Roll me another damn fag!
YOU know those things will kill you?
Although the remark was directed at around half-a-dozen latter-day pariahs defiantly dragging on their fags outside a pub, the huffy, obese item who made it was glaring directly at me when she spoke, so I felt impelled to respond.
I bloody well hope so, honeypuddle. I have invested a great deal of cash in tobacco over the years as part of an early exit plan, and I will be incredibly annoyed if it doesn’t do what it says on the tin.
Without a further word – words would be difficult as the prodnose now had her nostrils tightly pinched between thumb and forefinger – she jetted off into the night, leaving behind a vapour trail of self-righteous disapproval.
I was only half-joking when I made that remark. A while back, a quick, back-of-an envelope calculation presented me with a sobering revelation: retirement is a luxury well beyond my means. I will simply have to keep tapping at this keyboard until the day I drop.
It also occurred to me that, were I to heed the words of the gospel song You Better Change Your Way of Living – brilliantly performed by blues singer Alberta Hunter who died aged 89 in 1984 – cleaning up my act may leave me clinging miserably to the perch long after I had lost the ability to earn my keep.
When I was at school a careers advisor asked me what I intended becoming when I grew up. I shot back:
A burden on society, miss.
This earned me one very old-fashioned look, and loud applause from my peers.
Almost half-a-century on, those words look more like an accurate prediction than a joke.
But – unless straitjacketed and heavily sedated – I don’t plan to be a docile burden. I picture myself a cantankerous old demon, fizzing with fury over the fact that I was being kept alive against my will. Deprived of anything worth inhaling or imbibing, I will lash out at carers with all gums blazing, yank out drip feeds, and hurl objects and obscenities.
Where, for pity’s sake, is the dignity in that?
That’s the question veteran columnist Katharine Whitehorn, 80, (above) addressed last month on Radio 4’s A Point of View when she drew attention to some very scary statistics.
Some people who live long enough to receive a card from the Queen on reaching 100 – or even mere chicks of 80 or 90 – lead vigorous and fulfilling lives. But an awful lot don’t. So it’s small wonder that the question of how they live comes up more and more often.
It’s not surprising either that Mary Warnock, who has had to wrestle with the issues regarding the start of life – embryos and all that – and Elisabeth Macdonald, a distinguished oncologist at Guy’s Hospital in London, have turnedtheir attention to how we should die – how andif life should be brought to an end – in a book they have written, Easeful Death.
There has been more than one bill defeated in Parliament that was designed to make it easier for a really awful life to be ended, but they [W & M] think that, despite the difficulties, our views on life generally have developed enough for such a bill to succeeed now.
Until relatively recently people only lived a short time after retirement – now they may easily live on for another 30 or 40 years.
If you are educated, or have enough money, or obsessed by bridge or golf or grandchildren, you can have a good time – until your health packs up. If you suppose your life then is utterly meaningless, you can count on suicide. Not that it’s easy, as Dorothy Parker wrote:
Razors pain you,
Rivers are damp,
Acids stain you,
And drugs cause cramp.
Guns aren’t lawful,
Gas smells awful –
You might as well live.
Difficult and dodgy, even when you are reasonably healthy and have most of your marbles.
Whitehorn went on:
But along with the statistics about how long we are all going to live – in about a dozen years or so half the population will be over 50 – comes the chilling projection that the very old can look forward to ten years of chronic illness.
I know it depends on what kind of chronic illness. Properly cared for, invalids and disabled people can lead worthwhile lives, but many long-term illnesses are simply horrific in spite of good hospices and ‘living wills’.
Whitehorn revealed that her mother had died in her sleep while visiting friends:
But another relative starved herself to death – a horrible way to go – so fed up was she with constant, intractable pain, and in spite of really good care. It’s a myth that all pain is controllable.
And when we saw another relative in a nursing home the day before he mercifully died, we came away saying that if he were an animal, you wouldn’t let it go on.
Incredibly telling to me is a phrase from American philosophy professor Sam Gorowitz, who wrote a book on medical ethics. He tells of a young man who begged the doctors to give his agonised dying mother more morphine. He was told no, that it might suppress her breathing.
The man accepted this at first, but then came back and said: ‘Where is it written that cancer has some right to be the cause of death – that the doctors’ job is to keep the patent alive until the tumour can cash in its claim?’
Some European countries have some form of assisted dying, but in spite of the optimism of Warnock and Macdonald, I had always thought that it wouldn’t work here because we are so inefficient. If we can’t even ensure that a miserable old lady gets her disgustingly soiled sheets changed, if a hospital can send a very elderly lady with dementia back home with no-one to control her heart pills, how could we ever be sure that we would get it right whenever a sick person really wanted to go?
Warnock and Macdonald have hopes that the time has come for it, even so.
When Terry Pratchett was diagnosed with Alzheimer’s, and said he would rather have cancer, there was outrage. You can’t say you want to die of cancer; yet Alzheimer’s is arguably worse, but attracts a fraction of the amount of research money than cancer does.
We are not used to thinking that people have a choice about how they die.
And we’re not supposed to make jokes about it either, such as ‘I want to die peacefully in my sleep like my father, not screaming with fear like his passengers’. Yet even his passengers’ plight may be better than the long, drawn-out alternatives.
Whitehorn then tells of two retired medical missionaries who would cycle around Britain on a tandem, raising money for a hospital in South Africa where they had worked. The day after their golden anniversary, they decided to have one last ride around the British Isles.
They were hit by a lorry and killed outright.
Everyone wrung their hands and said how awful it was, but what could be better than a very swift death together, without the long agony of one losing the other; operations and care homes, hearing and sight gradually going wrong, pain only just controlled, if that?
I used to have a sort of Hollywood vision of my deathbed. I would lie on my pillows, pale but brave, and forgive my enemies on the grounds that nothing would infuriate them more.
I know now that I am more likely to be half-senile in hospital, hung about with tubes and drips, confused and hurting. It may be very difficult to form a law that would give me an easy death, but I just hope they manage it before it’s my time to go.
The horror that is state nannyism cares as little about dignity as it does about freedom of choice. It is blindly obsessed with keeping people alive well past their sell-by dates, but with no thought at all as to the quality of their lives, nor who the hell is going to pick up the tab for their continued existence.
I can’t help feeling that there must be many a geriatric now cursing the day they decided to pack in smoking, moderate their drinking and take lots of exercise.
Now top up my scotch and roll me another damn fag.
Editor’s note: A year after I penned this piece, Dr Michael Irwin, below, a former Medical Director of the United Nations, and a former Chairman of the Voluntary Euthanasia Society, founded The Society for Old Age Rational Suicide (SOARS) in the UK.
The main long-term objective of SOARS is to get the law eventually changed in the UK so that very elderly, mentally competent individuals, who are suffering unbearably from various health problems (although none of them is “terminal”) are allowed to receive a doctor’s assistance to die, if this is their persistent choice.
Surely the decision to decide, at an advanced age, that enough is enough and, avoiding further suffering, to have a dignified death is the ultimate human right for a very elderly person.
• This piece appeared in the October, 2008, issue of the Freethinker.