Voices Around the Campfire

Voices Around the Campfire: Living Will Stories

See the campfire. See the dark…the mosquitoes and no-see-ums around the edges of the light…little sparks flying up with the smoke. Hear the crackle of the logs (is that applewood?), the shifting of logs as something gives way…the laughter of children as they toast their marshmallows. See the dancing flames. Feel your imagination working as you gaze.

A soft voice speaks. And then another. What are the voices around the campfire talking about end of life?

Shift the scene to a modern law office where a husband and wife are consulting with their lawyer, me, about their Living Will. We talk of state forms, pain medication, comfort care, and guidance for the kids.

Here is where husband or wife says something like this: “I don’t want to be kept as a vegetable with no hope of recovering.” The other adds, “but if there is hope, I want them to do all they can.”

There is no language like that on the form. Nor does it answer the question of whether you should have a gangrenous leg removed (truly life and death) when you can no longer recognize your family. Nor a hundred and one other questions that can—and do—arise.

Here’s the sticking point: Death, like life of which it is part, does not present us with all or nothing, on or off choices. Death is a process, different for each of us: it is less a light switch and more a dimmer.

We are trying to fit life and death into a one or two page legal form.

But, you may be asking, wouldn’t a health care power of attorney solve this? Or a POST?

Of course!

But let’s remember what these health care POA documents do: appoint one or a few people to make your end of life decisions for you. What then are the natural limitations?

When you need them, they’re on vacation.
The crisis you expect is not the crisis you get. Whatever happens you will not have talked about that one together, so there will be agonizing decisions.
Your other children might not agree with what your Power of Attorney holder (Agent is another word for this person) decides, putting more pressure on your Agent. Of course, here is where your Living Will can come in—it provides a little—almost no—guidance.
Your Agent might not be able to find the document, and the doctor/hospital/nursing home won’t let her make the decision without it.

POST (Physician Orders for Scope of Treatment), became part of Indiana’s landscape in July, 2013. They give an in-between option for medical interventions (between do everything and allow natural death), and for tube feeding (allows a trial for a set period with a set target).

What would you want, deep down? That’s where we could use the voices around the campfire.

Your family, your nurse, your doctors are gathered around. You can hear the voices, but as if around the campfire over there. You cannot speak.

The first voice is all about the facts and the law. “Does she have a Living Will? A POST? What does it say? Does she have a Healthcare Power of Attorney?”

“Did you talk with Dad about what he would have wanted? What did he tell you?”

“What do the doctors say? What is the prognosis? What alternatives do they give? What hope do they hold out?”

Call this the voice of “It.” This voice objectifies as much as it can, seeks a bright line where this side is Yes and that is No. It reduces the grey area to the smallest possible territory.

We need this “It” voice. This voice in ordinary days tells us how the physical world is. “It” brings us home to our bodies and the body of facts in which we live. We need “It.”

Other voices are heard around the campfire. They are not as loud or as pushy, but they are speaking to us, for us, for Mom or Dad.

One voice you might hear is Thou. This is the voice that says “Ever since I was a little kid, I have known you, you have known me. Mom, you would have wanted…; Dad I can hear your heart….”

Answer now for your children: What does your heart want? Peace and dignity? Your child to hold your hand while you do the difficult work of dying? Privacy or at least less of an audience? Being in solitude with one or another of your loved ones to ask for or give forgiveness or blessing? What DO the two of you need to have pass between you?

This is the voice of Thou—the heart, the between.

A third voice, if you listen quietly beneath the many voices is the voice named Among. There is another quality that can arise when more than two are present. It can be deeper, it can go further.

When conversation is between the two of you, there are no angles. It is back and forth. But when you add another and another, the conversation can bounce, dance, play off many angles at once.

So when you get to a sticking place in your conversation together, your sister can bring in another memory, your brother can open a new direction with his quirky way of seeing. This can help you all wrestle with your decisions.

Yet another voice is that of the Poet. It is somehow not your voice as you lie there in your bed. It is not any single voice, and it is beyond our voice. A more universal voice. It might offer poems, or just sighs. Shh. Do not listen for it. Hear it. Take it in: assimilate, absorb, make it one with your being. This larger, this presence is speaking. Hear:

Death is a passage
Through an orchard
There are fruits
There are tangled parts
Where few have been
Orchards are part
Human intervention
Part natural processes
Over yonder is the house
Where I used to live
On the other side is light
In between is orchard friendly
And a little unknown

Shh. The stillest voice of all we can call Healer. When death is at the foot of your bed, cure is no longer even welcome.

But healing, making whole, is always possible. Death is an integral—and friendly—part of our life cycle. A gift needs a bow, education needs a graduation, a life would not have meaning as a complete life if it never ended. Turn, turn, turn wrote the preacher. Turn, turn, turn sang the singers. A time to live, a time to die.

And what would be a fitting death for you? For what would you hope? What will you work for if you can have it?

For me, Doug, I want to die kindly with others hearing me. I cannot give you any hard and fast rules. Just: be kind; be gentle; be loving; be wrapped in my love.

I want you to converse together—you who love me, you who are able to see me and discern what aid I need as I do my dying. Some of you may have rules inviolable for what medical procedures must be used or withheld—please cast those aside. Some of you may feel guilty and that might cause you to want things “for” me—know that I forgive you and please, cast that guilt and those things aside. See me as I am. Hear me—take in my real core needs—I am in need of dying with your caring touch. We are in need of dying and living with each other’s touch.

So this is the voice of the Healer. The Healer is here to take all the other voices and make of them action, to make of us one, to make of our setting wholeness.

For this is the answer to the mystery of the Living Will: not a single black and white answer, for there are none. A Living Will is good, but only to get the conversation started. Converse, converse, converse. With your children, your parents, your brothers and sisters, your priest or rabbi or minister or Friend, your physicians. Converse, converse, converse: with head, and heart, between and among, with healer and with hands. There is no substitute for making yourself heard and for hearing each other.

Our fire is down to embers. We can see our way, if dimly, to some new way of living this circle we call life, knowing it ever goes round, embracing all of us.

South Bend attorney Douglas D. Germann Sr. works everyday to bring more of all these voices to the law and to life. Contact Doug at 574/291-0022 or by e-mail, [email protected]

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