On Geezers Passing

I think I've mentioned on this blog that when I got an invitation to the 45th anniversary reunion of my high school graduating class, along with it was a link to the Dead List from that class. And when I checked it, I was shocked (really) to see the names of at least half the graduating seniors from my class listed as already dead. It was a small class, less than a hundred, and I counted fifty three names, though I knew at least two of them were still alive, so there may have been more errors.

None of the dead ones made it to age 65. I noticed that a lot of those who passed away did so suddenly in their forties or early fifties from heart attacks or lingeringly from congestive heart failure. A lot of deaths were from accidents -- either traffic fatalities or otherwise, or in one case a gun accident. Three that I knew of died of AIDS. There may have been more. Three were killed in Vietnam when they were... young. But a whole raft of guys I hung out with in high school were dead from unlisted causes. Four of their names were alphabetically sequential, and so they all knew each other from the time they'd been in elementary school, they were good friends with one another and their families were close. I was the New Kid, came into the district in 9th grade, and I got to be friends with all of them. After high school, I went to college and they didn't so we lost touch, yet it was a real blow to find out they were all dead. Good doG.

The list went on and on. Practically everyone I considered a close friend in high school was on it. That was hard to take. The handful of friends from those days who had not passed were people whose whereabouts I was pretty sure of and whose contact information I probably had in some address book in the desk in the dining room since I had last seen them no more than ten years before. I noted that some of them were on the "do you know what happened to...?" list and laughed because a couple of them were very well known about town, got their names and faces in the papers all the time, and it struck me as silly that the Reunion Committee didn't know where they were. Oh really?

Given that I knew what had become of the four or five high school chums who were still alive, and none of the rest of the people I'd want to see from my high school class had survived, I skipped that reunion. In fact, I haven't been to one since the 10th, whenever that was. The 50th will be coming up in a couple of years, and I have a hard time imagining I'd go -- or that literally anyone I'd want to see would live to show up at it!

I still have a link to the Dead List, and I checked it yesterday to find another half-dozen or so names added since last I checked, a couple of whom I knew had died, but others surprising me. There was also now a list of Dead Faculty and Staff. Yes, well. Practically all of them are no longer with us, wouldn't you know. But many seemed to have made it well into their eighties before passing. Good for them!

Then I looked up a post-high school buddy, my closest off-campus friend during early college years, someone I lost touch with for years, then briefly reconnected with about 15 years ago through his adult daughter who was part of the crew for a play I produced, but then I lost touch with him again, as our lives didn't really intersect anymore. Now that we were both in our dottage, I was curious to see if he was still working or had retired or whatever. What did I find but his obit.

Oh, Jeebus.

He died nearly three years ago, it turned out, from what was described as "a brief illness." No, he didn't make it to 65, either. I couldn't imagine what kind of "brief illness" might have killed him, as he was sturdy as an ox, but I could well imagine that if he had to be hospitalized something could have gone terribly wrong. There was a picture of him with the obit that was taken fairly recently -- I'd say within the last five years --  and I was struck with how well he'd aged, looking mature, yes, but not really old as so many of my age-group do. His death hit me hard when I saw his picture. It's still upsetting.

The passing of so many of these people I knew, all of them dying before they reached age 65, more than half of my high school graduating class for example, should have an effect on the canard that's become conventional wisdom that "people are living longer" and "life expectancy has increased" since the establishment of Social Security back in the Dark Ages.

Some people are living longer, to be sure. And some people's  life expectancies have increased. But for many, it just ain't so. Some people's life expectancies have actually been in decline for years. I'd like to see a statistical analysis of the life-spans of those Boomers in my high school graduating class, because if so many are dead now -- more than half -- then the average life expectancy can't be all that much beyond 65 -- if that, depending on how young the dead ones were when they passed and how much longer the rest of us geezers are going to hang on before we, too, shuffle off this mortal coil.

While it's possible there is a distinct anomaly in the high number of pre-age-65 deaths in my particular high school class and among my friends, I'm dubious. So far as I know, there is no special risk factor among them, though I could be wrong.

