The Poetry, Essays and Personal Journals of Larry L. Dill
The second in a series of essays on advance directives and living wills and specifically the 5 Wishes Document and including 3 poems by Larry L. Dill
I saw him perform at the Austin Opera House shortly before he died. He stayed true to his maddening promotion of drugs and a kind of counter culture dissembling or perhaps disassembling of rational discourse if his rambling presentation in Austin to a packed house of old hippies and the curious young was any indication. But the one thing that struck me that night was that in those early days of the internet, Leary claimed he was planning to be the first person to broadcast his own death live on the world wide web.
I never saw it and never really thought about it much again until the other night when it came up in a conversation with a friend. I thought about his death again this morning as I searched my mind for a way to begin a conversation with myself about my own end of life issues and the 5 Wishes document, a "Living Will" plan I began writing about in the March issue of this journal.
I'm looking now at wish number 2 "My Wish For The Kind Of Medical Treatment I Want Or Don't Want." The document is a kind of template for advance directives. You can file the document as is or strike out what you don't like or add specific instructions that are not in the template. There are headings like "What You Should Keep in Mind As My Care Giver" and What 'Life-Support Treatment' Means."
"I do not want to be in pain." sounds simple enough until you get to the next sentence which says, "I want my doctor to give me enough medicine to relieve my pain, even if that means that I will be drowsy or sleep more than I would otherwise." I have no idea how to respond to that sentence. Sure I don't want to be in pain. But like everybody else I have sometimes endured pain of various intensities, both physical and mental, for the sheer emotional sensation of being fully alive. When I think of mental anguish I think of romantic love which is sometimes considered a form of self induced madness. Both pleasurable and painful. Sometimes even at the same time.
I can say that the most excruciating physical pain I have ever experienced was when I developed a kidney stone a few years ago that I could not pass without a medical procedure that couldn't be scheduled for a week. I took all the pain killers the doctor would give me and the night before the operation, which I spent in the hospital, my nurses were instructed to give me morphine on demand. Which I did demand about every 2 hours through the night. I certainly didn't care if I was drowsy or not then. If that is any indication of my ability to tolerate pain then I guess I'm a wimp who probably needs to indicate that yes it is indeed my wish to be given whatever it is that will ease my pain. I live a lifestyle in which I drink alcohol every night both for pleasure it brings and the pain it deadens. The pain of what it is deadening is presumably anxiety. But anxiety about what? Love? The future? The past? Is it fear of death? Or is it fear of living? Or both?
The more I think about dying the more difficult decisions about it become. On Monday I might be in the mood to be given enough drugs to be almost in some sort of medically induced coma. On Tuesday I might feel like I have one last chance to talk to or at least listen to a beloved relative or lover and want to choose to endure the pain long enough to say goodbye and touch and feel their touch, their breath, their lips, and look deeply into their eyes.
I guess I am being overly dramatic here. But dying is dramatic and if you have a kind of film director's eye for drama, you want a storyboard and you want to direct the movie of your life and death as closely as possible to the way you originally planned it out. That is what the 5 wishes document is designed to help you do. But if you are using the film making metaphor to guide your vision, you have to recognize that film making is perhaps the most collaborative of all the arts. Only a foolish director wants to make every decision himself.
To perhaps make it less circus like than Timothy Leary's death (about which an actual movie was in fact made) and look at a model more modest and more purely human like the relationship between two people who love each other very much, then in that you have a collaboration of the very highest order. Certainly not the simplest order. But the very highest. It makes me feel that deep and profound conversations with the people you love and who love you is far more important than what you are able to write into a philosophical meditation on your own mortality, or a notarized checklist to be filed as a public record
I've written about a thousand words here and still haven't really answered the very first question. Still to go in this wish number 2 are things like, Do I want anything done or omitted by my doctors that would end my life?, Do I want to have life-support treatment? If I'm in a coma and not expected to wake up, what do I want them to do with me? If I have severe brain damage and am not expected to recover, what do I want there? Are there any other conditions under which I might not wish to be kept alive? "Describe in your own words." Ha! I seem to be more ambivalent now than I was when I started.
