Ubiquitous Elephant

Woman ill in hospital bed

I can’t leave this unspoken anymore. There is an elephant in the room. There is an elephant in every room, and not a one of us is brave enough to admit it out loud lest we stir the pot, finding ourselves at the receiving end of a whole lot of grief.

Medical procedures and pharmaceuticals extend our lives far into the frailest years, and, more often than not, this creates a lousy situation. In short: people these days are living too long. A long life is not a victory if it is an unpleasant one. Consequently, I believe that every adult should have the right to choose a humane and legal death.


My mother is living on and on in the isolation of her house. Granted, she’s got the deer and the birds and the woods outside her windows, she’s got her British murder mysteries, and all of the 70s and 80s sitcom reruns to entertain her. She’s got The New Yorker to read (and read them through she does!), she’s got her drink every evening, and she’s still able to prepare food (she knocked out Thanksgiving dinner again this year, a true feat in that her right knee is now quite literally bone on bone). But she’s not able to come and go and she did only months ago. She is stuck inside her house. It can’t be easy. But there’s no reason to highlight this. She knows. And she has adapted. People are really good at that.

Now she is faced with a knee replacement at the age of 88. (She has postponed dealing with this for a long time. That’s understandable, but at this point there’s no avoiding it.) It surely stands that a woman of her determination will come through it ok, but if not, then what? And, even if things do go well – what then? We need to make some modifications to her house. She knows this, and we discuss some of the logistics with success. But when I move too fast, offering to do something for her, she gets angry, and says I’m taking over her life. And she has drawn the line at care. Somehow, this future scenario does not involve any outside party coming in to assist her with things. She fights me on this, saying I write her off as incapable. Quite the contrary; I know that she is clever and resourceful, capable of surprising things in light of her limitations, but she is human, after all – and post-op, she will need care, one way or another.

I believe that the thing she’s battling with is not so much the details themselves, or that I am taking over, but rather it’s the beast that is pushing its way into the room which frightens her. I wish we could just acknowledge the creature, and make plans accordingly. It might make the beast less menacing.


Mom and Elihu both know my feelings about death. I believe that in a fully realized and modern society, a lucid adult should be afforded a medically efficacious, humane and affordable – and legal – death at the time of their choosing. Both Elihu and my mother warn that I might not avail myself of such a service when I become old and frail. They posit that when I am a very old woman, I might not wish for the end. Yes! I completely agree! How can I know possibly know how I’d feel in that moment? I can’t. But what I do know is that I want the option of a humane – and legal – exit.

I’m gonna stop you right now if you’re tempted to spout the reactionary “It’s a slippery slope” response. While the more litigious or philosophical among you may have specific points to support your case, I believe that for the majority of people, that response is born of fear. The religious among you will also take issue with this for your own reasons. This is where we will likely part ways; I do not believe a loving god would deny its children this most tender of mercies. I won’t be getting into the arguments here and now, but rest assured I’ve studied all manner of debates on the subject, a multitude of points and counterpoints.

I’ve been thinking about death for years. I’ve seen many videos of people’s final moments (a profoundly generous gift on the part of both the people themselves and their families). I’ve read many books, and listened to numerous talks on the subject. What helps give me the courage of conviction to write candidly about this is the number of people with whom I’ve discussed the topic, and the number of people who have admitted to me, in the safety of a private conversation, that they heartily agree. People should be able to choose their exits.


As a musician I work a fair amount in nursing homes, and I see the saddest outcomes for individuals who’ve lived the most glorious lives. After I finish performing, I always make informal rounds, visiting folks who I see to be awake and who welcome my brief intrusion. I’ve been playing at one facility for nearly seven years, and, sadly, some of the residents are still there… They are bedbound, screamed at all day by TVs, blaring at top volume. It is cacophonous. It is inhumane. It is terrifying.

I can recall meeting a fellow who had taught chemistry at Columbia University; he spoke about his life as a child in a small town in Finland. He recalled the fish that his mother had made, and told me how much he missed that. He told me about the research of which he was a part, he told me of his three children whom he’d raised in the city, now all gone. Dead. He and his wife had long since divorced. Was she dead too? He didn’t know. He was well-spoken and brightly recalled his memories which I followed with great interest. And yet here he was, bedbound, soiling himself and unable to move, dependent upon an over-worked and underpaid aid to restore his comfort, to say nothing of the basic dignity he’d lost in the whole mess. Bells and blinking red lights were always going off in the hallways; it was impossible for the staff to keep up with the need.

(We have all visited a relative in one of these places. And if you find the higher end joints a little off-putting, just imagine this bottom-of-the-barrel venue. No one in his right mind would ever send his mother to such a place. It goes without saying no one would wish this outcome for themselves, either.)