We were all living in middle class (white) suburban neighborhoods; there was no perceptible crime, certainly none of violence, and no gangs or widespread drug use (there was some, though, that I can recall from before graduation but far less than the routine use of alcohol.)  We were near an Air Force base, however, and lot of the households were military. A lot. The base has since been closed by the Air Force, and it took years to clean up the pollutants before it could re-open for civilian use, so I'm wondering if pollution might be an anomalous risk factor.

Vietnam took three from my class, AIDS another three, accidents perhaps ten, heart attack or heart failure another fifteen or so. I only counted two or three listed as cancer deaths, but I know several who survived bouts with cancer and -- so far as I know -- are still alive. As for the rest of the deaths most have no cause listed.

My post high school buddy didn't live near the base, but he had grown up near -- and his father had worked for  -- the railroad yards, which was/is even more contaminated than the base was. Which might have been a factor. He worked in construction for 40 years, specializing in drywall installation later on, had his own company and such, and he was very busy during the construction/real estate boom. That was probably a more immediate factor in his death, but I don't know specifics, so I can't say for sure.

My own parents died relatively young, but not that young -- my father of  cancer at age 69, my mother of emphysema/lung failure leading to heart failure at 74. My sister, however, died at age 61 from a blood clot following surgery to repair knee injuries she sustained in a prisoner take-down; my brother died at age 40 or 41 of unspecified causes.

So even in my own family, a relatively small sample to be sure, the average age of the dead ones is 61. (If we threw in the twins that died at birth, the number would be much lower.)

What I'm getting at is that the "longer lifespan" argument for cutting Social Security benefits and making Medicare access more difficult and expensive is simply bogus for larger and larger numbers of people. A few people -- mostly the very rich with access to more expensive and higher quality medical care -- are living longer (and longer) which may be driving up statistical averages (much as their income does), but the vast majority are not living longer and most have no chance of living longer; too many will have shorter lifespans than those of their parents. The panic over "longer lifespans" has been whipped up by the media (in the pay of certain billionaires it would appear) and it is nothing but propaganda.

Breaking through this propaganda barrage is essential on many levels. It seems to me that what passes for the "left" in this country is very late to the game, letting the propaganda go essentially unchallenged until fairly recently, too recently to be able to counter it effectively. Unfortunately, a sizable percentage of the leftish commentariat has bought the bogus "longer lifespan" argument, and while not openly supportive of cuts to Social Security and Medicare, will not substantively argue against them nor indeed will they argue the correct policies of expanding rather than restricting these and other social programs, increasing Social Security benefits, lowering retirement ages, and instituting something like Medicare For All.

What passes for the "left" in this country is among our many failed institutions since the turn of the millennium. Somehow, the People have to take control for their future and their own sakes.

Terminal

The Health Care "Debate" seems to have devolved into a question of euthanasia thanks to the media's obsession with anything that comes out of Sarah Palin's prolific tongue/pen/keyboard.

OK. Let's talk.

Digby has a good post up about the origin and development of Advance Directives, DNRs and Durable Powers of Attorney in California, and I've had considerable recent experience with the whole panoply of those things (as have many others, it appears, on the blogosphere.) I'm not at all sure where we'd be without them.

Well, no. I can figure how Betty's care and passing might have been different without her advanced directives and my power of attorney over health care issues.

Her last episode began last October when I took her to the clinic where her primary care physician was medical director. She'd been complaining of shortness of breath, chest pains, and she had developed wounds on her lower legs that were not healing. Her doctor was off that day, but Betty was seen by a nurse practitioner and one of the other staff doctors who diagnosed a heart attack in progress, ordered up an ambulance, and took her to the hospital.

She already had an advance directive stating that that no extraordinary efforts should be made to keep her alive if her condition was terminal. She was not considered to be in that state, although her heart was giving out, it was still functioning in afibrillation, and she was able to consent to treatment at the hospital. They determined that the primary cause of difficulty was edema, fluid build up, and they drained her of the excess fluid promptly. She felt much better almost immediately. A heart specialist was consulted, and she was taken for angioplasty and stent insertion. Her decline in the hospital commenced thereupon, not so much because of the angioplasty and stents themselves but due to some botched after-treatment including misplaced injection shunts (that missed the vein causing immense pain and suffering whenever fluids were administered through those shunts) and a very strange (and still inexplicable) determination that Betty could not eat or drink and so was being fed and hydrated through an NG tube.

Then her wounds became infected.

