Our own death is a pretty abstract concept, or it is for most of our lives. We don’t think about death much until we reach the end of our natural span and then we are conditioned to acceptance slowly as we lose our physical and mental capacity and the spring in the clockwork mechanism that drives us loses its temper. When our life is swiftly and prematurely extinguished we engage with death even less. In war, road accident, drowning or murder we are present and vital at one moment and the next we are no longer, with little or no time to think.
I have castrate resistant metastastic prostate cancer (mCRPC). It’s a terminal diagnosis, one I received only a few months ago. The data shows I face a median survival of 18 to 24 months. Androgen deprivation therapy no longer works and chemotherapy offers an extremely limited extension to that time, then after that there is nothing left. Prostate cancer is the most frequently diagnosed cancer and the third biggest cause of cancer related deaths of men. My mets (metastases) are in my lymph, the bones of my spine, ribs and hips and in spite of both internal and external radiation it has also regenerated in my nuked prostate.
My experience, the anticipation of my death is already different, already extraordinary. The longer time horizon gives me more time to think. The unexpected and dramatic shortening of life expectancy impacts hugely on the way I do. Shoes purchased today will never be worn out. The lifetime guarantee on a fly fishing rod no longer influences that purchase decision. The two year old thoroughbred in the string of racehorses I manage no longer forms part of my expectations, the visualization of one day leading her into the winner’s enclosure is just a blank screen. New questions like does one take on a young retired racehorse to retrain into a polo pony knowing that you will probably not finish that job. What will happen to the horses I already have and promised a forever home, a promise I shall be forced to break? Will I be at my daughter’s graduation or meet my grand children?
Impending death does focus one. In my case it focussed me to search for and find a radical new but still experimental treatment, one showing considerable positive results and suddenly presenting me with a new pathway to a normal lifespan. Thoughts of my impending demise have moved backwards in my consciousness and since been replaced with hope. Until that discovery the end game was very much being played out. I had already decided that the side effects of chemotherapy will not form part of my final defense. I would trade those extended months for some quality of life instead of merely marginally delaying the inevitable.
This is the same decision that I would make for my animals, the quality of their life being rated in my mind much higher than quantity. When I know I must euthanise a faithful polo pony who has played her heart out for me for many years it always is when the arthritis in her joints is still bearable, when her coat is still shining and while her eyes still sparkle. It’s hard to make the decision to euthanise but I have always known that it must be made in her interest and not mine. That only I can give her that gift. The decision I make is based on loyalty, love and respect although it is far easier to avoid it altogether and so turn her out to pasture and out of sight on the hill until finally she is found one cold frosty winter morning lying with a rough coat and tangled mane, when the struggle to just keep warm for one more night was too much.
When I finally do go I would like to go that way. To die with dignity, with a sparkle in my eye and because I chose that day as my last. To die surrounded by the love, loyalty and respect of my dearest family and closest friends. That they too would allow me to slip away with a brightness in my gaze and laughter on my breath. Not wait until when finally I was so weak that I too could no longer fight off the frost. I would like that when I left I still had control and was not forced to follow a path unwillingly through a state of complete pathetic uselessness.
Original article: Death be not proud… by Walter Pike