After I have finished with my visits, I invariably end up speaking to the staff. At the conclusion of our conversations, I always pose the ultimate question: If you could choose to end your life in a safe and legal manner, thereby eliminating the need for living in such a place, would you? And of the dozens of people whom I’ve informally polled, not one has ever answered differently. Every single person has said that they would choose a humane, safe and legal death over life in such an institution.


My mother comes from a generation which was raised to live in hardship without complaint. (Use it up, wear it out, make it do, or do without.) This generation was encouraged to be self-sufficient and responsible; living in this manner is often a point of pride. It makes sense then that her needing or asking for help feels wrong. Perhaps like a tiny failure. Hard wiring is not easy to undo. So at the end of her eighth decade, it’s a bit late to expect that my mother will change her way of thinking. I get it. Additionally, a woman like her who’s done an expert job at hosting hundreds of people over the years might have a hard time letting go of that authority and yielding up the most basic tasks to another person. It might also be that accepting help means that true frailty is not far behind. And, however heartbreaking it may be to conceive, that really is the truth.

Yes, I can understand that it’s got to be frightening to be in her shoes. I think we’re all scared of finding ourselves at that place in our lives. And yet so few of us have the courage to admit our fears aloud. Most of us keep silent; we stifle our gripes and concerns. We suck it up. And I really wish we didn’t.

It’s my hope that people all across this earth can learn how to speak candidly and caringly about the end which awaits us all (as well as the feelings of uncertainty that precede our final days). My mother and many of her generation may find self-advocated death an abominable thing – and certainly my mother is likely not the type to avail herself of such a service were it even available – yet I still assert that a humane and swift death needs to be the legal right of every rational, healthy adult.

Would you have surgery without anesthesia? No, you would not. Would you have your dog suffer? No, you would not. You would use medical tools to minimize or eliminate suffering. If you’re a doctor, you will likely cite the “do no harm” bit of your professional oath to me in protest. Well, I believe that preventing someone from obtaining a wished-for, safe and legal death at the conclusion of a long life is doing harm. Quality over quantity. It’s simply one step beyond a DNR. But, as things stand in December of 2022 here in the US, it’s one hell of a big step.

The elephant will seem far less menacing when we can get her fed and comfortable. She may even turn out to be a welcomed guest. But we’ll never know until we can all agree that she’s sitting right here in the room with us.


Drawing by Jules Bradbury

To see further examples of the work of Jules Bradbury, find her on Instagram: @no_still_life

or visit her website: www.no-still-life.com

The Other Shoe

Thursday morning

We’re going to take dad to the hospital today as he’s been complaining of stomach pains for a few days now. While mom and I think it might be good old-fashioned constipation, and he’s been drinking more fluids to help things along, the pain hasn’t really gone away. Mom suspects all he needs is some hydration by way of an IV. That, and the overall stimulation that another atmosphere and new people might provide. I’m not so sure this will have a happy ending. Martha, the other matriarchal figure in our lives, is also in the hospital today. She awoke around four this morning because she was having difficulty breathing. Martha knows the drill well. She pushes the button on the pendant around her neck, calls her friends Doreen and Mike, and shortly an ambulance arrives. She’s been in the hospital – admitted through ER – many times over the past couple of years. Sometimes things appear dire, yet she always ends up returning to her large, historic farmhouse in Greenfield. And every time she enters the place, I pray she makes it home again. Above all things, Martha is a woman who must die in her house. And no matter how infirmed her state, it seems she always has the resolve to make sure that one day she will.

My father, on the other hand, might have a different story. If admitted, he might be considerably disoriented by an extended stay in the hospital. Mom’s hope is that he ends up staying for a few days. She’s even posited his going then to a rehab facility in town (Martha’s done that herself several times). But if he can be made well by a simple round of hydration, then why would he need to stay there? My suspicion is that mom isn’t even aware of her own secret wish to be relived of her care-taking duties, if only for a couple of days. I’ve been lobbying hard for a weekly visit from an private nurse, but mom continues to say ‘we’re not there yet’. ! A few days ago she began to acquiesce, and told me her intention was to call the office of the aging and schedule an in-home interview, yet every manner of obstacle has prevented her from doing so. She doesn’t work, dad doesn’t get up til way past noon. What on earth could be preventing her from calling, save her own, deeply-embedded fear of entering this next phase? This is all a sad new territory for sure, and it’s made even harder to navigate by virtue of my parents’ values and upbringing. They are not a generation that discusses their feelings. And my mother is definitely not one to accept help. This creates a challenging environment when it comes time to deal with these issues of aging. Man, if there’s one thing I’ve made good and clear to my own son, it’s that he should do what he needs to do when the time comes. If I don’t know who he is and I can’t wipe my own butt – then  by all means ship me off. And honestly – you may think me morbid, I do not care – I am all in favor of assisted suicide (however loathe that term) if a person should face an irreversible, debilitating disease. It’s even my hope to be able to sock away enough money to have that be a viable option one day (one possible place is in Zurich, Switzerland. It’s legal there). After all, looking to my father and paternal grandmother, the genetic possibility for growing old with dementia is a potential reality for me. I cannot pretend it isn’t.