She became depressed and despondent. Her physical condition was not improving, and her psychological condition was deteriorating alarmingly. She wanted to go home, that was really all she thought about or cared about. She wanted out of the hospital, the sooner the better.

Her attending physician, however, wanted her to stay another week, and then go to a skilled nursing facility for three to five more weeks. Then she wanted to put a PEG in her stomach to feed her. Then, maybe, she would be allowed to go home.

Betty verbally agreed to this regimen but she was disconsolate with us about it, and we determined she was going home no matter what, and it practically took an act of congress to get her out of there, but out she came, and home she went.

Ten months later, she died, but she died at home.

She outlived every prediction of her impending doom, and her passing was as close to what she wanted as it was possible for us to provide.

Had she stayed in the hospital and/or gone to skilled nursing for "recovery" I sincerely believe it would have been a death sentence. She would have been dead within a week or even less.

I would call her continued treatment in the hospital or nursing facility a form of euthanasia, in that it was not what she wanted, and her will to live was being sapped there every day.

And if she had not had advance directives, DNRs and durable powers of attorney, quite likely she would have stayed in the hospital and would have died there. I will not, for the moment, go into the ways and means that medical professionals can and do prolong and/or retard patients' survival.

So there's your goddamned Death Panels, and I don't want to hear another stupid word about it.

"Gone from our sight"

Betty passed away peacefully yesterday afternoon. She lived a long and rewarding life, a life of adventure for her, and one of kindness and generosity toward everyone she met.

She had a profound influence on a rippling circle of individuals, most lately of course, the professionals who cared for her as her life waned away, but more inclusively, her family, and the friends who came to visit her in the last few weeks.

As we make "the arrangements", we come to realize that many of those she touched, perhaps all of them who are still alive themselves, have come to visit her and pay their respects for her life and her inspiration. Oh, there have been many tears, to be sure, but there has been far more joy and sense of honor just to know her.

She literally saved my life -- more than once -- and I am eternally grateful to her.

As far as we could tell, she went gently into that "other place" which she had visited before but where she had never been able to stay. We believe that her spirit left her body some time before her body shut down completely, but just when she completed her journey we can't know. She was at peace, though, when the end finally came. The serenity on her face and the easy appearance of her body as she lay in bed while we put up with all the bustling to and fro of the various people who came to certify and to pronounce and to call various others and to pray and to take her body away to the mortuary was a blessing; she was so beautiful through it all.

The friend who called yesterday called again about ten minutes after Betty died. His name appeared on the screen as the phone rang. I answered the phone, "So you know do you?" He said, "I knew yesterday." I told him that Betty had breathed her last just a few minutes before, and here he was calling... He said, "I drove by your house a few minutes ago, but something told me not to stop. I sensed I should go home and call instead." Yes, it was the right thing to do, and we talked for a while, remembering a mutual friend who had been through somewhat the same process of dying several years ago. I said, "You're still welcome to come over. Would it help you to see her one last time?" He said, "I'll be over, but first I'm going to get you all some burgers at the [Burger joint name redacted] and make sure you get some food in you." I thought OMG.

So we went through a whole raft of processes and procedures ending with our waiting with the priest for the nurse who would "pronounce" the death, when my friend arrived knocking on the door, and sure enough he'd brought big sacks of fresh-cooked hamburgers -- which smell wonderful -- and he and the priest, and we and Betty's granddaughter chat about what a wonderful person Betty had been, how much she'd touched our lives, etc, etc, and my friend went over to Betty, who was still very serene on her bed, and he gently took her hand, kissed it and stroked her head and turned away, tears streaming down his cheeks, and just whispered "Thank you." He left not long afterwards, reminding us that we'd better have those hamburgers, and we said we would.

And about an hour later, when all the hub bub was done, we did; we had a wonderful little wake, Betty's granddaughter and us, as we talked about Betty's life, listening to music she liked to hear, and making preps for the next step.

At this point, I don't think there's going to be a funeral as such. Betty's body will be cremated, and her ashes will be split. Her spirit will be honored, and her memory will be secured. I suspect a number of people will write about her -- I couldn't possibly be the only one who does so! Those words will be assembled and distributed to those whose lives she touched so profoundly.

Rest in peace, Betty. You may be gone from our sight, but you will always be in our hearts. It was a privilege just to know you.