An Unrecognized “Stage” of Dying

                                                   An Unrecognized “Stage” of Dying                               

                                                               by Marco M. Pardi

Note: All comments are appreciated, read, and responded to accordingly.  The comments sections for all previous articles have been opened for use.  I will certainly look forward to your comments.

 “We die only once, and for such a long time!” Moliere (1622-1673) Le Depit amoureux, 5,3, 1656

“When a man lies dying, he does not die from disease alone. He dies from his whole life.” Charles Peguy (1873-1914) “Basic Verities: The Search for Truth”

By now every reader is familiar with Elizabeth Kubler-Ross’ discussion of the stages people may go through in dying: Denial, anger, bargaining, depression, and acceptance – DABDA. My issue here is the unrecognized and most often lengthy stage which begins with the realization of mortality.  In a separate piece I deal with the continually inadequate discussion of the “stages of dying” which, like the Near Death Experience (NDE) have become so formulaic and with which  everyone is so familiar. 

Somewhere early in childhood – opinions vary considerably, we become aware that we, like the life forms around us, must one day die.  Every culture we know of, past and present, has a means to address this.  But culture is a super organic; it is an intangible cloud of “they say” and “everyone knows” of which we are expected to partake and to internalize.  The culture provides answers to questions it presumes are asked and it does so often with the specter of severe disapproval if these answers do not suffice.

But what of the individual, the one who can unerringly pronounce the socially approved memes while abiding in an inner life of uncertainty and of influences of which he or she is not always consciously aware? What of the individual who examines his present circumstances and projects for himself the likely circumstances attending his dying process, which are sometimes contrary to the culture driven story?  I call this stage: Anticipation. We enter it as we become aware of our mortality.  We push it to the background with various culture provided aphorisms.  But, as Carlos Castaneda’s Don Juan (Don Juan: A Jaqui Way of Knowledge) reminded him, Death is just over your left shoulder.

When I speak of uncertainty I am not referring to whether one will die, but how and when.  In the early days of some of my Death & Dying classes I asked students to anonymously answer the question: If someone could tell you when you will die, would you want to know?  Invariably the answers came back mostly negative. But some people, especially as they observe or become knowledgeable of other family members, begin to establish a perhaps realistic, perhaps magical paradigm for themselves.  This is no “Ivory Tower” discussion (the etiology of that term is at the conclusion).  This is a discussion for everyone, student or not.  Here’s an example:

In my 12th through 15th year we lived on a couple of acres about 15 miles northeast of Cleveland, Ohio.  Only a couple of homes had been built on what was once a very large farm and orchard.  Our neighbor had turned most of his back property into a very large and varied vegetable garden.  He was a science teacher at the local high school and was a bit over 61 years old when we moved there.  Taking any and all opportunities to get out of the house, I soon befriended him and helped him work that huge garden.  I was in quite good physical condition; he was a bit portly, with WWI shrapnel embedded in his right bicep.      

We worked that plot year round.  I often found myself exhausted and unable to really compete when we finished our work with a couple of games of horseshoes. But as the years passed I noticed a sharp decline in his stamina and mood.  As we talked he told me his grandfather died at 64 and his father died at 64.  Although he did not put it into words, it was clear he felt his end was drawing near.

As he reached 64 he became a dead man walking.  The garden weeds got ahead of me because without him helping I could not keep up.  He came outside far less often, and then only to sit on a patio chair and stare into space.  His warm stories of growing up on a South Indiana farm petered out, at around the same time as he began giving me artifacts from those farm years. He was dying himself to death.  And this was a well educated science teacher.

My family moved to another State and I soon went into the military and back to college.  Of course, in my line of work in the military of the 1960’s death was not abstract. Although no one spoke of it much, for fear of being considered unfit, the general attitude seemed to be when your time is up, it’s up.  Looking back later I was struck by the absence of discussion about life changing wounds and injuries – although there were many of those.  It was an all or nothing concept.

When my neighbor reached his early 70’s he and his wife visited my family at their new home.  I got a short visit with them.  He looked pretty worn out, but my mid 20’s mind told me that’s what people in their 70’s look like.  His wife did tell me he felt every day would be his last, but he just kept getting up in the morning.  Was this normal life?  Should I review the family males of preceding generations and make my plans accordingly? At least in his case he could share his concerns with his wife, even if she wasn’t equipped to rebut them with anything more than a vague “God knows”.

Another, more current example is an older couple I have known for some years.  He is retired from a high level, very cerebral career.  She retired early from a very low level job.  Although her I.Q. seems to be only a bit over half of his, she never misses an opportunity to criticize, mock, and belittle him even in public, often saying untrue things.  She often presents herself as his caretaker, as if he is incompetent. His daughter and grandchildren from a previous marriage want nothing to do with her.  He has withdrawn from all active engagement in life, reading at least one non-fiction book per week and, if going to a rare social event with her he sits quietly by himself.  Any attempts to discuss his reading with his wife meet with hostility.  “If I don’t talk to myself, no one else will.”

In talking with him about the trajectory his life has taken he told me, and I’ve seen it, that since his wife blames and criticizes him for everything and anything that happens, he dreads the possibility that some debilitating condition, such as cancer, should one day develop.  “If I do develop cancer, and if I do elect treatment, I will hire someone to take me for chemo so as not to inconvenience her Bridge parties, dinners with the ‘girls’, or vacation cruises she so loves. But, I’m inclined to reject treatment and just get it over as quickly as possible.  And, I’ll move into a residential hospice as soon as I’m eligible.”

It is fair to say this is a man who is fully into Anticipation, charting out the possible – if not likely development of events.  While some may rush to assure him he is seeing only the negative, there comes a time when one faces reality.  And reality, in this case, is mostly if not entirely negative. 

In sum, Anticipation is common in some form to most of us who are able to think.  Of course, there are extreme ends of this spectrum; “Sure, some day”, “I hope I go in my sleep” are at the threshold while waiting through each day past a magical marker (the example of being 64) is at the other.  Anticipation becomes irresponsible when simple acts like devising a Will are postponed or ignored.  It becomes morbid when planning for family events is curtailed because “I might not be here.” But it must be recognized and integrated into the ongoing life process in a productive and healthy way.

How did “Ivory Tower” become a meme in our culture?  In the development of America’s Ivy League universities the long standing English universities Oxford and Cambridge served as models. Perhaps the most insulated of these American universities was Princeton.  Its faux Gothic architecture borrowed from both Oxford and Cambridge.  And, most of its endowment came from the Proctor family (Proctor & Gamble).  When the tower at the Graduate College rose, funded by Proctor, it was a copy of the tower at Magdalen College Oxford, but it quickly became known as the “Ivory Tower” since Proctor’s greatest product at the time was Ivory soap.  Since then this title has come to stand for any academic institution which stands aloof from the general population which surrounds and supports it.