Friday, July 29, 2016

In The Midst of Life

I participate in a private Facebook group, the PMP Appendix Cancer Support Group. (Very highly recommended for anyone who belongs, as an “individual and their caregivers/advocates who have or have had Pseudomyxoma Peritonei (PMP) and/or any other form of Appendix Cancer,” and mostly irrelevant and not particularly inviting for everybody else.) This is a small group because PMP/AC is uncommon (for example, a couple of hundred new cases per year in the United States), but almost 2,000 members because Facebook has a worldwide reach and because we are survivors, for days and months and years. However, almost daily, it seems, somebody dies. About as often I determine to turn it off (but I don't). Death is hard, and it seems like it’s always people I know, even if just the wee bits we get through social media. And selfishly, I’m always reminded of me.

I am now going to quote from "Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human." (Recommended, but I should acknowledge that the author Samuel Brown is a long-time acquaintance and friend.) For the thesis of the book in one line, I could do worse than this line from the book: “A modified advance directive could state simply, ‘If I’m ever in a situation where I could choose to undergo medical treatments or choose instead to allow a natural death for myself, please advise me and my family of this before we start the treatments.’”

And here begins the long quote (with my own unmarked edits and ellipses) which is about life and death and the people we care about:

“Media vita in morte sumus is a phrase that has circulated among Christians for many centuries: “In the midst of life we are in death.” No one knows who first said those words. Most believe the language comes from an old French hymn, perhaps as early as the eighth century. Whatever the source of this saying, it contains centuries of wisdom.

A much-simplified version of the old Christian phrase says to “Live every day as if it were your last.” That’s a complicated saying too. It seems to suggest that we should not waste a single day, that we should savor the beauty life has to offer with all the vigor we can muster. It might also suggest that we should do great things we would otherwise procrastinate. The concept of a “bucket list” is based on that concept. While I support living life to its fullest and recognize that the specter of death motivates a certain immediacy in experiencing rare or special things, I am skeptical of a bucket list of adventures as a response to mortality. It’s not that we shouldn’t dream and achieve, but there is much more to life than a list of expensive vacations or risky spectacles.

Living life in the midst of death means creating relationships in the presence of our confounding temporariness. It means recognizing that we will grow and age and sometimes lose our way. Life in the presence of death means consistently treating people with the marvelous, tender poignancy that arises spontaneously when we discover that they might die.

One thing advance care planning gets right is that it’s better not to wait until it is too late to say or do certain things. In the rush of life, we commonly forget to acknowledge how important we are to each other."