"Better Deaths Than Any I've Ever Seen"

There are only a couple things I pray regarding the end of my life. One of them is that I will die well. By that, I mean that if I have any advance warning of my impending earthly demise, I desire to die in faith, confidence, trust, and peace, not "like the rest of men, who have no hope" (1 Thess. 4.13). I want to honor God not just in how I live my life, but also in how I "live" my death.

If it's a protracted death, Iwould love for it to be something like what's described in today's New York Times. The story profiles nuns at a convent and the provisions they've made for each other to die among friends, with dignity, in an environment of hope. Here are some excerpts:

July 9, 2009
Months to Live
Sisters Face Death With Dignity and Reverence
By JANE GROSS
PITTSFORD, N.Y. —
…
A convent is a world apart, unduplicable. But the Sisters of St. Joseph, a congregation in this Rochester suburb, animate many factors that studies say contribute to successful aging and a gentle death — none of which require this special setting. These include a large social network, intellectual stimulation, continued engagement in life and spiritual beliefs, as well as health care guided by the less-is-more principles of palliative and hospice care — trends that are moving from the fringes to the mainstream.

For the elderly and infirm Roman Catholic sisters here, all of this takes place in a Mother House designed like a secular retirement community for a congregation that is literally dying off, like so many religious orders. On average, one sister dies each month, right here, not in the hospital, because few choose aggressive medical intervention at the end of life, although they are welcome to it if they want.

“We approach our living and our dying in the same way, with discernment,” said Sister Mary Lou Mitchell, the congregation president. “Maybe this is one of the messages we can send to society, by modeling it.”

Primary care for most of the ailing sisters is provided by Dr. Robert C. McCann, a geriatrician at the University of Rochester, who says that through a combination of philosophy and happenstance, “they have better deaths than any I’ve ever seen.”
…
“It is much easier to guide people to better choices here than in a hospital,” he said, “and you don’t get a lot of pushback when you suggest that more treatment is not better treatment.”
…
Few sisters opt for major surgery, high-tech diagnostic tests or life-sustaining machinery. And nobody can remember the last time anyone died in a hospital, which was one of the goals in selling the old Mother House, with its tumbledown infirmary…and using the money to finance a new facility appropriate for end-of-life care.

“There is a time to die and a way to do that with reverence,” said Sister Mary Lou, 56, a former nurse. “Hospitals should not be meccas for dying. Dying belongs at home, in the community. We built this place with that in mind.”

….Here, everyone mixes. Of the 150 residents, nearly half live in the west wing, designated for independent living….Forty sisters live in assisted-living studios, and another 40 in the nursing home and Alzheimer’s unit, all in the east wing, with the chapel, dining rooms and library at the central intersection. Closed-circuit television allows those confined to their rooms to watch daily religious services.
….
Dr. McCann said that the sisters’ religious faith insulated them from existential suffering — the “Why me?” refrain commonly heard among those without a belief in an afterlife. Absent that anxiety and fear, Dr. McCann said, there is less pain, less depression, and thus the sisters require only one-third the amount of narcotics he uses to manage end-of-life symptoms among hospitalized patients.

On recent rounds, Dr. McCann saw …Sister Jamesine Riley, 75, once the president of the congregation, who barely survived a car accident that left her with a brain injury, dozens of broken bones and pneumonia. “You’re not giving up, are you?” Dr. McCann asked her. “No, I’m discouraged, but I’m not giving up,” Sister Jamesine replied in a strong voice.
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Some days, Dr. McCann said, he arrives with his “head spinning,” from hospitals and intensive-care units where death can be tortured, impersonal and wastefully expensive, only to find himself in a “different world where it’s really possible to focus on what’s important for people” and, he adds, “what’s exportable, what we can learn from an ideal environment like this.”
….
Barbara Cocilova, the nurse practitioner here, sees differences in the health of these sisters compared with elderly patients in other settings….Among those with Alzheimer’s, Ms. Cocilova said, diagnostic tests tend to produce better-than-expected results among those who are further along in the disease process, a possible result of mental stimulation.
….
Sister Bernadine Frieda, 91, spry and sharp, spends her days visiting the infirm with Sister Marie Kellner, 77, both of them onetime science teachers. Sister Marie, who left the classroom because of multiple sclerosis, reminds an astounded sister with Alzheimer’s that she was once a high school principal (“I was?!”) and sings “Peace Is Like a River” to the dying. “We don’t let anyone go alone on the last journey,” Sister Marie said.

