“They put pets out of their misery,” my mother said.
Mom then glared at her newest visitor. I tried to appear calm. Regardless of any success in disguising emotions, it’s unlikely that my sisters or the nurses paid attention to me in the hospital room. Everyone was focused on Mom’s “chat” with the surgeon.
She continued with, “Why can’t you do that with me?”
Mid-forties, the surgeon resembled other doctors that had stopped by Mom’s room after her recent procedures. They paraded through like wooden birds announcing the hour in a cuckoo clock. He had the clichéd stethoscope looped around his neck and wore the inevitable white lab coat. But he was different because he sat beside her. The others stood with forced smiles, talked as if completing a to-do list, and then hastily retreated into the hallway.
In late July of that terrible year, my mother was diagnosed with cancer. Because the cancer had spread so rapidly through her eighty-something body, the doctors couldn’t pinpoint its origins. However, the cancer was no longer the worst of Mom’s concerns. Surgery had been attempted for temporary relief from the opportunistic spread of tumors. It failed. On the following day, another operation was needed to fix the first mess. I suppose the second effort succeeded, except Mom was stitched together by rows of metal staples. They appeared like the tips of landmines on the battlefield of her abdomen. She dubbed them, “My barbed wire.” They were still there when she died several weeks later.
“Put me to sleep, Doctor,” Mom told the young surgeon in the lab coat.
In the innocent past, Mom and I (and my sisters) had discussed “end of life” preferences. She’d signed her Durable Power of Attorney for Health Care (DPAHC) forms and other paperwork. No extraordinary measures. No life support on machines.
Just let me die a peaceful, natural death.
No decision that we made—with the cancer or wrestling with the aftermath of multiple surgeries—contradicted Mom’s desires. Except I think they did. But how could we anticipate the cancer’s savagery when no doctor identified it until that grim fourth stage? How could we know surgery would fail? Or that a second surgery’s success meant increased pain?
Especially because I work in a hospice, I encourage everyone to complete the forms, to document what you want, or don’t want, for health care.
But forms can become formless, a barely remembered exercise in futility.
A year after Mom’s diagnosis and death, my wife and I had our fifteen-year-old cat Madison “put to sleep.” Days before, she’d seemed her usual aloof and secretive self. Then she crashed. According to the vet’s scale, our ten-pound cat barely tipped six pounds. Madison wouldn’t drink or eat. Soon, like many pet owners, we faced lousy and limited choices. As I witnessed the vet prepare Madison for the drugs that would end her life, I thought of Mom.
How could I not?
“Put me to sleep, Doctor.” Mom didn’t add a please to her bedbound demand. Normally polite, and respectful of the medical profession, she had abandoned pleasantries.
I don’t think the surgeon ever answered her. How can you? Humans and pets are different, right?
In watching my parents die—Dad slowly (so slowly) from dementia, Mom with cancer like a plane dropping elevation in turbulence—I have no easy answers for why there is such suffering. Why put Madison “to sleep” while Mom lived her last furious weeks in anguish? Yes, the good doctor by her hospital bed promised that no more “extreme measures” would be used. He kept his promise. And yes, she received medications that—so the professionals reassured—managed the pain until her final breaths.
Did I treat Madison better and Mom worse? All I can claim is that we tried to make our kitty’s life as happy and as safe as possible. All I can claim is that my family tried to honor Mom’s wishes.
While I could argue the pros and cons of euthanasia for all creatures great and small, here’s my truth: the rights versus wrongs, the laws versus ethics, can feel pointless. I care most about relationships, about honoring the bond of love. Madison was my wife and mine’s responsibility. We did our best for our cat. Mom, who raised me to think for myself, who sent me into the world to live independently, asked me (and my sisters) to help her and Dad think through future decisions that represented their lifelong values.
At Mom’s literal end, we tried to do the best with and for her.
But I never once felt good about what happened.
Honoring your parents, there in the middle of Moses’ ancient laws, can be the hardest commandment to follow.
Larry Patten is a retired United Methodist pastor, currently working in grief support for a Fresno, California hospice. He maintains the websites larrypatten.com and hospice-matters.com and recently published A Companion for the Hospice Journey.
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A humane end seems sadly lacking in the western hemisphere. A dignified and loving parting can be observed in so many ‘primitive’ countries. In Indonesia, families and neighbors rush to your bedside to push away death. Everyone smiles and laughs until the end.
Thank you for sharing your story, so loving yet the frustration is palpable.
I deeply appreciate these responses to my essay. As Cheryl Miller wrote, this is “one of the most important topics.” And, too often, our dying and death is the topic most avoided. If my words help anyone start or continue a conversation with their loved ones about dying and death, I will be grateful . . .
