choices.

Our bodies begin to shut down after 72 hours without food. The molecules we use for energy are filtered & rationed. Muscle begins to breakdown to provide the energy we need to stay alive. And after just 96 hours without food, our body creates new molecules that, left for days, can become toxic to the brain. In other words, we need to eat.

She hadn’t eaten in at least 48 hours. A myriad of tubes & beeping machines stood at her bedside, weaving under & over her seemingly lifeless body. The florescent light that flickered above gave her skin a yellow, jaundiced tint. If you watched long enough, she’d open her eyes every few minutes—her iris’ jumped back & forth, up & down, as if she was trying to focus on something none of us could see. Then, eyelids would close again silently leaving us with only the faint memory that they opened at all.

When I saw her for the first time, I was surprised to find out she had already lived over eight decades. I guess it’s the printed blue hospital gowns & tangled mess of sheets that skews a bystanders perception of age, and maybe of human life altogether.

I found out she had been married twice, her second husband stood faithfully at her bedside. No tears were shed—he knew she had to leave him at some point, probably much sooner than he’d hoped for. Between the two of them, they had 17 children—all of them from their previous marriages. But they had been married for a long 33 years and at the moment, it just seemed too soon to say goodbye to their “new” marriage.

Only two of the seventeen children were in the room. They informed me that a nasogastric tube (NG tube) had been placed the night before. I barely noticed the thin tube filled with white liquid among the octopus of clear tubes & blue tubes, smooth tubes & corrugated tubes, that emerged from her sheet-covered body. They said it was a hard decision—but that “Dad just wasn’t ready yet”.

She wasn’t breathing on her own—a BiPAP (Bilevel Positive Airway Pressure) covered her mouth & nose, sending air into her lungs & sucking it back out again. I’m not sure how long she’d been on the machine, but once a patient is on BiPAP it becomes increasingly difficult to take them off as hours & days progress. Similar to intubation, a BiPAP causes airway & lung damage—damage that, in the elderly, is often irreversible.

But despite the BiPAP this patient’s lungs were already damaged. She had small cell carcinoma, an extrememly aggressive form of lung cancer that can infamously spread to any & all parts of the body in a matter of weeks. She was a survivor though—she’s lasted at least a few months. She’d fought. Chemo. Radiation. Surgery.

And now her fight was nearing its end. Her body was starving. Her lungs had stopped working. Her cancer had spread to the liver. And her body was, quite literally, giving up on her.

Was she ready? Was she ready to die? Is anyone really ready?

As I stood there I couldn’t help but think of all the pain she went through. Chemo drugs take a toll on the body—nausea, vomiting, cell damage, kidney damage. Radiation is supposedly very painful. Hypoxia had surely taken over as well, altering her lucidity, speech, & even brain function. What HAD the last few months of her life been like?

They were probably painful, emotionally & physically. Overwhelming. A bit discouraging, perhaps, due to the nature of her cancer if nothing else. And yet, she was still here.

Would I make the same choice? Would I choose to live my last days & weeks, maybe months, strapped to an IV pole sending toxic chemical throughout my body? Would I choose to shoot radioactive rays through my body in an effort to kill a cancer that would certainly eventually kill me? Would I make the same choice? Would I want my childrens last memory of me to be a body, covered in sterilized sheets with tubes & machines at the head of the bed? Would I make the same choice?

...would you make the same choice?