Sunday, February 10, 2013

Passing On

Have you ever considered how much of our everyday behavior is learned from someone else?  Most of the routine events in our lives require a previously programmed response.  All of us have learned how to react, get along, and behave in most social circumstances because we assimilated over time what was acceptable behavior.  That is, most of us learned…some better than others… I can assure you.  Step out of line and somebody will be quick to call it to your attention and will assuredly try to put you in your place.  Count on it.
Do you doubt me?  Let me give you a humorous (hopefully) example of what I am talking about.  Ladies, before I go further, let me challenge you to check out my example with the man of your choice.  I am certain that, after you stop laughing, you will find that I speak the truth.

Assume you are a male person who needs to urinate in a busy public place. Perhaps a large building, a convention center, an airport, a hospital or a courthouse.  You walk into the men’s room and are confronted with a row of ten urinals.  Let’s label them one through ten, starting on the left with one and ending on the right with ten.  “Four” is in use; the rest are unused.  Which urinal do you pick to do your business?  The possibilities theoretically are one through three and five through ten.  Simple enough, right?  WRONG!  The reality is that the possibilities are one, two and six through ten.  Given the scenario I have presented, no man I know is going to use three, four or five.  Why is this?  I do not know, except  to say that all men have somehow learned this. 

 Let’s take it a step further.  Suppose two, five, eight and ten are in use.  What now?  You have no doubt figured out that the point of my examples is that two guys are not going to stand next to each other and pee if it can be avoided. However, if the row of urinals is crowded, standing next to your fellow man is acceptable, providing you do not look around (certainly not down and/or to the left or right). Where and when did we men learn this?

 Doubt me?  Ladies, ask your guinea pig what would happen if in the first example he walked in and took the urinal on either side of four.  I can assure you that the user of four will zip up and be gone in seconds because that is weird behavior on your friend’s part, which will set off everyone’s alarm bells.  (Let’s not even consider where it is is permissible to look and what to say while peeing with your fellow man.)

The urinal example is just one small bit of learned behavior males seem to instinctively recognize.  I am sure ladies have your own unwritten rules that your momma taught you or that you picked up somewhere, so I will not comment on your rules, since I do not qualify as an expert. 

 On the other hand, all of us, both men and women, have been taught what to say when confronted with recurring behavior.  Let me give you another example.  You are at a party.  Your host or hostess hands you a drink, which you promptly spill because someone bumped you.  Do you get into a fight with the person who bumped you?  Of course not.  All of us would immediately begin to apologize to the host or hostess  and make an offer to help clean it up, which we know is going to be refused and is going to be met with the inevitable “it’s no big deal…the stain will come right out.”  Everyone has a part to play in this scenario and most of us know our parts perfectly.  And it is all learned somehow, from someone, somewhere.  Probably, we learned this programmed behavior from our parents, spouses, friends, at school or just by experience with what seems to work and the rules of common courtesy.  It is how we get along with other people and circumstances.

Most of us know how to behave at work, with the boss, with the spouse, with the children, with a new client, with our physician, with the coach, with the teacher or professor and with our parents and/or grandparents.  We have been well taught, mostly, and this shared, universal knowledge serves to take the rough edges off polite society.

But let me ask you this.  Has anyone given you instruction or advice on how to die?  Think about it.  Death is universal.  All of us will experience it eventually.  No exceptions.  Talk about recurring behavior!  Death is an experience that is unavoidable, all-encompassing, significant and totally inclusive.  It is going to hook every one of us.  As Mick Jagger said, “No one gets out of here alive.”

I have been thinking about this lately.  I cannot recall getting any advice or instruction on dying from anyone, including my dad, who had good advice on almost everything.  In fact, I cannot recall even a single discussion with anyone, ever, about how to die properly.  How does one go about dying properly?

