The line between denial and acceptance is porous
My grandmother calls me every Saturday around the same time, between ten o’clock and eleven o’clock in the morning. Actually, she should be calling me soon, but this time I’m not going to answer—my phone is in the other room. My grandmother lives in the Upper Peninsula of Michigan, so far north she’s in the Eastern Time Zone, although her house is west of Chicago. We usually talk about politics—out of everyone in the family, the two of us are the most left-wing—or about the weather, but now the weather is political, too. “There’s no such thing as winter anymore,” my grandmother says. “There’s only fall, late fall, and late late fall, followed by early early spring, early spring, and spring.” When she talks about it more seriously, she adds, “I’m glad I won’t be alive to see what happens.”
Though my grandmother is young, or at least young for a grandmother (73), her health is the subject of some conversation between me and my aunt, my father’s sister. Her relentless pragmatism, coupled with an unwillingness to get old, can be, at times, distressing. She has no impulse toward self-preservation; her attitude is to let nature take her when it takes her. To her, the whole apparatus devoted to keeping people alive is unnatural and full of denial. My aunt always thinks that my grandmother should go get something checked out, that her life is not solely her own, that it partially belongs to the people around her. I, on the other hand, cannot imagine her in a hospital, even when she’s had surgery. In my mind’s eye, she simply gets up out of the hospital bed and walks out, the same way she announces, after a slow cup of coffee in the morning, that she is about to “spring into action” before launching herself out of the chair into the day’s activity.
Last week, I had a dream that she called me—a usual Saturday morning affair. The dream was realistic: it was early early spring, cold, and I was just returning to my apartment after running some errands. She had called to let me know that she was planning a physician-assisted suicide, opting out of the process of death, electing simply to die. “It’s only going to get worse and worse from here,” she said. “I can see it all before me.” She had talked it over with her doctor, the decision was made. The feeling in the dream was of a sentence being handed down for nothing: as though she were K, in The Trial, only she was braver than K and had sentenced herself, and I was the one facing a black box of bureaucracy. I was not allowed to see into the decision, only to accept it without understanding. I said, “OK.”
This dream was not about my grandmother, primarily. My mother is closer to death, and refusal of chemotherapy has been on and off the table. Likewise, I have been accepting what my mother tells me without any direct knowledge. She will say, “My numbers are up,” without my knowing what numbers she’s talking about. She will tell me which treatment she chooses, and I will not know if there are other options. I have not tried to get her a second opinion; the thought didn’t even cross my mind.
When I speak to friends about this, or rather, when they ask me normal questions that normal people would know the answers to, and for which I have no answer, I worry I look irresponsible. I defend myself against imagined criticism: I am more present in other, less pragmatic ways, which would be difficult and sentimental to list here.
The black box: the room where she and the doctor sit and discuss, where she learns things about her body I’m sure she doesn’t fully understand and cannot completely relay. Inside the black box are the results of bloodwork, the varying levels of enzymes, the possibility of gene therapy, the physical exam, the side effects—all the data points, adding up to a tortured semblance of understanding of what will happen next, how long she will live. There is more input into the black box than output; many factors go into the decision of what treatment course to take, at what level of intensity, but only the decision is spewed out. The only thing I hear is: weekly chemotherapy through an IV. The black box is dense with facts; the body is crowded with tumors.