I suppose I could’ve come up with a better title, but David Brooks doesn’t earn anything more sophisticated. His New York Times op-ed on ‘end of life’ care and its costs to society is a dismal attempt at meaningful thoughts.
Rather than composing something insightful and provocative, seeing as we’re dealing with our deaths, in Death and Budgets he writes a cliche. It’s what you’d expect from a Conservative sharp enough to earn the routine praise of “He’s not that bad.”
It was a post from the wittier and far more engaging Dudley Clendinen that inspired Brooks to his latest humdrum. Dudley is dying from one of the most awful, most cruel afflictions, amyotrophic lateral sclerosis. Lou Gehrig’s disease. It will rob him of all his fundamental neurological functions: movement, speaking, eating, crapping and breathing. Dudley knows his future, and he’s made his plans:
When the music stops — when I can’t tie my bow tie, tell a funny story, walk my dog, talk with Whitney, kiss someone special, or tap out lines like this — I’ll know that Life is over.
It’s time to be gone.
That is awesome courage. It’s humbling to be aware of what he faces and how he’s chosen to die. Dudley will kill himself. I thank the stars for my having avoided challenges even half as terrifying, so far. I hope my luck continues.
Reflecting upon the life and approaching death of Dudley, David Brooks appreciated something else; he was struck by the appropriateness of it all. Why don’t more people do this? If only they knew.
Clendinen’s article is worth reading for the way he defines what life is. Life is not just breathing and existing as a self-enclosed skin bag. It’s doing the activities with others you were put on earth to do.
Ugh. I’d like to apologize for Brooks. I immediately recall the quadriplegics in the world who go on living difficult but meaningful lives, each an apparent “self-enclosed skin bag.” I think of the brilliant and productive Stephen Hawking, now 69. Brooks won’t sniff the edges of the boundless idea “What makes life worth living?” An over-simplification of Clendinen’s idea suffices totally for Brooks. Dreadfully lazy.
Lumbering forward, Brooks adds that our elder society aren’t really getting any better. They’re merely lingering in an enfeebled state.
Years ago, people hoped that science could delay the onset of morbidity. We would live longer, healthier lives and then die quickly. This is not happening. Most of us will still suffer from chronic diseases for years near the end of life, and then die slowly.
Huh? From where did Brooks conjure a “die quickly” objective? I don’t work in research any more, but I used to, in molecular biology. And in all my days, I never heard any rational person say that old people dying suddenly was either a likely or worthwhile development. It’s a senseless claim.
Brooks made this up, I think. If anything is the hallmark of poor medical care, it’s sudden death. This is what goes on in Third World countries, with their lacks of doctors and drugs and hospitals and research. Lingering death is what you get when you have good medical care, period. This is a good sign, David, and you should hail its arrival.
Knowing this, yes, it’s time to have some serious discussions. We are likely to end up in a chronic, debilitating condition. We should be thankful for the many years we had before we got there. But it is not incumbent upon us to bow out in a manner convenient to David Brooks . .
. . it is hard to see us reducing health care inflation seriously unless people and their families are willing to do what Clendinen is doing — confront death and their obligations to the living.
. . especially when you see what a dreadful animal of convenience he is. Clendinen, in choosing suicide, obliges no one but himself. He chooses to die, in the face of any and all of Brooks’ societal obligations, because that’s what’s best for him. Brooks comes close to lessening Clendinen’s wholly personal courage by tossing him into a utilitarian hopper. It’s clumsy and ugly, frankly.
And I can imagine someone else facing the same fate who’d write from the opposite perspective: that he or she would reject any other way out, that they would fight on, with all the indignities, to the bitter end. I promise you, I would be moved by that. And I don’t particularly care to think of what it means to society.
Accepting death in a manner appropriate to you is a daunting thing to ponder, awesome in its size and consequence. If we’re to take ‘end of life’ issues seriously, let’s avoid lazy parables. Let’s avoid lauding suicides as practical and good medical care as problematic.
Let’s also affirm that the growing tendency of the dying to be capable of hanging on is a positive development. This is a choice mankind never had before. Let’s agree lack of medical care prevented millions of people from getting the opportunity to say ‘yes’ to this particular fate. Let’s admit that David’s friends, the insurance companies, have been sentencing people to premature death for decades, and this is not a solution. It has been an anti-societal abomination. Let’s call out David’s buddies for their war on science and scientists in the form of Bible-based Creationism and head-banging Global Warming denials. When a medical ‘scientist’ tells you your condition will deteriorate and result in death, you’ve got to be able to accept his prognosis. Given the most important decision of your life, you’ve got to know he isn’t lying.
When everyone has the right to hang on long after perhaps we’d predict, then we can have a robust discussion about what’s best for all of society. After.