This December will be the third anniversary of my grandmother’s death. While I definitely get sad thinking about her not being here with us, I’m also reminded of the way death is managed in this country, and that makes me makes me angry.
It started on Thanksgiving Day in 2019, I had just finished dinner with my family. We’re early eaters, so it was only about four in the afternoon. My grandmother didn’t come to that dinner, opting instead to stay home and let people from different branches of her family tree visit her over the course of the weekend instead. She wasn’t feeling great. Since Thanksgiving with my in-laws was later that night, I resolved to visit her on Friday.
Coffee and Death
That Thanksgiving is bookended by two cups of of coffee.
Having finished with my side of the family for the day, I had a few hours to kill before needing to be at my inlaws. I wanted to write somewhere, and the Starbucks near my home was the only place open. I felt both happy to have a quiet place to drink a latte, but I felt bad for the people working. So, I ordered my coffee, put what I hoped was a surprising amount of cash in the tip container, and sat at the coffee bar with my notebook.
I sat there tapping my pen against my notebook, stuck in the middle of trying to make a joke about the third amendment funny. I’d brought this joke into rotation more than once in the last few years and just couldn’t nail it. But i wanted to make it work for a specific show in January. So I was sipping coffee and thinking about the name Cotesworth when I answered a call from my mom, who had taken a plate of food to my grandmother. Grandma was feeling really sick, she said. She was about to call an ambulance, but I told her that I wasn’t doing anything and would drive them. So I closed my notebook, and left that Starbucks and Charles Cotesworth Pinckney behind.
When I picked up my mom and my grandmother, my grandmother was complaining about a persistent cough that had been getting worse. That cough turned out to be stage four lung cancer that grandma had known about for a while and had kept secret, because she feared hospitals, and doctors, and surgery, and the kind of life cancer treatment meant for someone approaching eighty years old. While I hate that she kept this secret, I understand it.
I was standing there next to a Keurig machine in an alcove of the hospital waiting room drinking the worst cup of coffee you can make, processing this information. I had written a joke in my phone about how if I died in this hospital, I would haunt it until they figured out something better than generic k-cup coffee. That joke never made it further than social media.
DOGS GET MERCY – HUMANS GET MEDICAL BILLS
What followed was the beginning of her dying process, first in that hospital, and then under in-home hospice care provided by my mother and her sisters for the final week of her life. All-in-all it was a two week lesson in how fucked up dying is in this country for anyone who isn’t wealthy.
And I mean WEALTHY. I’m not going to post a bank statement here, but I do alright. I get paid to tell elaborate shaggy dog stories. I get money deposited in my bank from a podcast I regularly take three months off updating. And I have a day job that fits perfectly with my creative outlets and provides me with a level of financial security I couldn’t have dreamed of when I was a poor kid growing up in this city. I’m not flexing. But I want to make a point here.
I’m Just Saying, I Do Okay
And it doesn’t matter. For all the financial security I pretend I have, I am one rogue cell away from financial ruin, and traumatization by a medical system where the level of care you recieve is determined by actuarial tables, profit and loss statements, politics, and luck.
Way back when I did taxes (*shudder*), and when I saw more than one client, clients with medical insurance, go from six figure salaries to figuring out if they could survive living in the car for a bit, all because of a week or two in a hospital bed. Our medical system is a monster that can financially destroy anyone. (This is why I don’t understand when people white knight for the super wealthy in this country under some misguided notion they’ll eventually be in the same league as them. You are much more likely to have everything disappear in an instant, and your politics should be formed with that thought in mind. But that’s a different essay.)
If anything could have been done to save my grandmother, we would have made it happen, as long as she would have let us. My brothers, cousins, and I would have pooled whatever resources we had, without question, to save her life. But that wasn’t in the cards. Her cancer had progressed to the point where death was inevitable and any treatment or surgery would have caused more pain than benefit.
In a civilized society, a person presented with this inevitability would be given the power and resources to decide how their death would play out. They would be allowed to determine the level of pain they wanted to endure as they planned their goodbyes. They would be allowed designate some one to help them manage their exit from this world on their own terms. Their family and loved ones would still be hurt by the loss, but would know this person died with a sense of control, instead of feeling helpless and at the mercy of the universe. A civilized society would place the decision for when a life ends with the owner of that life. While we can argue about how that should be paid for, that basic right shouldn’t be up for debate.
We do not live in a civilized society.
Apart from the doctors, nurses, technicians, and other patient facing roles, there are no good actors in the American medical system, at least not from an institutional perspective. That’s not to say that there aren’t hospital administrators here and there who try to make compassionate decisions, or an insurance company executive who wished their company could do better. But as a whole, we’ve created a system that is Kafka-esque in its bureaucracy and operations.
It’s a system that isn’t just at the mercy of accountants and actuaries projecting a cost/benefit analysis for every single action that can be performed by a medical professional, but is also at the mercy of cherry picked religious tenets that make good talking points for politicians trying to appeal to the dumbest among us. And nowhere can that be seen more clearly than in how we treat end of life decisions.
Euthanasia is only illegal because it would affect productivity. Because if you wake up in the morning knowing you’d be dead by the end of the day, you’re not going into Quiznos.
The CDC estimates that 10% of Americans considered Ending their own life in 2020.
That’s 3,000,000 people. That’s the amount of people employed by the airline industry, the automotive industry, and the meat packing industry combined.
You think anyone in Congress is going to give up flying to Hawaii, driving from the airport to the restaurant, and eating a T-Bone while they wait for a suitcase full of cash to be slid under the table in exchange for their vote against universal healthcare just so you can escape a world devoid of hope? Hell no.
Can you imagine the damage this would do to banks if ending your own life was legal? You’d go out and get cash advances on all your credit cards, drown yourself in sex workers of your preferred gender, hire a personal pastry chef to serve their creations to you all day, and then walk off into the sunset leaving those balances unpaid. Congratulations sad boy, you’re the new mortgage crisis.
In order for any society with a hierarchy to guarantee it remains a going concern, there are certain ideas that have to become cultural norms, verging on commandments. Among those is the belief that ending your own life is always wrong. You owe it to your family, society, and GOD THEMSELVES to keep on keeping on. Work through the pain. Stay on the factory line until you drop. Never demand rest.
This Post Needs A Denouement
Ironically, it’s hard to tell when to end it.
Chris Cyr is a writer and nationally touring stand-up comedian from St. Louis, Missouri. His album, “Adult Child of Children” will be released on Helium Records in September 2022.