As a precedent and side note, I was in my oncologist’s office the other day when I made the comment that dying of cancer was a “chickens—t” way for a real man to die.  She looked at me not understanding what I was saying.  When she asked what I meant, I said that a real man would die pulling eight g’s trying to outturn a SAM missile, or the wing would fold up on his airplane, or he would be a little hot in the turn on a motorcycle and hit a tree, or would be lost at sea on a solo voyage in his sailboat or would make one last charge at the enemy, having run out of ammunition. I commented that dying at home in bed, comatose from painkillers, having wasted away to nothing did not appeal to me.  She just shook her head.  Maybe she knows something about dying I do not know.  Since I know absolutely nothing, that is certainly possible, but she didn’t volunteer any inside knowledge or advice either, and I am sure that she, like my sister, a nurse practitioner, has seen hundreds of people die in a variety of circumstances.

What about the rules of dying?  Are there such rules?  If there are, where do we find them?  And if found, are they good rules?  I just do not know.

My wife and I recently had a discussion about dying. I told my wife that I wanted to die like “an officer and a gentleman,” whatever that was.  Smiling, she responded that in her view the goal should be to “die well.”  As usual she is right. I like that.  It sounds good, but what does that mean and, more importantly, how do you do that?  I am not sure, but I have been thinking about it.

A few of us are going to die violently and suddenly in car or motorcycle crashes or as victims of crimes.  But the majority of us are going to meet our end by heart attack, cancer or other disease, after a significantly long illness.  If that is what gets you, you might have a say in the place of your death. But probably not.  Any choice you might have comes down to whether you prefer a healthcare facility or your home.  The healthcare facility is not really a choice, because if you present yourself at the ER in the final stage of a terminal illness, someone is going to tell you, “There is nothing we can do for you.  Go home.” 

 I know this for a fact, because I have checked it out.  Show up with a few days to tough out before you die and you are going to get sent home to die.  Dying in a hospital has its benefits, to be sure.  It is clean, warm, nurses are there to take care of you, they can kill the pain and clean up your mess, if you can’t get out of bed.  Kind of like a hotel that you never check out of.  At least while alive.

On the other hand, if you die at home, presumably someone will be present to take care of you.  Maybe.  Maybe not.  Like the hospital, your bedroom will be warm and clean, and familiar to you, but there are no 24 hour nurses, and you will wait to get painkillers from a visiting nurse, providing she can get orders from the physician.  A precarious situation.  And someone has to clean up after you and give you a bath if you need it.  Gross.

If you want visitors, then home is probably a better place to be, providing they can be regulated by someone.  Chances are there are a few people you do not want to see.  Nurses can get rid of them in a hospital.  All you have to do is push the call button and ask for assistance.  But what about at home?  

How do you get rid of an unwanted family member?  We all have them, you know.  Particularly ones who may be concerned about the will.  I have been in a room where a person was dying and the relatives were openly arguing about who got what, totally oblivious to the not-quite-yet deceased.  Very grisly.

Suppose you are in extreme pain.  Most of us do not do well in pain.  We tend to be difficult, nasty and say unkind things to whoever happens to be standing there. At least I do.  I do not want to unload on or snap at some well-wisher who is there to pay his or her last respects.  Also, there is the privacy issue.  Most of us do not want people we care about to see us squirming in pain.  Most of us do not want to be seen having to deal with bedpans and urine bags either.  It is not dignified.  It is not how we want to be remembered by anyone.  So what do you do, tell them to get out?  I do not know.

I think most of us would like to be visited in our last days or hours by friends and loved ones who have enough sense to know when to leave.  But I think such people are rare. I think that I would like old friends and most, but not all, family members to hang out.  But it must be within reason.  I know some people who have actually ordered a pizza for themselves and ate it, washing it down with a few beers in front of the dying person.  Talk about no couth.  

The bedroom I have shared with Lynnie for thirty plus years, in addition to the king-sized bed, has three rocking chairs in it, along with my Ducati motorcycle, which is currently wintering next to our bed. Three rocking chairs means at least three visitors.  Or is that six with spouses?  Is some ignorant person going to sit on my motorcycle?  I have no doubt someone will try to buy it from Lynnie, just as soon as my last breath has slipped away.  Do we need to move some of the rocking chairs out of the bedroom, so people will have to stand and, therefore, will not stay long? Relocate silver Duckie? I just don’t know.  I suppose my wife will handle it.