Thoughtful words Larry. I want to believe that we make the best decisions based on the information we are given. That’s what you and your sisters did. Kudos to the (one) doctor who sat down and listened—I think pretty darn rare in today’s delivery of medicine. This article reminds me to be that listening, patient caregiver, no matter the circumstance or situation. Thanks!!
Thank you Larry for the article. Thanks for sharing a story which we all will share when the time comes.
This article, beautifully written, hit home for me. A moral dilemma that I have faced, and acted on the best way I knew. Thank you for sharing this. It makes me feel good to know I am not alone.
After my husband was diagnosed with lung cancer, the doctors recommended Hospice. They did not operate or try to do anything to ‘cure’ the cancer. We had all the forms necessary and completed. He went into Hospice on a Wednesday and passed away in his sleep the following Tuesday morning. I wish that all those who are diagnosed with untreatable cancer have the option of going to a Hospice and provided the drugs that ease their discomfort and are allowed to pass on in peace as they and their family wished. No heroic operations or treatments that you get in a hospital where they prolong the pain as long as possible, but an opportunity to pass on in peace and dignity. Thank you for a well written article that provokes thoughtful consideration.
Beautifully put Larry. After loosing my father in law only 4 weeks after a diagnosis I struggled with the same questions. Bravo
I am an Oregonian who has volunteered as hospice and bereavement support person off and on for over 35 years. Even though euthanasia is legal in Oregon, as a person of Faith I formerly opposed it. After years of volunteering and thoroughly researching this sensitive subject, I have had second thoughts. Larry’s excellent heart-felt article bolsters those second thoughts; especially with cases where there is no guarantee from a well respected Hospice physician that morphine induced sedation would keep a comatose terminally ill patient pain free. My human inclination now, is that a loving God would not want anyone to endure writhing and screaming in agony on their deathbed. Furthermore, no one should have to witness their loved ones preventable tortuously painful last weeks, days, or minutes before death. As a mere human I could be wrong, but I seriously doubt it. Bravo, Larry Patten!
Last May 1st, a date chosen by my sister in law Margaret, we traveled to Saskatoon to say our sweet and loving goodbyes. Diagnosed with stage 4 lung cancer, she bravely chose to end her life rather than continue a course of painful chemo treatments. This is the fifth time I’ve been privileged to be present at the end of life. Some a human, some a beloved animal. Those that were aided by compassionate medical professionals will be forever a peaceful transition. The others were weeks of struggle, pain and total exhaustion.
Thanks for the thoughtful writing. I think it’s good to acknowledge that every step we take in caring for a dying parent feels wrong somehow, because we don’t want to say goodbye. We do our best and try to listen, but sometimes it feels like the listening is too late. I hope to make it easier for my children and say “Allow me to go to sleep.” Like us, they will do their best.
Thank you Larry for sharing this most personal and painful journey.
One of the most important topics.
Your thoughts and especially these lines will stay with me: “While I could argue the pros and cons of euthanasia for all creatures great and small, here’s my truth: the rights versus wrongs, the laws versus ethics, can feel pointless. I care most about relationships, about honoring the bond of love.” Throughout my husband’s illness, I was grateful that despite his exhausting and debilitating illness, he didn’t have acute pain. I don’t know how we would have handled it. Thanks for sharing your way which will likely be mine, but I won’t know until I get there. (I’m glad the doctor listened and sat with your mom. That matters so much.)
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Cherie L. Dargan
November 30, 2019
This column addresses one of the biggest taboo topics in our society: dealing with the death of a parent in terrible pain who just wants to die. In full disclosure, Larry’s father and my father were brothers; however, he grew up in California and I grew up in Iowa. Our fathers were the closest of the four Patten boys, and wrote and called each other into their 90s, until George was not able to talk. My mother died first, abruptly, after surgery, at 76, and we never expected our father to live another 17 years. Finally, at 94, prostrate cancer caught up with him. He suffered for more than a year, gave us more than one scare, and finally died. We were exhausted and sad.
However, It was the death of my mother in law that I thought about while reading this very heartfelt column: she had numerous broken bones from falls and was too stubborn to use the personal alert device we got for her, and then she was diagnosed with cancer. It was a horrible ordeal when she fell and broke a hip, and they decided not to do surgery. She died in agony every time they moved her. I found this column profoundly moving because I agree that there comes a time that enough is enough. We don’t let pets suffer, but must sit beside our loved ones who can never get well, and watch them suffer. It’s cruel and wrong. Thank you, cousin Larry, for opening the door to a conversation that is long overdue.