My wishes? I wish I didn't have to think about it. I mean I've gone my whole life without a tattoo, for God's sake. Not because I don't like tattoos. But because irreversible commitments make me very uncomfortable. Because I could never make up my mind about what I wanted to say permanently to the world or the women I've loved or even to myself. This is a lot harder to think about than a tattoo. It is more "painful" than a tattoo, too, to use a wildly subjective medical term.
One thing is clear. What ties all the questions together is "Pain" in all the various definitions I've tried to elucidate here. In fact, ironically, the whole 5 Wishes Document is really a response to a modern cultural backlash against the pain inflicted by the success of modern medical science in keeping people alive that just a couple of generations ago was not usually an issue. A hundred years ago it was not even a concern because it was simply not possible to keep people alive once they had suffered the debilitating effects of major human deseases like cancer, heart desease, stroke or the failure of other internal organs. The whole rationale of the 5 Wishes document is that different people have different ideas about how far and for how long they want to go on living in a debilitated condition when there is little or no hope for a return to good health and a normal life but because of modern biotechnology the actual length of their life, could be continued beyond the horizon. The scariest part of dying in the modern world has become not the dying itself or what one might anticipate after death but the kind of iatrogenic Hell one might enter as the result of medical progress that has not been supported by an equally sophisticated cultural, religious and philosophical revolution in understanding the ultimate meaning and value of a human life. This latter has always been under the purview of poets, artists, philosophers and religious leaders from Plato and Aristotle to Dante and Shakespeare. In the modern world the job has fallen to a ragtag army of revolutionaries made up of clowns like Timothy Leary, serious comedians like George Carlin, writers and film makers like Philip Roth and Clint Eastwood, a few social critics like Ivan Illich and a scant handful of heroic doctors like Jack Kevorkian. Compared to modern medical science, the humanities, the arts, and the social sciences are still living in the dark ages.
What does an old poet like me still wish for in the darkening days of the modern world? I wish I was having a drink right now with a beautiful woman who would look into my eyes and without saying a word convey to me how much she wanted to make love to me. The drink? I'm having that now. The woman? That's likely to be far more painful than dying or getting a tattoo. Modern science has invented Viagra and plastic surgery. But no one has ever even suggested a cure for a broken heart.
--Larry L. Dill
Asheville, North Carolina
Intelligent Design
These things can be said in many ways:
the “truths” we call them,
Prayers, really… wishes.
What we want we try to make other
people understand;
and we tell them we are half-way
to heaven and that they should see
the importance of that and help
with the driving home.
We ratify our longings with religious fervor
Hoping not that God will hear our prayers so much as
that they will be channeled into the ears of
the poor penitent beside us.
We pray to each other for grace.
We see each other too often and under
such terrible circumstances not to recognize
the enormous mess we make of each other’s lives.
We beg forgiveness both because we need these
people and, due to the accidental imperatives of love,
because we know that they need us.
Existentialism Re-Examined
Given the hours as they pass,
our lives would pass for nothing.
But something else happens.
Inspired by each others passions,
moistened by our own sweaty dreams,
we are able somehow
To climb out of our skins
and sweep with sudden shifts like smoke
In other directions,
gaining for ourselves the character of spirit.
Thought does not so much become flesh
As flesh becomes thought.
And our thoughts weave new histories
Like mysterious baskets
afloat on an open sea.
Extreme Unction
I wanted to go to Zanzibar
to lie in a wordless night.
I wanted an African moon
to shed a blue-green African light.
I wanted the smell of cloves
dancing ghostlike through the trees.
I wanted drums and I wanted high seas.
I wanted the souls of animals
to fill my animal heart.
I wanted love and I wanted art.
I wanted an Arab woman
gently pouring Arab tea
and I wanted death to have to
catch its breath and sigh
before it seized me.
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