Having thought about these problems and discussed them with my wife, I guess what I would like is to be comfortably lying in my familiar bed bathed in the morning sunlight, wrapped in my eiderdown comforter, warm and toasty, pain free or gently floating on morphine, being held in my Lynnie’s arms and with the Iverson resting her chin on my chest, with quiet music playing and a few much appreciated friends quietly rocking away my final moments.  I think that would be “dying well” by anyone’s standards. It appeals to me. Perhaps there will be a smile on my face when I take that last look at my Lynnie and begin to hear the music.  I think maybe this is doable.  I shall see soon enough.

Mike out.


  1. Other than a little more insider information than I care to have about urinal behavior - I love your sharing your thoughts about what will for you seem to be the best wa to die... friends, rockingchairs, dear spouse and pup; music - and the dukati nearby... I like it! love and prayers for you both, janis

  2. You said, "quiet music playing"-- what is the ONE song you pick? I send my loving wishes to you and your family!

    1. "This could be the day" by Steve Amerson

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    4. this could be the day by my brother in law steve amerson, i will rise by chris tomlin, amazing love by newsboys and ain't no grave by johnny cash.

    5. Can I suggest Curtis Mayfield's "People Get Ready"?

    6. sure. never heard it. i will check it out., thanbks.

    7. Heavenly:

  3. The Duc definitely stays. Just in case you're taking a poll...

  4. Mike, your blog is getting progressively better. Keep blogging. This is without question your best post yet. One of my family members died in a hospital and one at home. Home is better. Dying was much more of a learned behavior before 1950 and certainly before 1900. My daughter in medical school recently reported that "..the mortality rate is holding steady at 100%..." and that goes along with the "...nobody gets out alive..." quote. Everyone wants to die either in a blaze of glory or peacefully in their sleep. Some are lucky enough to have that happen, but most of us will just have to take what we get. Having had both family members die from cancer, my thoughts on the disease have changed over the years. I am now of the opinion that cancer at least affords us the ability to say things that we need to say and to those with whom we need closure. It is the long goodbye. Bang the drum slowly. Certainly bittersweet, but that does have some appeal to me as I enter the back nine of life. Just keep raging against the dying of the light.

  5. thanks Bill. I am not doing too much raging these days. Out.

  6. Mike -

    You said you wanted my thoughts on the next post. I checked it for a couple of days before it appeared, then didn't get back til now. Sorry for the delay.

    You are definitely correct on the urinal behavior - and hilarious!

    Re: dying instructions. Without looking anything up, I can't think of any either, other than making sure our faith is in the right place, which you have done. I'm sure Lynne will be with you and honor your wishes.

    Going back to our previous thoughts on being angry and hating the process and the disease, since then I read a book by D.A. Carson titled, "Scandalous" - 5 lectures/messages by him about the cross & resurrection of Christ. You probably know he's a scholar from Trinity Evangelical Divinity School in Chicago. Chapter 4 is about the resurrection of Lazarus and Carson says all the English translations have it wrong - all the German translations have it right. When it says Jesus came to Lazarus' tomb and was "deeply moved and trouble in spirit" that is a bad translation. What the Greek actually says is that Jesus was "outraged". That makes the whole story different! Jesus is outraged at death, at the original source of death, at what death and the dying process does to us, and that his friend, Lazarus, would have to go through it a second time! So, stay mad friend. It is a righteous, godly anger at something God never intended for any of us anyway. Everything here is the "shadow of life" - not real life, evidenced by the fact that we can't live naked in a Garden. From the shadow of life those with faith in Christ will walk through the shadow of death and come out on the other side into the life that God originally planned anyway.

    I'd love to give you the book - maybe we can connect next week.

  7. randy, i will read the book and be prompt in returning it when done. mike out.