Quote for the Day

In honor of Lucy and with much love for Dolly:

The creation of a thousand forests is in one acorn. 

~ Ralph Waldo Emerson 

Death is Not a Dirty Word

     For as long as we have records, people have been afraid of dying – partly because we didn’t have good pain strategies and partly because many feared the unknown or their own beliefs about what comes after death. 

     But it has only been in the last 100 years that the dying process itself  has become so foreign and invisible to us that the unknown about the dying process causes us so much fear and anxiety.

     Less than 100 years ago 80% of all people died in their own homes, the average life expectancy was 50 years and the infant mortality rate was 24 times higher than today: more than 16% of children died before their first birthday.  People may not have liked it, but they were very familiar with death and the dying process.  Parents knew the anguish of losing a child; children witnessed the decline and death not only of grandparents, but also of siblings and parents; and the primary caretakers through illness and death were close family members in the home.

     Today, almost 70% of people die in institutions (hospitals and nursing homes) and the average life expectancy is close to 80 years.  We do not witness or participate in the dying process often in our lifetimes.

     Dying has become a mystery to us and the rituals we once had of washing the body, preparing for burial and the burial itself have been transferred into the hands of strangers.

     In addition, medicine has come so far that we expect it to prevent death, stop the aging process and keep us eternally happy, healthy, comfortable and young.  Aging and death are seen as failures of the medical community and our own will.

     Death has become a dirty word.

     We are awkward around the dying and bereaved.  We don’t know what to do or say.  We avoid witnessing dying and prefer that others do not discuss it.

     But we are making a big mistake.

     Death comes to all of us and everyone we know and love at some point.  Our ostrich approach to dying benefits no one, least of all ourselves and our children.

     Those who have witnessed the peaceful  death of a loved one – human or animal – are  universally transformed in any number of ways, almost always in a positive way.  Most feel a deeper and stronger connection to the one who has passed, a reduction in anxiety about dying ourselves, an appreciation of the beauty and gift that is our own lives and the lives of those we love, and a peace within.

     There are times when it is not possible to care for your loved ones at home, and some occasions where there is a need to be in a hospital, but there are many times when there is a choice whether to care for our own at home, allow others to care for them somewhere else, or hide from death altogether by ignoring the situation.  In the animal world, we are also often faced with the choice of euthanasia.

    Not every situation allows for hospice-assisted natural death at home, but if the opportunity were there, would you have the courage to try?  Would you be able to overcome your fear of death and isolation from the dying process to take that leap of faith?  Could you trust yourself, your knowledge, your skills, your instincts, and most of all your compassion enough to be that loving family caretaker?

     We think you can.  We believe in you.  And we know, no matter what comes,  you will never regret trying.

     Death is not a dirty word.  Take that leap of faith.

Quote for the Day

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When a person is born, we rejoice

and when they're getting married, we jubilate,

but when they die, we try to pretend nothing has happened.

~ Margaret Mead

Quote for the Day

Photo Courtesy of Shawn Dovey

Listen to your heart.

It knows everything.

~ Paulo Coelho

Burdens and Blessings

     Some years ago when I was going through a particularly difficult period of loss and despair, a dear, dear friend gave me a collection of saying stones.  You know the ones - tumbled river rocks of various sizes etched with a word or phrase intended to inspire or console you.  They were beautiful and I was touch by the gift.  One of the stones was engraved with the word: "blessings"

     Ultimately, as part of my healing process I planted a memory garden in a visible but out of the way corner of my backyard.  I had never done anything like that before and cannot say what drove me to do it, but the entire process was incredibly therapeutic: the research of plants gave my mind something to do, the physical labor of digging and planting gave my body something to do, and the artistic design gave my heart expression.  In the center I made a small labyrinth of stones and the Blessings stone went in the middle.  The memory garden remains a special place, but the act of creating it was the powerful piece for me personally and once planted that spring, I rarely give it much thought.

     Summer and the New England snows came and went and when the spring thaw came, the little garden was covered in leaves that were missed in the fall clean up.  My husband ran the lawnmower over the whole area and the Blessings stone was picked up and spit out far from where I had initially placed it.  I found it on a chilly early spring day and put it in my winter coat pocket - which was soon after stored away, the stone completely forgotten.

     The next fall when it got cold and I put on the coat, I wondered why it was so heavy and putting my hand in the pocket rediscovered the Blessings stone.  By then I had more perspective and distance from the despair of the previous year and the stone spoke to me in a new way.

