We used to venerate the aged, but then our culture shifted. But instead of venerating youth as though the pendulum shifted to its opposite, we learned to venerate the indendent self.
At least that is Atul Gawande’s claim in Being Mortal. I don’t disagree. This culture preferences neither age or youth, but rather celebrates the one who is independent. Even over character, spirituality, connection, our culture prizes the one who finds and clings to their independence.
For Gawande, he finds this clearly in the way American culture (and the world in following) treats its aging and then dying people. The one who is most in control at the time of their dying days is the winner per se, seen almost as a hero right? You’ve heard the pride that grandma lived at home alone serving the church right up to her dying day, or the doctor that kept coming to work until days before his death because he was independent and thriving…they were living still. But it has some scary consequences.
- Dying is relegated to anonymous sterile places, not the home or among family.
- Old age tends to bring intimacy with loved ones at a distance, not closer.
- Hospitals grow at unbelievable paces.
- Nuclear family replaced the extended family.
- We tend to pursue slivers of hope (mere extra days of life) rather than swaths of meaning (high quality of life and relationships).
It’s all true to a greater or lesser extent. What gives me rise for concern is how it has affected how we prepare, treat, and give structure to those children who are entering their final days. When children are dying these days, we prize the slivers of hope rather than spending quality time at home with family. I mean, if an adult dies at the hospital, it is sad but not overly so. When a child dies at the hospital, I think about the lack of a home they in, the family who couldn’t be with them, the sterility of a hospitality rather than the warmth of a home. This is not always true of course- some families and kids have a truly dignified death in our ICU’s where they are quite loved and cared for and surrounded by family at the last breaths. Nonetheless, we prize independence over anything else. The child who is special needs often meets relief by our culture who are grateful since they lacked independence but the child who was “normal” is greeted with sadness.
All to say, independent selves are great. Independence brings freedom, liberty, and beauty to places and people who may not have otherwise experienced them. But we have often traded the veneration of family and community for independence, and that hurts for some of the kids in my hospital who would thrive even in dying by having family and friends fully present loving them or by being in the place they find as home. Independence is important, but it doesn’t always mean dignity. Independence is great but it doesn’t always have a community. Independence is critical, but it doesn’t always equal dignity or beauty it meaningfulness. In other words, when it comes to health, we make independent realized selves and the avoidance of death at all costs- costs of family time, peace, warmth, and quality of life- we make those the opposite of giving up. So we push families and parents to avoid death and pursue slivers of hope, instead of treasuring the invaluable love and perseverance of hope that parents express when they surround their children peacefully, joyfully and tearfully. Perhaps instead of venerating age, youth or independent selves, we ought to venerate the abundance of real love we see in droves, and that may allow us to disarm this fear of dying, life cycles, death and grief our culture continues to run from.
