An orange Post-it note still sticks to the inside cover of a folder I long ago labeled “Health Care Directive.”
I immediately recognized my scribbled phrases crammed onto that little square of paper. And, even though I wrote them more than eight years ago, I clearly remember the context for my weighty note-taking.
“ … comfort measures only.”
“ … life is for the living … ”
“ … know, please, that this is absolutely my wish.”
The year was 2008. I was recently divorced with three children, one of them just 9 years old, and I found myself less inclined to put off the what-if-something-happens-to-me? discussion. I wasn’t rich, but suddenly I was looking at my wedding china, my inherited art, even my modest 401(k), with queasy urgency.
I smile now at my many attempts, documented by arrows and circles and crossed-out words, to compose three equitable lists of my worldly stuff, weighing the financial and psychic value of each item in a desperate attempt to make sure that all three of my cherubs knew how much I loved them.
That was the easy part.
Part 2 was the reason for the orange Post-it note — and a call to my mom.
Like most things that are really interesting in my life, this experience began with a work assignment. I was writing a story about wills and came across a start-up called itsmylife.com, one of a growing number of companies offering legal do-it-yourself options.
I decided to try it. What the heck? It was summer. I was on a staycation. What better time than a gloriously sunny Minnesota day to think about death?
I powered through Part 1, about specific gifts, and checked my desire to donate my organs and tissue. Under “final wishes,” I got weirdly goofy. (Is this why they call it gallows humor?)
Items to be placed in casket? “Swiss chocolate.”
Burial plot? “Something with a coffee bar.”
Type of get-together after funeral? “The Jewish kind. Lots of food.”
Then came Part 2, something I knew little about. It was titled “Living Will,” which is more commonly referred to today as a health care directive.
This part, which delves into end-of-life issues, was just four pages long. Two pages for witness signatures, two pages for excruciating self-examination.
I read Question 1. “If two doctors, one of whom is my primary physician, confirm in writing that my condition is such that there is no reasonable hope for recovery and I will die in the near future unless my life is prolonged artificially, I want my life to be artificially extended … ”
Answer yes, no, or don’t know.
I went to Question 2.
“I want food and water administered through a tube or IV or other medical means.”
Answer yes, no, or don’t know.
I highlighted in yellow marker phrases including “vegetative state.” On one page, I just wrote a question mark.
I felt more confused than ever. It was clearly time to call in the professional.
My mother, Estelle, is a retired public health nurse and former nursing school dean; a cancer and heart attack survivor first widowed at 55, then widowed twice again.
At 84, she still travels the world, still thrills at meeting interesting people.
Nobody knows better than my mom that life is for the living. And nobody takes a more pragmatic approach to the reality that it’s all going to end at some point.
“I’m really struggling because the language is so vague,” I tell her in an e-mail. “It’s something like, ‘If there’s no chance for a recovery …’ but that could still mean I’m in a vegetative state for six months or six weeks or six days or whatever … my choices would be so different. So, how do you answer this thing? Would I still want water? My plan is to live a long, long time, but as a single parent now, I’m thinking that this is a good thing to do. Help!”
She calmed me in her response. She encouraged me to use language such as “comfort measures” and “pain medication.” She introduced me to one of my now favorite phrases: “Please do not prolong my death.”
And then she cleverly turned the tables. She wrote candidly about what she wants, and expects, of her three grown children.
“When I can no longer feed myself with a spoon, you are to let me go,” she wrote. “That is something you all can understand. I have watched too many well-meaning people keep the drip going and the patient lingers. We all must choose what we want. Accidents happen, but most of us will die in bed. Hope that this is not too direct and also hope it is helpful. May you live as long as you want to.
“I love you. Mom.”
I completed my directive. On the front, I wrote in purple pen, “Sample — used in article — nonbinding.”
Then I tucked the damn thing away — for four years.
In 2012, I felt ready to take another look, to make things binding. Four years of thinking gave me much needed clarity. Four years older and once again partnered, I figured again that there was no time like the present to deal with the future.
Through the University of Minnesota Extension, I downloaded an easy-to-use health care directive.
I appointed my cousin, a doctor, as my “agent” to make decisions for me should I be unable to communicate them for myself.
I thought back to what my mom told me. I emphasized pain control and comfort measures, and my wish that loved ones not “prolong my death.”
I again expressed my desire to donate my organs. I requested that I be buried in a “plain pine box,” following Jewish tradition.
I wrote that I have already won the lottery with this life, this family, these friends and experiences. I had the document notarized. I provided a copy to my doctors and to family members.
And then, relieved and proud, I stepped outside to embrace the awesome privilege of another day.