     The weight of it reminded me that  we all hold blessings that can feel like burdens.  

     We expect blessings to be light, easy and perpetually joyous but  in reality the most treasured blessings bring with them substance, weight and complexity.  A blessing is not a temporary or fleeting joy, but a thing that becomes part of you and your heart, that has meaning and richness which grows with time and imparts meaning on a truly deep level.  Blessings are confusing, complicated and bewildering - revealing themselves only their own time, not ours.

     Like the stone that appeared at all the right times and yet so often hid out of sight and mind, blessings come to us.  We can not plan for them or work towards them.  They arrive on our doorsteps not when we schedule them, but unexpectedly and often inconveniently.

     The question is this: Can we recognize and honor the blessing that comes wrapped in the weight of a burden?  Can we stop our time to honor the gift that comes in its own time? Can we be humble and open enough to wade through the complexity and live in the ambiguity that accompany the most treasured of all blessings?  Can we see past the light, easy and fleeting to appreciate the meaningful, difficult, and lasting?

     Can we recognize that our both our heart's ache and our heart's joy come in direct proportion to the blessing we have been granted?

A Funny Thing Happened in Oregon...

     Oregon is the only state in our nation that has legalized Physician Assisted Suicide.  On September 27, 1997, Oregon's legislature enacted the Death with Dignity Act which allows patients to self-administer a lethal dose of prescription medication, prescribed for that purpose by a physician.  The person must be at least 18 years old, suffering from a terminal illness and informed of the opportunity for palliative and hospice care as well as counseling.  Being elderly or having special needs does not qualify unless also combined with a terminal illness.  Two doctors must agree on the diagnosis and there is a 15 day waiting period between the written request and the prescription.

     I cannot count the number of times people have said, "If I had X,Y, Z Disease, I would want to die rather than suffer to the end" and "I am so grateful we are able to give the gift of euthanasia to our animals and can't believe we don't have the same right for people."

     But here is the interesting thing, according to the most recent statistics available (for the period from 1998-2010), after thirteen years only 525 people in total  had in fact used the Act to commit suicide.  In 2010, there were 65 deaths under the Act, representing 20.9 deaths under the Act per 10,000 deaths -- or 0.00209%.

     The most recent comprehensive report issued by the Oregon Department of Human Services (2005) indicates that in the first 8 years the Act had been in effect, a total of 246 people committed suicide under the Act as compared to 76,947  people who died in the same period of the same underlying diseases.  In other words, only 0.003% of people who could have elected assisted suicide chose to do so.

     This does not surprise me.  Those of us working in hospice see people dying every day who suffer in innumerable ways, lose the autonomy and dignity that are most often cited as the reasons for electing assisted suicide, and yet fight to stay alive as long as possible.  It's easy to say, and easy to believe, that we would want to die in that situation, but the reality is that when it happens most people do not.  The vast majority want to live.

     So what does this have to do with animal hospice?  

     I live in a state where physician assisted suicide is not legal for humans and euthanasia is expected for animals.  A perplexing situation for many.  If euthanasia is the most compassionate choice for our animals, shouldn't it also be true for our human family members?  If assisted suicide is morally wrong for humans, why is it the kindest gift for our animals who do not have the ability to express an opinion or make a choice?  Is there something fundamentally different about a dying animal and a dying human?  If so, what is it?  Is it a qualitative difference or a quantitative one?

     Although I am a big believer in our ability to sense  what our animals need and want, we do not have the ability to ask them what they want and have them respond in clear words for all to understand.  Research in the last 10 years has shown, however, that animals perceive and experience pain in very similar ways as humans do.  The leading thinkers in animal pain management today tell us to expect that anything which would cause us pain or discomfort will similarly cause pain and discomfort in our animals.

     Is it such a leap to suggest that if most people want to live as long as possible, most animals do also?  That if the vast majority of people given the opportunity to elect painless, simple, legal euthanasia when facing a terminal illness do not choose it, perhaps some (many? most?) animals would prefer to die in their own time, in their own home, with their pain controlled and their family at their side?

Quote for the Day

Photo Courtesy of Jenny Downing

One isn't necessarily born with courage, but one is born with potential. Without courage, we cannot practice any other virtue with consistency. We can't be kind, true, merciful, generous, or honest.

~ Maya Angelou