No Escaping the Inescapable
I had an uncle who refused to accept conventional treatment for a terminal illness. He did not undergo radiation, chemotherapy, or hospitalization. He did not go to a hospice or spend his last days in a tangle of iv cords and beeping machinery, wearing a backless gown. He lived for several months beyond his diagnosis, at home and in as ordinary a way as possible. He died suddenly while helping a neighbor perform a farm chore.
I don’t know what kind of pain he may have suffered during his last days, or whether he took anything to alleviate it. Clearly, whatever conservative palliatives he may have employed did not prevent him from making his own decisions, performing ordinary tasks, and even offering to help someone else.
His choices about how to die–one might even call them his collective rebellion against the current conventions of death by terminal illness–were a lesson to me.
Would he have lived longer had he entrusted himself to the great grinder of the medical industry? Maybe.
Would he have experienced less pain had he not declined conventional care? Possibly. He didn’t complain.
Would what remained of his life have been better, had he surrendered his autonomy to healthcare providers? I don’t think so.
I hope for an easier crossing than he had; the soft death of simply going to bed one night (preferably a long time from now) and not waking up. Don’t we all want that mercy? But regardless of how I reach escape velocity, I hope to get there as my uncle did: lucid, charitable, independent, wearing my own clothes, driving my own truck, and choosing my own actions.
I used to think I was unique in this eccentric and possibly dangerous view. The radical idea that one might not want to purchase a few additional breaths at the cost of one’s dignity, self-direction, and entire life savings seems best spoken only in a whisper. Honoring someone else’s wish to avoid the standard conclusion could lead to troubling inquiries about one’s intentions, or to accusations of neglect.
I’m not suggesting that no one should ever employ standard treatments, use hospice services, or die in a hospital. I’m suggesting that it shouldn’t be unheard of to do otherwise. For some, the loss of self-direction and quality of life might be worse than death.
I was pleased when a friend posted this article on Facebook:
Doctors, it seems, frequently avoid the treatment that many other patients and families purchase in the face of the inevitable.
I think my uncle had it right, given who he was and what he could tolerate. He was lucky that the end came before his strength and faculties failed; but perhaps that was a direct consequence of his refusal to submit to powerful toxins when the end was likely to be the same, regardless.
May we all be so lucky, or so resolute. Best to leave while the band’s still playing.


Bravo.