody brought a dish. It was Ginny who added, “Can I get you something to drink?”
Nuts were offered. It felt wrong to take a handful and chew in his presence. Dick and Ginny told us about the wonderful family dinner they had eaten the night before. He was thrilled that his two granddaughters had come. They said it was like a birthday party.
The phone rang as we were leaving and I could hear Dick laugh, a deep chest laugh that I could recognize anywhere. Would I ever have the courage to follow his example if I had a terminal illness? I don’t know.
My best friend, Nicky, had a different death. She died slowly at Wake Robin, so slowly that when I visited her in her last few months, I wished that she would have died sooner. It was difficult to understand her speech. There were moments of clarity when she knew who I was but then she would disappear into her cavern. She received kind physical care at Wake Robin but she was distraught—a butterfly caught in a net for months.
When Nicky was wheeled into the dining room I sat across from her. She wore a bib. I could not tell if she was hungry or not, but when I brought the spoon to her lips, she opened her red mouth like a little bird without a chirp. Despite knowing that food would prolong her life, my mouth opened when hers did. I believed food was good for her.
“Dear God,” I said to myself. “Let me die before this happens to me.”
Louise died as she wished. She was suffering from the ravages of a stroke. She stopped eating. Then she changed her mind and announced that she wanted to live a bit longer to find out what would happen to Senator Bernie Sanders in the Democratic primary against Hillary Clinton. Louise had always been a progressive liberal, but with an overlay of class. She had lost a son in Vietnam, and that was how we met, at the Vietnam Memorial on Interstate 89. She had demonstrated against the war passionately. Then, when her husband was transferred with IBM to Vermont, she became a passionate advocate for prison reform. The Sanders campaign dragged out longer than Louise’s desire to live. She could no longer find any joy in life.
“Louise is dying,” my friend Betty told me.
The straight, narrow fold in the bed was Louise. I bent down and spoke to her. “I’m here. This is Madeleine. You’re leaving. It’s okay. We love you,” and I let go of her hand.
She mouthed words back to me with surprising force. She wanted to talk. She may have made a last pitch for Bernie, for all I know. Contrary to what many might think, starvation at the end of life is not painful. She died three days later, in peace. Still, it is not easy.
How will I die? Will I be like Dick, Nicky, or Louise? Or will I be lucky enough to die like Marilyn, who turned around to go home as she was walking downtown with her husband. She had indigestion. She was sitting on the couch when she took her last breath. Gone. Ideal.
Lately, colon cancer has been ranking first in my list of anxieties, because I have irritable bowel syndrome. My large intestine has a mind of its own. It is often cross, and I suffer from abdominal cramps. I never paid attention to my colon until I got older; it functioned fine without me. Then, after a colonoscopy ten years ago, I was informed that I had a “redundant colon,” which means that it loops around twice and has to work twice as hard. That may be why it sputters and groans so much. On bad days, my worst fear is that a tumor may be snuggling inside the double coils and growing quietly. I think of my cousin, who almost died from an intestinal blockage and arrived at the hospital just in time for surgery. Or, I wonder, are my intestinal problems caused by stress? I know there is a brain-gut connection, but how do I control it? Lack of certainty opens the maw of worry wide.
I worry less now about lung cancer, even though I used to be a smoker. It’s been forty-two years since I quit. I started smoking when female film stars untangled their complicated love lives with cigarettes in their beautiful hands. Stars even appeared in cigarette advertisements. Their smoky, sexy portraits pulled me in. I wanted to be like them. I had my first cigarette when I was sixteen or seventeen, along with my first mixed drink: a daiquiri. I felt extremely sophisticated as I posed on a barstool facing my date, Kenny.
Smoking was a way to announce my independence and step over the threshold of youth into adulthood. Then I turned to throat-scratching Gauloises Bleues and pretended to be French when I was a guide at the Brussels World’s Fair in 1958. Soon smoking became a habit. I could not write, or even think, without a cigarette. I seem to have escaped the ultimate punishment for that indulgence—so far. But when I get out of breath walking up a familiar hill, one that never taxed me before I turned eighty, I wonder if the ashes of those long-ago cigarettes still rest inside me.
Flying is not a new fear for me. I never liked to fly, but because I have flown so much in my career, I am getting better at it. I know that it is unlikely my life will end by falling out of the sky. Still, my palms sweat when there is turbulence. My body fights back against the plane’s rattles and shakes. I try to inhale and exhale slowly and lecture to myself that the pilot wants to stay alive as much as I do. But what if he doesn’t? In 2015, when a Lufthansa airliner plunged headfirst into the French Alps, it was flown by a suicidal pilot.
