A considerate death
We live our lives in sickness and in health, and we hope to die in our sleep. When we are young, we consider ourselves to be immortal and dying is something that happens to other people. As we grow older, assuming that we do, we either fear death or we don’t. I have never feared death, although I do fear pain and suffering, and I made a decision a very long time ago that if I had no quality of life, then I would end my own life. As an atheist, I’m not remotely concerned about religious viewpoints.
Before we go on, you may have noticed that I said I would end my own life. I didn’t say I would commit suicide, which is exactly the same thing, but the connotations of the word suicide are so strong that it causes a visceral reaction in many people and makes them feel very uncomfortable. Is it that suicide is a sin? I don’t know if that is the reason why the word makes us squirm, but if it is, why? Why should any word have such power! What are we afraid of? My gut feeling is that the word itself reminds us of our mortality, but we are all going to die someday. To digress a little, I believe that we become conscious of our own mortality when one of our parents dies. When the other goes, we know that we are on the downhill slope.
But let’s talk about what I mean by quality of life. It’s simple. If I am enjoying life and able to take advantage of all things that one can when in good health, then I have quality of life. If I’m infirm and everything I do is either a struggle or painful, or I get no enjoyment from anything, then I have no quality of life. I see so many old people, hunched over, using walkers or in wheelchairs, and it doesn’t seem to me that they have any quality of life, yet they carry on. Should I get cancer, I will not submit to any of the treatments that are recommended; the cure is worse that the illness itself. I will fight it for as long as I can, and then I will end it.
Recently, I came very close to having to make that decision.
About a month ago, I woke up one morning in debilitating pain. It seemed like every joint was on fire, with my lower back in particular agony. It was an effort to get out of bed. I finally made it, took some Ibuprofen and called a Spanish friend to ask for advice. She asked if I could walk over to her house (a ten-minute stroll that took me 20 minutes) and she then walked down to the Emergency clinic with me.
Before I go any further, I should mention that I live in Spain, have legal residency and am covered under the Spanish medical system. We arrived at the clinic, and I was checked in within minutes. 5 minutes later I was in with a doctor describing my symptoms. 5 minutes after that, they were taking x-rays and had given me two injections; one for inflammation and one for pain + a prescription for some painkillers.
While they give you a prescription, it is for your own records and the pharmacies don’t need it. You simply walk into any pharmacy, hand them your medical card, and they fill it from the computer screen. This is unlike the US, where you have to specify which pharmacy you want to go to.
My total out-of-pocket expenses for 1st class treatment was less than $1 which, I believe, goes to the pharmacy.
A week went by with the aches and pains slowly fading. Then I woke up with severe pain in my right arm; in the muscle tissue below the shoulder. It was intense, and I headed back to the emergency room where the same thing was repeated only, this time I was given three injections, one of which was cortisone and when I say it was a big needle, I’m not exaggerating. It hurt; a lot. This time, my out-of-pocket costs were $1.25.
However, this pain didn’t go away; it got worse and by the following Sunday, I was in excruciating pain. Back to the Emergency clinic, who sent me to Elche hospital, about 15 miles away. The taxi ride was about $27 each way. At emergency there I was registered and in with a level 1 consultant within 5 minutes where I explained what I was going through. They transferred me to the Trauma wing where I was immediately seen by a doctor who sent me off to x-ray, and I was back within 10 minutes, so he could review the x-rays. They showed nothing, which was not unexpected, but he said that he thought the pain was radiating from the shoulder itself, gave me some stronger painkillers and referred me back to my doctor.
The next morning, I woke up in worse pain than before. Every single movement was agony. To give you an idea of how much pain, I was in, I seriously considered going up to the roof and jumping off, but I wasn’t sure that 5 stories would finish me off.
My friend, Sally, who I owe a great debt of gratitude to, went to the emergency room and waited to see my doctor, since I couldn’t have made it outside my door. He sent over a medic to give me another cortisone injection and yes, it was the same size needle as before, but I didn’t care. He also prescribed some transdermal patches, which I have on my arm. I have to go to the clinic for blood and urine tests and then on Monday I see the doctor to review those results, at which point he is probably going to send me back to the hospital for an MRI/imaging.
I’m still in pain, but it is now manageable, and I can move, albeit slowly. So far, with 3 visits to the clinic, one to the hospital, the nurse doing the home visit, all the prescription medications and the taxis. I’m out of pocket less than $50. No, they haven’t figured out what is going on yet, but the care has been absolutely 1st class.
Had the pain not receded and become a permanent part of my life, then I would have felt that my quality of life had gone. Yes, I would still be very mentally alert, creative and in a good situation, but the pain would have superseded all of that. Pain is pervasive, and it is all that one can think about.
But then it comes to how does one end one’s life. Euthanasia is illegal in most countries, which is absolutely stupid, but such is the absolute moral power of the religious groups. You could crash a car into a wall at high speed, but that might not kill you. In fact, you might end off in a worse situation. Swimming out to sea and drowning is an option, but then some poor soul will likely find your rotting corpse on a beach and have nightmares for the rest of their life. You could jump off a building or in front of a train, but again, people seeing that would never be able to forget it. It’s a knotty problem. How do you kill yourself in a way that will not disturb others and which might fail?
Ironically, the doctors who treated me have provided the answer. The transdermal patches that I have been using are Fentanyl, an overdose of which is fatal. It is a quiet, peaceful death; you simply go to sleep, which is the way all of us would like to go.
