AANS Neurosurgeon | Volume 28, Number 4, 2019


How to Go

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Dylan Thomas’ youthful rally to “rage against the dying light” doesn’t move me anymore. The many years glimpsing my reflection in the belly of a 10 blade has dared me to probe my own dimming. Although in no hurry for lights out, I doubt I will “burn and rave” when that time comes. If Thomas had blazed to mature age, perhaps he would have revised or even cursed his masterpiece. The reassurance of a soft exit when, as Emily Dickinson wrote, I am “called back” and, as Wordsworth said, I “cease to be” is the balm for me now. Those old poets knew dying. 

During residency, I heard respected neurosurgeon Dr. Thoralf Sundt say, “there are some things worse than death.” He was ill at the time. His message suggested that agony can be profound and fighting on may be futile. I do not possess the will that he or some of my patients have in the face of unremitting pain and disease. I hold other courageous traits, but this is not one. For me, if the choice of going gently were available, it would be a gift. Without legal acceptance for assisted demise, the only prophylaxis against my future suffering is to pray for sudden death. I do not fear Nothing, I fear being able to do nothing.

How apropos that a pathologist, a specialist in the study of dead tissue, taught us how to go. Jack Kevorkian raged against the cancer of silence surrounding mortality. But, we were not listening, and he paid for our deafness. No matter your belief, we all end up where Jack went. That old pathologist knew dying. 

Instead of the buzzing casino ICU, I will go in a place of low light and long shadows, accompanied by the murmur of the poet’s rhyme. Those looking will see themselves reflected in dull corneas as the sound of my eyelids closing fills the room. And guided by the call of the old Masters, poet and pathologist, to come home.  

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Leave a Reply

Carole J. Amodeo | September 17, 2018 at 4:25 pm

I am for going gently indeed!

John Bennett MD | September 24, 2018 at 1:04 pm

Yes, Kathryn, I want to go loaded up on beer, listening to Stevie Winwood’s “Roll with it”

Karen Fanning | October 19, 2018 at 2:23 am

After battling chronic pain for 10 years already, plus a number of other illnesses like DM2, adrenal failure & needing chronic steroids, fibromyalgia, arthritis, spine problems with 4 surgeries so far, and the fact that I was an ICU RN for 15 years, I can truly, HONESTLY say that I want the smooth, quiet ride out. My own bed, my daughter nearby, my favorite music and lots of good, sedating medicines if needed. I want to be able to go on my own terms, not anyone else’s.