The Orange Form


Today I took my mom for an appointment with the cardiologist, who told her she needs a valve replaced in her heart. He wanted me to come into the examination room when he discussed her need for a new heart valve, which she doesn't want. She thinks the operation would kill her, and I tend to agree. The doctor said she isn't having any serious problem with it right now but that she is getting too old for the surgery if she waits. He gave her an orange form, just in case ...

The orange form is for people to tape to the refrigerator if they want the paramedics to allow them to die if they have a serious cardiac or respiratory problem. My mom said, "I'm not afraid to die. I think the people in the graveyard feel better than I do, don't you?" She laughs. It isn't robust or even that humorous. It's an invitation to take what she says lightly, a kind of shy offering ... I remember it from when I was a child ...

When we get back home she sits and studies the form, trying to decide what to do. She is one of those women who often look to please other people when she makes a decision, even this one. She asks me what I think. "I think you have to decide if they're going to prolong your life or your death," I say. "What the doctor didn't mention is that when they resuscitate old people with chest compressions they break all their ribs." I am thinking of how many old people who would otherwise die in peace, instead die in pieces, with the shit beat out of them, hooked to a respirator and without a chance in hell of recovery.

When I was young I was writing for a magazine, and did a piece on a medical student. He got in a lot of trouble for telling me the truth. We were in the hospital and there was an old woman there that was being kept alive to accommodate the family's wishes. She was covered because if she wasn't the family would see that the doctors weren't even bothering to sew her back up, she was so far gone. I never forgot that they do that in hospitals. They store people who haven't got a chance in hell of ever recovering. They just won't let them die, and the family thinks there's going to be a miracle and they're going to come back.

Equally disturbing as the tendency to prolong death is the medical establishment's insane idea that old people shouldn't be given the painkillers they need because they might get addicted to them. Dad told me that when he was in the hospital with a heart attack, trying to not die even though his body wanted to, the nurse came in and said, "We can't give you any more morphine, because we've reached the legal limit." The DEA is now in charge of how much opiate a doctor can give somebody in great pain.

What difference does it make if you are addicted to something when you have so many medications you have to take, every day, for the rest of your life, that you have to use an electronic reminder? But that's the way it goes. Even with the advent of treatment for traumatic memory available, the Bush Administration opposes it, because of some convoluted moral reason that is hard to grasp. The treatment doesn't make you forget the trauma, it just blocks the adrenalin associated with it so that it isn't debilitating anymore. One doctor described the opposition to it as equal to opposing giving painkillers to somebody who was just in a bad auto accident. By the same logic used by the administration, they ought to suffer the pain because to not do so would make their experience inauthentic.

I was staying with mom while dad went to town to get groceries. He needs to get out of the house once in awhile, because he is her caregiver. The woman who lives next door comes over to clean and do laundry and so on, and will take only a little money from them for doing it. When I tried to talk them into as full time caregiver my mother dismissed the idea. "I don't want somebody hanging around all the time."

She called me yesterday because she was having muscle pain. She gets around, very unsteadily now, on a walker. She wants to use a wheelchair but dad insists that she keep walking as long as she can, and has proclaimed that he is taking her to physical therapy. She just looks over at me with a shy smile and gives that little laugh when he says it. "He won't let me rest," she says.

There is a wide screen television in the living room, but they decided against cable or a dish, announcing that the channels they pick up for free are enough for them. "I like 'Everybody Loves Raymond,'" she said, "and I can get that, and the news. She switches it on and the newscaster is showing the camera a pair of pants with the ass blown out of them. He explains that these pants were worn by a man struck by lighting on the 27th of July, and that 27 years ago, also on the 27th of July, he was also struck by lightning.

On the floor, an old black German Shepherd is sleeping in the coolness of the air conditioned room. When dad brought her home he'd had bypass surgery, and the puppy represented his determination to keep on living. He and the dog, Sasha, are facing old age together and both are doing well, except they both are crippled some and have trouble getting around. Dad is going to a back doctor to try and get some help for a pinched nerve. Sasha is taking DGP (Dog Gone Pain), an Australian herbal formula I order for her to keep her moving. I recommend it for old dogs in need of a new trick.

On the front patio there's a scooter dad bought for mom because she kept complaining that if she only had one, she could get out and putter around. She rode it around the yard once and decided it's too hot out for her, so it is sitting there waiting for cooler weather.

"I say something about dying," mom says, "and he says, 'Why do you want to talk about that?' He's afraid to die." She makes the sound again, somewhere between laughter and apology. "I don't reckon you feel anything at all after you die, do you?"

"I don't reckon you do."

I wonder how many other old couples are in their houses, waiting for the defining event from which they won't recover. I wonder how many of them have the orange form on the refrigerator, so that when the paramedics come in, if there really isn't any way to stop them from dying, they won't prolong the dying. When she was given the form at the hospital I felt the emotion welling up, and had to make an effort to keep my composure.

The truth of the matter is that when somebody gets too old to live, there is a complicated feeling, at least in me. What I really want is for them to be young again. I guess I could join the Mormon Church and, through the phenomenon of shared belief, think that it will happen. But I don't want to hang out with Mormons so that's a problem, and besides, if it's going to happen that way it's not going to happen because of organizational affiliation.

What I do believe is that there is, in the dreams of people who are approaching death, an indication of radical transformation. I don't know if those dreams contain this as a protection, but I don't think so. The unconscious is amoral and tends to be objective. In these dreams, a typical motif is a field of grain being burned to the ground, and some new shoots come up from the devastation. Maybe it refers to children. Maybe it refers to something else. I don't know. Maybe it is just what it appears to be; a radical transformation of energy.

What I know is that each of us lives inside our time, and that there is an overwhelming sadness in coming to an acceptance of the inevitable end of that time. Mom is from a big family, and all the brothers and sisters are gone now. She is there, tonight, with the orange form and the television that gets maybe six stations. I'm hoping she gets stronger, and that she'll be riding her scooter around the property on a cool fall day, maybe in October, when dad turns 90, and his back isn't hurting anymore.

Posted: Mon - July 30, 2007 at 04:13 PM