I understand (sort of) how cars move, but I don’t know how airplanes fly. The sky is wide open, a mysterious ether with no perceptible speed limits, no white lines. I know that pilots are told by air controllers to fly at certain heights, and even stay within certain lanes. The trouble is, I can’t see them. If there were chalk marks in the sky, I could easily peel my fingers off the armrest and “enjoy my flight.” Lately, whenever the captain announces that the flight attendants should stop serving drinks, sit down, and buckle up because of expected turbulence, I tell myself that I am ready to die. I have lived a good life. In my mind, I begin to write my obituary. I wonder, will my death make the headlines? Then the air becomes smooth again, and I take it all back.
Driving a car is no doubt the most dangerous thing anyone can do, and I am more conscious of the risks now that I am over eighty. What if I put my foot down on the gas pedal instead of the brake; what if I don’t turn my head around far enough (because it hurts) when backing up? My worst fear is not my own death but killing someone else: a bicyclist pedaling up the road or a child running across the street. I sometimes rush through a yellow light and then chastise myself midway across the intersection as it turns red. I am no longer young. Drive carefully, drive slowly, I remind myself, even as I suspect that the person in the car behind me complains that I’m driving “like an old lady.”
I no longer like to drive at night. One evening, going north on two-lane Route 7 at twilight, the sky turned from blue to black too soon. It became harder to follow the tire-scuffed white lines where the asphalt shoulder turns into dirt. I shifted my eyes slightly to the right of center to avoid the direct glare of oncoming cars. It seemed as if every car had its brights on and aiming directly for my startled pupils. My eyes adjusted slowly, too slowly, I feared. I was afraid to look up at the stars. As night’s blanket folded over the road, I saw small squares of yellow light glued onto black houses. I thought of the families inside, clearing the dishes, or already sitting in the living room watching TV. There might be a fire, a curled-up cat, a sleeping dog. Soon they would go upstairs to a nice warm bed. I envied them. They were home.
A stroke could happen anytime, anywhere—a marble-sized blood clot traveling through my body and then, pow, it hits my brain. I try to recall the diagrams of the heart that I memorized in high school and have not thought about since. I have no idea how strong my aorta is, or the condition of my jugular vein. I take a steady flow of blood to my heart for granted until I encounter a friend being pushed down the hall in a wheelchair at Wake Robin. I say hello. She smiles a crooked smile back.
Some strokes are baby strokes and leave little evidence of their impact. Others are like a tornado ripping through the body, leaving destruction and silence in their wake. Please God, spare me. Don’t leave me half alive, or half dead, I pray. An easy death, a good death, is what I wish for, just like everyone else.
Old Age. The two words together shock me. Am I there yet? But I am not really old, not as old as she is, who needs help dressing, not as old as he is, rolling slowly past me in his wheelchair. I live independently. I don’t need a walker. I can walk upstairs and down (okay, my knees hurt a little). I can hear (with the help of new hearing aids) and see (just reading glasses). I take pills, yes, but not that many.
I know that death is close, but life is always closer. Although my future no longer feels infinite, it is filled with possibilities that I want to explore. As long as I’m curious about what will happen next, how things work, how the world works, I want to be alive. I try to cultivate awareness, what Buddhists call “mindfulness.” But of course, it’s impossible to practice it all day long. My mind wanders after three minutes, drawn to the blooming sunset spreading across the horizon while I cover my husband’s hand with mine. I focus for one minute when my tongue tastes a delicious salad, or another minute or two when I sidestroke in the cold waters of Lake Champlain and feel reborn. Savoring moments. Giving thanks, to someone, or something, even God. Perhaps that’s enough. Maybe I’ll get better at this with time. It may be one of the unanticipated benefits of old age: experiencing an intense love for life with only a tinge of regret. I don’t believe in life after death, although it is tempting to believe that I will meet my parents and grandparents, Edgar, and all my loved ones in heaven. It would be a crowded reunion. When I am close to death, I hope I will have someone hold my hand. Then I will let go, say farewell to life, and go to sleep in peace, as if I were resting on a cloud.
LAST SPRINGFirst the daffodils die,
then the tulips stiffen,
then the lilacs’ perfume
turns bitter brown,
and the peonies slump
to their graves.
I mourn them,
each one,
like I never did before.