Dying with dignity

My wife bought me this little book for Christmas, "Tuesdays with Morrie" by Mitch Albom. Apparently it was (is?) quite a bestseller, and there was even a movie  based (loosely) on it, under the same title. The book is mostly an account of 14 conversations the author had with Morrie Schwartz, his favorite professor from his university days, who had been diagnosed with ALS ("Lou Gehrig Disease"), and who eventually succumbed to the disease after a 6-month struggle.

 Although "struggle" is not a good choice of a word here, considering that Morrie didn't seem to be "fighting" the illness so much as accepting it, even learning from it. From the vantage point of a man with an irrevocable death sentence, Morrie is dispensing wisdom on everything: from culture, to marriage, to emotions, to money, to death. This book moved me and annoyed me.  It moved me because I could not help but admire his nearly stoic attitude toward his terrible physical deterioration and the suffering that came with it - not that it would necessarily have been my choice in similar circumstances.  

The sense of annoyance came from many angles. Only a small part was caused by the fact that a lot of the wisom being passed onto the reader was pretty trivial and terribly cliché: money doesn't buy happiness; we will all die eventually; having a sense of purpose in life makes it worthwhile; family and friends are very important; we are living too fast; ours is a materialistic society; etc. After all, having had these pearls of wisdom repeated ad nauseam doesn't make them less valid.

What frustrated me the most didn't even have to do anything with Morrie himself, or what he said. It was this: here's a sweet, smart, old guy, who made the choice of waiting for his death, of enduring whatever pain and indignity were thrown his way. He also made a decision to be increasingly dependent on others, including having his ass wiped. (He feared that moment, considering this a kind of a threshold of humiliation, and yet he quickly adjusted to it, even... enjoyed it to some extent, comparing his dependence to that of a child...) He was celebrated for it - NBC's Ted Koppel interviewed him three times, at different stages of the disease. Scores of people came to visit him, many more wrote him letters. Obviously, he inspired a lot of people. That's great. But what about the people who want to make a different choice?

 There are those of us, who don't want to follow Mr. Schwartz's path, passively waiting for nature to take its course, in whatever cruel manner it chooses. Those, who would prefer to choose the moment and maner od their death themselves. Isn't it a legitimate and noble choice, worth celebrating? The book talks about the kind of dying that allows to say final good-byes, and be surrounded by one's loved ones while doing so. If that's so desireable - and it is - what is then wrong with saying good-byes and then quietly and peacefully taking one's own life?

People who help a dying person by adjusting his pillows, tending to his sores, dulling his pain with potent painkillers, and  yes, wiping his ass, are admired as persons of compassion. Rightly so. At the same time those who would help that person die with dignity by committing suicide are treated as villains, threatened with jail. Why is one kind of compassion better than the other? Why isn't it considered an inalienable human right to refuse to endure the pain and indignity of a terrible illness? We have laws against torturing people, and would applaud if someone helped a victim of torture run away from his tormentors. We would condemn a doctor working alongside the torturers, who is making sure that the victim doesn't die prematurely and will be able to endure more pain. Why is then OK for nature to torture people and for doctors to be enablers, who prolong the agony?

I know, there are guns, and rope, and poison, and sharp blades, and plastic bags, and tall buildings, and myriad other ways by which people can kill themselves if they want to. But what if they can't? What if they are paralyzed and unable to pull the trigger, unable to get to the top floor of a parking structure to jump off from? And what about the dignity? There is nothing dignified in a wife coming home to find her terminally ill husband with his head blown off. Or hanging from the rafters in the garage.

Of course, there is the "slippery slope" argument: if we make dying nice and easy, will we start nudging at first, and then pressuring ill people toward that easy way out? And what about those suffering from depression, who would now find it so much easier to act on their impulses? Those are legitimate concerns, but shouldn't our advanced society be able to address them? Shouldn't we at least start talking about ways of addressing them?

Tellingly, even Morrie had his limits of acceptance. In his final interview with Ted Koppel he mentioned

 "other people who suffered from ALS [...], some of them famous, such as the brilliant physicist Stephen Hawking [...] He lived with a hole in his throat, spoke through a computer synthesizer, typed words by batting his eyes as a sensor picked up the movement. This was admirable, but this was not the way Morrie wanted to live. "

 What if he was dealt this kind of card? Would there still be a bestseller about Morrie Schwartz, the mild-mannered professor who stoically endured to the end?