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Thursday, early evening

I’ve been at the hospital for much of the afternoon with mom and dad. The staff at Saratoga Hospital continues to impress me, and I’m so very grateful for their service today. Turns out dad just had a hernia. Not a big surprise, he had one on the other side years ago which he had fixed surgically. The doc massaged it back into place, and dad felt relief right away. He had a CT scan which showed some ‘white matter’ around his brain; the ER doc surmised that it may have been many ‘tiny strokes’, but mom and I wonder if it might not simply be evidence of his memory loss and the related diminishing brain volume. Either way, my feeling is that it doesn’t so much matter. In my eyes, it’s my father’s quality of life and comfort that is most important now. Little prevention can be done to stop the progress of what’s probably inevitable. Guarding against falls is another concern of mine now too (mom and dad have a tile floor, argh. Knock on wood). In the end, dad’s cheerful, as well as he can be, and most importantly, feeling better. And I for one am relieved that he didn’t need an overnight stay in the hospital. (Although mom might feel differently.)

Martha was just down the hall, and on the way out, we wheeled dad into her room for a visit. It only just occurred to me right now – that it might have been the last time that dad and Martha will ever see each other in person. On Martha’s 87th birthday, just a few weeks ago, it took dad nearly fifteen minutes just to get inside her house. It was a huge production. I think we all knew as we watched his incredibly slow progress to the car afterward, that this was probably his final visit to the farm. This whole chapter is bizarre and bittersweet. I realize I’m lucky to have both of my parents alive and doing relatively well. So many of my friends are in that stage of life when they’re losing theirs. I watch, I wait, I worry. Nothing to do but try to savor the time remaining.  It’s tough for me, yes, but I think of my folks. My dad is actually blessed by his dementia; he can’t truly appreciate that his life is reaching its end. And my mother, while she herself is actually doing ok (in spite of bad arthritis and chronic back pain), I can’t help but I wonder if there’s not a low-grade worry present in her thoughts about how her own end will come. An occasional passive-aggressive aside will come out every now and then which betrays a darker side to her concerns. On the face of it however, she jokes, she makes light… There is a mildly haunting sense to this time in all of our lives, although none of us ever says as much. But even if we were to talk, what would we say? I’d like to think that Elihu and I will face these tough conversations with absolute honesty when the time comes, but I can’t know that for certain. I cannot begin to assume that I will behave any differently, or approach the last years of my life with any more candor than my folks. I just don’t know how it will feel to be in that situation. I’d like to think that I’ll be able to face it, but it’s been a bigger challenge than I’d thought just turning fifty!

For now, I cherish the little things that have been so familiar to me all of my life. That certain, charming way my father has of laughing. The way my mother always shows concern, the way she always takes care of things, and makes me feel in the end like everything will always be alright. I can’t grasp in this moment, today, that one day they will be gone. And as frustrated as they can make me, they are my only parents, and I love them so. Every remaining moment is important, because you never truly know when the other shoe will finally fall to the ground.

ER 2013 126I am a fan of Saratoga Hospital. The staff there have all been so kind and gracious.

ER 2013 063Dad was in good spirits all afternoon.

ER 2013 053There’s his gallbladder. All looks just fine.

ER 2013 078Now we’re in Martha’s room for a visit. Note how she raises her hand for emphasis as she speaks. She is still in control! And she remembers the name of every last person who comes into her room – not only that, but she remembers where they live! Martha always inquires where people are from. That’s signature Martha Carver. !

ER 2013 091That profile I know so well.

ER 2013 097You can see what a production it is to move dad.

ER 2013 101Aaron was so kind and patient.

ER 2013 105Mom needs a cane these days – she can’t walk far without it. Even so, she’s the rock in the duo so far.

ER 2013 113So fragile looking.

ER 2013 122What a relief. I asked mom if she needed help on the other end – getting him back inside the house – but she insisted she didn’t; she said it simply took a long time. I can’t help but wonder each time he leaves the house if this will be the last time he does. You just can’t ever know for sure.