Arriving at an acceptance of one’s mortality and a clear understanding of the limits and the possibilities of medicine is a process, not an epiphany.
Being Mortal: Medicine and What Matters in the End by Atul Gawande
Since I was 20 I have known of Epicurus’s view on death which simply put states that death brings no pain. Since there is no pain we cannot possibly fear it.
As a young boy death happened to my neighbour next door in Buenos Aires and the lottery was won by a neighbour across the street. Both the winning and the dying happened always to someone else. I was a bad luck immortal.
Life in Mexico brought me closer to the concept of death which seemed to be a happy-go-lucky-why-care by most Mexicans.
I talk a lot about death and of my own. Both my daughters and my wife object to it. They particularly dislike my telling them that my hope is to be vaporized in an airliner mid-air explosion. There would be not bits left for the worry and expense of a burial.
My mother died in bed in our own house (one that she had helped my Rosemary and I to buy). She died of peritonitis something that now with a good doctor could have been prevented. Rosemary and I heard her breathe in but she never did breathe out.
My father died in the street and had enough money in his pocket that I was able to pay for a modest burial in the Chacarita Cemetery in Buenos Aires.
In the last five years I have lost four mentor/friends (three lifelong ones). Three of them cried in my presence and one of them simply told me, “After me, the deluge.” This, latter, man, Vancouver architect Abraham Rogatnick and I had discussed for years the prospect on how we would face death. A year before he died he decided to stop treatment on his prostate cancer. He knew he was going to die.
A few days before it happened I read to him by his hospital bed Ambrose Bierce’s Parker Adderson Philosopher. It is the tale of a man ready to die the next day as he has been caught as a spy. He does not fear death, he tells his captors. His captors unable to understand then decide to have him shot then and there. The spy and an officer have struggle and they shoot each other. Rogatnick and I talked about the fact that while we may not fear death and be prepared, little by little to let go, the situation would be different if someone put a gun to our temple. We can never know and Rogatnick, who was dying could not tell me how he would react.
A few years ago, while driving through a Vancouver back alley I spotted a gull that was in the last throws of dying. Perhaps it was sick, perhaps it had been hit by a car. I felt saddened and curiously ashamed to be watching. I seemed that in dignity we (humans and gulls) have to die alone. In fact we are often told that we all die alone.
In so many Hollywood, the wounded warrior, sickly wife is surrounded by friends or relatives. The “expert” gets close and then nods (this expert is always a man) negatively. He knows the person lying on the floor or being held by the hero’s arms, is a goner. Mark Twain, famously begged to differ.
Every time I feel that numbness in my elbows, a knot on my chest and I am short of breath I think of death. The first time it really happened (October 2013) in a motel room at the Toronto Airport all I could think of was, “I am not going to see my Rosemary or our cats again.”
All of the above and more went through my head as I drove (alone) my Malibu to OIiver, BC yesterday Monday. I consciously made it a point not to turn on my radio or play CDs. I wanted the relative silence to mull in my mind that my friend Mark Budgen whom I had met in 1977 had brain tumours and that his prognosis made it doubtful he might see 2016. I was going to visit him at the hospital. Returning home, there was no music in the Malibu. I had too much to digest.
Budgen is an eccentric Englishman who is a connoisseur of food, good books, music and an orderly and mostly uncomplicated living. He is also a very good essay writer known for precision and for meticulous fact-checking. He is well versed in politics and when after having met my first cousin/godmother, Inesita O’Reilly Kuker in Buenos Aires in the late 80s she gave Mark the nickname Marx because of his left-of-centre views. To this day Inesita, who is 92 remembers Marx fondly.
Budgen would invite our mutual friend Ian Bateson (who also was in Oliver on Monday) and I for sumptuous lunches in his heritage house in Strathcona. There is one day I remember most fondly (Bateson was not there that day). By my plate there was a little bowl with a peeled hard-boiled egg.I looked at Budgen quizzically. His explanation was, “Try putting some of that flaked salt from that little container on your egg.” The egg exploded in my mouth with flavour I had never experienced before.His explanation was, “That’s Maldon Salt. It comes from the Maldon Sea in England. The Danes defeated the English there. There is blood of Englishman in that salt.
