Thursday, March 28, 2013


     My last two posts, on the Newtown massacre and the movie "Amour," have gotten me thinking about mortality and my close contact with it every two weeks at the hospice hospital where I volunteer.  The "Wilderness Rejoined" subtitle above is a follow-up to my earlier Consolation Four, "The Wilderness," posted May 19, 2011, in which I define wilderness as every natural object, event, and evolution that has or will come to pass in post-Big Bang, cosmic spacetime.  There I also define mortality as a rejoining of the atoms and molecules that comprise every percipient being after it dies with this cosmic wilderness and further argue further that the human species, like all other species, randomly evolved from inorganic matter and merges back into it at death.
     Now that I'm approaching my seventy-seventh birthday, I feel like giving mortality more attention than I have in the past and hence in future will probably write occasional posts like this one that focus on it.  While I realize that relatively few people choose to ponder their own extinction much, I hope that those who do and who happen to read this blog will be joined by others interested in seeing an aging materialist like me wrestle with the subject.  So until I'm either too depressed to write about dying any more or have said all I have to say about it, I'm afraid my readers will have to put up with posts like this from time to time.
     Every two weeks I spend Wednesday mornings at the hospice hospital sitting with actively dying patients.  Patients who are "actively dying" have been so classified by the medical staff because they're within minutes, hours, or at most a day or two of the end.  Though normally comatose and unresponsive, these patients often show signs of restlessness or discomfort.  Sometimes their sounds or gestures are nothing but neurological cycles repeating themselves over and over and needing no help.
     But occasionally they're distress signals.  In that case, I call the nurse to come and decide if additional help or medicine is called for.  Of course I'm also there simply to keep the patient company, as has been customary in many cultures for millennia.  None of my patients have relatives or friends with them when I arrive, and I move on to unattended patients if anyone like that shows up.  Either in alleviating pain or by just being in the room, I find the work satisfying, despite its lack of communicativeness and sociability.  Helping dying people through their final ordeal gives me a greater sense of fellowship with them than anything else I can imagine doing, especially since, as has so far always been the case, they're total strangers to me.  Having now sat with more than a hundred such patients, half a dozen of whom have died in my presence, I'm convinced that, given proper medical care, no one needs to fear death.  It can be, and in my experience as a witness has been, an easy process, like a cup of water cooling or a spark burning out.
     That said, I'm also sure it's never easy nor anything but cataclysmic for the person going through it.  Death is no fun to look forward to or experience.  Everything evolution has built into our brains and bodies fights it.  We're hardwired as infants to assume we'll live forever, and even after lifetimes of watching plants and other animals die, we have a hard time applying such evidence to ourselves.  Most people in fact choose to  believe they'll personally survive death in some way.  It's hard not to hate and fear the impending annihilation of all we are and all we feel, sense, and know as conscious organisms, even if we find comfort, as I do, in the fact that the material elements we're made of survive us.
     My mornings at the hospital are part of my own effort to understand and accept my own annihilation.  Seeing death up close and personal or a regular basis helps me appreciate how mundane, unspectacular, and unavoidable it is.  It's also absolutely impartial.  Wealth or fame exempts no one from it.  When we die, we pass through the same portal from consciousness to oblivion that every other brain-equipped animal in the planet's history has already passed through.  We human beings are in this sense indistinguishable from countless other terrestrial organisms that have died and will continue doing so as long as life on earth exists.
     Death's impartiality and even-handedness was driven home especially clearly during my hospital shift this week.  When I arrived and checked the status board in the staff room, I found only four of the thirty-odd patients in the building marked as "actively dying" by a green dot or yellow triangle next to their names.  Since I prefer sitting with the same patient as long as possible, I followed my usual routine of arbitrarily picking a green-dot or yellow-triangle room from the status board and going there first to see if friends or relatives were present.  What I found was a large, well-built black man in his early forties alone, breathing oxygen through a nose tube.  He was slack-jawed and profoundly unconscious.  No cards, flowers, or other mementoes indicated he'd had any visitors.  The ceiling fan was on high, and I turned it off to warm up the room.
     After an hour, two aides came in to clean and reposition him, and I followed protocol by leaving.  Back in fifteen minutes, I found the aides had laid damp cloths on his forehead and arms and restarted the fan.  I located them a few rooms away and asked them why, and they told me he was running a fever.  I also learned  later from the duty nurse that he'd suffered some kind of brain damage, but exactly what kind and how she didn't yet know because she'd just begun her shift and hadn't had a chance to check the charts that came with him to the hospital twenty-four hours earlier.  All she knew was that his temperature was above a hundred and three.
     I'd never seen a patient like him before.  Much younger than most, he looked physically fit and free of external signs of disease or injury.  Though his breathing was slightly convulsive, sometimes restarting with a gasp after stopping a while, and his arm, leg, and face muscles never moved, he seemed quite healthy.  But like all comatose patients, he looked so helpless and vulnerable that he was more like a sleeping child than a grown man.  I wanted to help him, but I knew there wasn't much I could do but watch his breathing.
     As usual, I sat next to his bed and read a book, glancing up now and then to see how he was doing.  The hospice doctor dropped by, said hello, and asked me if I'd noticed anything unusual.  I said not during my shift, now going on three hours.  He nodded, checked the patient with a stethoscope, examined his hands and feet for mottling, thanked me, and started to leave.
     I stood up and said I had a question.  As is customary, we stepped out of the room, and, to my query what had brought the patient here, the doctor said he'd suffered massive brain in a fall at the Baltimore city jail, where he was an inmate.
     I paused.  "The city jail?  What kind of fall?"
     "I'm not sure," he said.  "Some kind of fall."  He added that he'd been taken from the jail to a nearby hospital, then, when judged to be terminal, transferred here.  I didn't think I was getting the whole story, but I didn't press it further.
     I thanked him, he thanked me, and he left.  Alone again with the patient, I studied him with new interest.  Never having had personal contact with a prison inmate before, I was doubly struck by how innocent and childlike he looked.  Except for his youthfulness, he was no different from any of the scores of other comatose patients I'd sat with.  He was no more menacing or menaced, troubling or troubled, unworthy or worthy than any of them.
     Was he a hardened criminal?  Rather than a fall, had some kind of fight or attack at the jail landed him here?  While probably relevant to his former life, whatever it had  been, such questions now struck me as meaningless.  Lying there clinging to an existence he was no longer aware of, he seemed archetypically human, a modern Everyman accidentally born from the wilderness and destined to rejoin it soon.  Nothing else about him was significant -- whether he'd  been likeable or unlikeable, lucky or unlucky, fairly or unfairly judged.  All that mattered now was that he was dying, and I was with him.  He died next day without regaining consciousness.