Worse Than Death | Caring Choices

One of my occasional early Sunday morning indulgences is to lie in bed and watch old episodes of AMC’s Mad Men. The debauchery of many of that show’s characters never ceases to amaze me. This morning I caught an episode from Season 3 titled “The Arrangements”. Squeezed into this episode are a brilliant few minutes of dialogue between Betty Draper and her gruff, war veteran father. Betty’s dad invites her to join him at the kitchen table to discuss his arrangements (will, funeral, etc.). Betty is visibly uncomfortable. Noticing Betty’s discomfort, her father says something like “it’s all written down; we’ll never have to talk about it again.” Betty’s indignation flares and she accuses her dad of being ‘selfish and morbid’ for wanting to talk about this with her. She says “I’m your little girl” (albeit enormously pregnant with her third child) and follows that with a most damning statement: “I know it must be horrible to look at whatever it is you’re looking at, but can’t you just keep it to yourself”!

This particular episode is set in the spring of 1963 – an era when people did not speak about taboo topics like death, especially their own. In the five decades since 1963 in real life, death is still something most would rather people keep to themselves. People often ask me how I can be comfortable around death and work with people who are dying. I credit my parents with making me “comfortable” with death. I attended my first family funeral at age four. (A 16-year-old cousin was killed in a car accident.) Not long after that, one of my brother’s Little League teammates died. There were many family and friends-of-family funerals throughout my childhood and adolescence. Death was not something from which we hid. We heard about death in church sermons and Bible stories. Death was a natural part of life. And it was always possible that Mom’s health could take a downward turn at any point.

With reliable regularity, Mom would land in the hospital each winter with pneumonia. Several times, Dad would make peripheral comments about not knowing how long Mom would be “with us”; especially if she had more than one hospitalization a year (which she often did). Mom always came home, though, and life continued on its path. She never hid her disease and its ravages from us. (COPD is not easily camouflaged anyway.) Because she lived with her disease every day, so did we. Chronic illness was always a part of our lives and we learned from Mom how to manage it and support her.

The greater lesson she taught me through the progression of her disease was how to talk about what was happening and what would eventually happen. She talked about her death matter-of-factly, often saying she’d be happy to reach 70. One afternoon we were watching a medical documentary (she loved those!) about some awful affliction and Mom said that it would be “worse than death” to suffer as the person in the documentary had. I was, of course, shocked – how could anything be worse than death?!?

Mom was the most pragmatic person I’ve ever known. She learned through having COPD that she could not allow herself to be overcome by emotional outbursts because she wouldn’t be able to breathe. If she thought something, she said it. If she wanted to talk about something, we listened because we knew every sentence was uttered through labored breathing. So, on that particular day, I listened to Mom tell me about things that she considered would be “worse than death”:

Gasping for breath, as if suffocating
Drowning in COPD secretions
Having cancer in her eyes
Being hooked up to a ventilator and knowing we would have to “pull the plug”
No longer knowing who she was or who we were

Her list was longer although I don’t remember many others all these years later. We were able to have an open conversation – one that she needed to have, so that I could understand what she was facing and would know what to do. Unlike Betty Draper, I did not think Mom was being selfish or morbid. She was being practical. She was being proactive and preparing me for the duty of carrying out her wishes. She was being selfless in acknowledging her own mortality and sharing her quality-of-life values with me. She was giving me the benefit of her last loving act so that when the time came (and it did come), I would know what to do. I would not have to second guess decisions. I would not suffer with anxiety wondering if I was doing the “right” thing.

Was it easy to listen to Mom’s “worse than death” list? Was I comfortable with her talking about her own death? NO WAY. It was profoundly sad. It was beyond difficult. I didn’t want to think about life without my Mom. But Mom wanted (needed?) to have that conversation, like Betty’s dad wanted to have in the TV episode this morning. The important difference between me and “Betty” was that this daughter listened.

When people you love want/need to have these conversations, Caring Choices can help you listen.