Everybody in my family will not touch, eat or season any dishes without the glorious Maldon Salt.
There is a curious fact about how Budgen eschews certain types of technology to the point that he simply ignores it. Consider that he owned records and record players, but skipped the CD and went straight to podcasts. Budgen would listen to obscure Norwegian classical music stations at night in bed. He is a master of his iPhone is and is good with computers and when he didn’t want to talk to me on the phone his excuses were many but never repeated. My favourite was, “Alex I cannot talk to you because I am monitoring my fax machine.”
Budgen when he wants to can be one of the best dressed and most elegant men around. This is true, even though he has a preference for strange Mountain Co-Op foot gear. My best memory of his elegance happened in a VAG party during Expo 86. There was Budgen in an immaculate suit and beautiful tie. He was standing next to a similar kind of man except that the man, Patrick Reid was a lot taller.
One of the funniest moments (funny for me) happened in Lima in 1991. I had arrived to interview and photograph Mario Vargas Llosa. I had, knowing Budgen was already in Peru, found him a job with Maclean’s. He was furious with me but softened up a bit. Before we even left the airport (he had come to pick me up) someone had managed to steal his wristwatch.I want to add that both of us were members of the Explorers Club. We both went to the Lima clubhouse.
The man I saw for about 13 minutes in the Oliver General Hospital was sitting in bed eating blueberries and peaches. He was dressed in street clothes. He looked exactly like I remembered him even though I had been warned that he had lost 20 pounds in two weeks. With his exact and sonorous diction (he could have made a fortune as a hard news TV reporter) he gesticulated with his open hands (a very Mark Budgen trait) very much like a fisherman showing you how big the fish that got away was.
He asked me, “How do you find me?” I answered truthfully, “You are the same but different only in one way. You are a tall man and you always looked down on me from up there with your long nose. Now you, on your bed are at eye-level.” He then said, “You can take my picture.” I declined as the ones that I took back in 2014 for his future website are much better than anything I could have taken of a man on a hospital bed.
Budgen told me that in January he had read Being Mortal: Medicine and What Matters in the End by Atul Gawande. “I read it before I knew anything about what was going to happen to me.” And to inject a bit of that Budgen taste for good and lofty things he added, “He writes for the New Yorker.”He then said what seemed so easy for him to say and something I will never know until, (will I be lucky or not?) I am in the same boat, “I am dying.”
I told him of my experience with Abraham Rogatnick and reading him the Ambrose Bierce story.
Budgen was keen to explain to me of his terrible hallucination/nightmares. In one of them he learned that his policeman brother (who visited him recently from England) had died. He recounted this “fact” to his nurse who simply said, that is not true, you dreamed it. She (the night nurse is a woman) then gave him a pill to take away the anxiety. Budgen explained that they are not dreams or hallucinations but projections from his cancerous tumour.
I then said, “Please tell me when I should leave.” He said, “That is now.”
As I left I thought of a man with lots of dignity. I thought of a man with tidy habits and extreme pulchritude. I thought of that dignity and how matter-of-factly he had told me, “I piss through this tube.” At some point as this man of dignity is pressed by a diminishing of it, I know he will come to some sort of decision. But then I could be completely wrong. This man is private and his most innermost thoughts are unknown (at least to me). He told me that his mother had died of cancer in a little hospital surrounded by friends and relatives, “She was too polite to tell them to go.” He then told me while looking at me (with his new cancerous telephoto vision), “Most people think they will die surrounded by relatives and friends at home. That does not happen anymore. They now die alone in a big hospital surrounded by unknowns.”
Let’s make sure that does not happen.
Originally published at blog.alexwaterhousehayward.com.