We were watching "Sicko," Michael Moore's documentary of the American health system this afternoon while I was reading submissions for a writing contest and working on my novel. If you haven't seen it, it's of course a well-done documentary highlighting the inequities between the American health system and other nationalized, single-payer, "socialized" systems such as Canada, England, France, and even Cuba (the part in which Moore takes 911 First Responders who are still struggling with medical bills and ailments then 5 years after 9/11 to a nationalized hospital in Cuba is brilliant).
Although I am all for nationalized care, the question that never seems to arise from these discussions is not cost but how much is too much? There was great article a few months ago in The New Yorker about patients in the final stages of lung cancer who were still demanding to be entered into new drug trials when it was apparent that they would not survive the treatment, increasing the costs of not only their own care, but also everyone else's. As Americans, we feel entitled to everything, including cutting-edge care, without having to pay to for it. Sure, insurance companies increase our costs, but so do $75,000 ultrasound machines and every other technological advance in the past century. The fact American wages have stagnated since the early 1970s certainly complicates the equation of what we can afford, but at what point do we acknowledge that we will die from something, throw away the pills, unhook the machines and meet fate eye to eye?
It was difficult watching my stroke-addled grandfather wither away for the last five years in his bed, not recognizing us, and not able to do anything much else except not recognize us. Or my grandmother, who died recently in the beginning grips of dementia, but not before arthritis and balance issues turned her into a stiffening paraplegic who fed herself with one very gnarled hand until that hand also became too disfigured. We don't have the luxury, like we do for our pets, of ending their suffering. But it does feel as if so much of medical technology is merely prolonging life at the expense of quality of life. I would rather die earlier with most of my faculties and mind intact than be a empty wrapper on the bed, waiting for an errant breeze to finally blow me away.
And why do we want to live forever? Should our life not have a natural story arc? One of the main characters in my novel, The Tide King, realizes that, after ingesting a mysterious herb, that he cannot die. For him, with no anchor to the traditional timeline that his family and friends have, it is a curse. He is a man looking for a connection to people who will all leave him through death.
Of course, I do not know how I will react when confronted with evidence of my inevitable mortality. Maybe I will be a terrible hypocrite and cling to every last breath regardless of expense or harm. But as medicine becomes more and more about beating death, no one seems to be questioning whether the means justify the end.
I was just thinking that it's amazing I'm a writer when I'm so incredibly boring as a person— one of my favorite times of the month is changing to a brand-new bar of soap when the old one becomes a slither. And maybe it's even more telling that I feel compelled to share this with you.