Can't we talk about something more pleasant?

Roz Chast has been a frequent cartoonist in the New Yorker for many years. Her cartoons, usually a page, resemble the panels of a comic strip, and tell a story. Her humour, while not quite black, often comes in assorted shades of grey.  Now she has drawn and written a memoir of the last years of her parents, George and Elizabeth Chast, a devoted couple of retired school teachers who had been married for 67 years. They were offspring of Jewish immigrants who came to the USA from Russia at the cusp of the 19th-20th century. They were an inseparable couple, parted only during the war which for them lasted from 1941 to 1945. George spent much of the war in New Guinea; during that period of separation, he and Elizabeth wrote to each other almost every day.

This book is mostly humorous in shades of grey that sometimes descend into the blackest of black and are not so much funny as heart-breaking.  It is a memoir of the slow decline of an elderly and fiercely independent couple into senescence, dependency, loss of autonomy, loss of mind, loss of control of bodily functions, and it is a sobering message to all of us about the tragic, unspeakably unpleasant fate that awaits us if we postpone death for too long. Like many old people, they were in denial about their increasing need for help. There are lessons for all who have to care for aged kin who have lived on long past their "Best Before..." dates. Long-term care of the very old is a labour-intensive business, a 24/7 business that is very hard on the care-giving kin, taking over their lives, sometimes tearing them apart from their own spouses and children. Roz Chast doesn't say anything about this even by hints or inference but it must have been hard on her husband and teen-age daughter. Long term care is a business that generates big profits for the owners of nursing homes and assisted living establishments,  and for the pharmaceutical and surgical supply corporations. It can pauperize the dependent elderly, in extreme cases can pauperize their next of kin too.  Roz Chast does describe in searing detail how costly it all is. Fortunately her parents had good pensions, but the vitally important features of their health insurance coverage were valid only in New York, and ceased when Roz Chast had to move them from their cluttered apartment in Brooklyn to an assisted care residence nearer to her home in Connecticut. The book reproduces Roz Chast's hand-written accounts  of the major crises on her parents' lives, illustrating these not only with cartoon panels but also with photos of her parents' tiny, cramped apartment, the unworkable mess of piled heaps of papers on their "work stations," her father's old electric shavers, her mother's old blenders.

There are sobering lessons here for all old people, and for all who are growing old, becoming less autonomous, more dependent upon others for help, then ultimately for mere survival.  There are lessons for me! My father and grandfather lived to advanced old age, until they became blind, bedridden, lost control of bladder and bowel, lost all autonomy: after lifetimes of independence that in my father's case was fierce to the point of savagery, they became utterly dependent upon others in order to survive.  My father was infantilized, washed, fed, diapered like a baby, a fate that he must have felt almost worse than death, although he was too proud ever to say so. Above all else I want to avoid that fate! I hope by the time I need it, assisted suicide will be legally permissible in Canada.

Few of us get our preference about how we will die.* Advance directives and legally sanctioned assisted suicide (if Parliament decrees this) can help us old farts get our wish - everyone’s wish - for a tidy, stress-free end of life. Unfortunately the harsh epidemiological reality is that increasing numbers languish for years, even decades, in warehouses for the partially dead that we euphemistically call nursing homes. Aging baby boomers could exercise political clout that might lead to enabling legislation, but many are like Roz Chast’s parents: in denial. I’m closing in on my 89th birthday and somewhat in denial although I can still fend for myself, do my own shopping, bathing, dressing. I have help with cleaning and cooking. When/if the need arises I’ll squander my kids’ inheritance to pay for personal care worker, home nursing care: stay home and evade warehouse demi-living. When push comes to shove, however, I’ll probably shy away from assisted suicide because like my father before me I’m intensely curious about the world, and about my progeny’s lives and what they will do next.  

* My preference is to be shot in the back by a jealous husband on my 98th birthday. I’m sure I won’t get that wish!