Seven priests moved here in old age, paying their own way, as does Father Shannon, who presides over funerals that are more about the celebratory “alleluia” than the glum “De Profundis.”…He shares with them the security of knowing he will not die among strangers who have nothing in common but age and infirmity.

“This is what our culture, our society, is starved for, to be rich in relationships,” Sister Mary Lou said. “This is what everyone should have.”

I've often criticized the Times for cluelessness on religious matters. This article is a notable exeption. You can read the entire thing here.

And click here for a short audio slideshow about the sisters and their home. It's excellent.

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(In case you're wondering, my health is fine, as far as I know. There are no veiled messages in this blog post!)

What Could Make Me Ashamed To Be An American?

My old passport was nearing its expiration date, so I sent off for a new one. Mindful of last year's processing bottlenecks, I paid the extra $60 for expedited handling. And that's what I got; the new passport arrived exactly 1 week after I sent in the paperwork.

That's the good part.

What I actually received is a nightmare. Have you seen the design of the new passports? I'll be embarrassed to flash that thing on any foreign border. It used to be that passport pages were demure backgrounds for the visas and stamps you'd get while travelling. Now, the passport has been turned into a gaudy picturebook, complete with quotations from historical Americans, the national anthem, and the constitution. How those poor border guards are supposed to find a place to put their stamps, or how anyone is supposed to be able to read them against the dark, intense background colors, is beyond me.

Reportedly, the design was approved by Secretary of State Colin Powell. All I can think is that he signed off on this travesty only after he had already decided to resign. It must have been his way of getting even with the administration that he felt had mistreated him.

Apparently, I'm not the first to have this low opinion of the new design. It's been called "the ugly khaki shorts of passports," "like being given a coloring book that your brother already colored in," and "a tangled mess," Here are a few other choice quotes:

• The new passport comes with its own name: “American Icon.” It’s hard to think of one that was left out. (NY Times)
• “There is also something a little coercive about a functional object serving as a civics lesson, even a fairly low-grade civics lesson.” (NY Times)
• Apparently, someone forgot that passports are mainly meant to be read by, you know, foreigners. Plastered like a NASCAR vehicle with cheeseball patriotic clip-art that might have been swiped from the Colbert Report's opening credits, the new books spill jingoism the way traveling Americans once spilled hard currency.Fair enough, given the administration that introduced the new passports. Unfortunately, where the Bushies once excelled at logos and backdrops, the redesign is also hideously, hideously ugly. (Design Cultures Blog)
• The passport's subsequent pages--the ones that are supposed to be used for foreign visas and entry stamps--follow along with illustrations as predictable as a junior-high American-history project. Cacti! Mountains! Independence Hall! A gargantuan rendering of the Liberty Bell! The whole romantic panoply, from coast to coast. (Design Cultures Blog)

Where did the designer go after this project? Apparently, he moved on to the Acura TL redesign.

What Would You Do?

NPR's Morning Edition had a sobering story today about the persecution of Christians in Iraq. You can listen to it here, or you can read a CNN article about the same subject here.

It's not just Iraq where Christians are having a hard time, of course. Most incidents never reach the press and we never hear about them.

Nevertheless, the NY Times, that bastion of liberalism, ran a story yesterday about the persecution of Christians in India. (Last November, I blogged about the hard time Dalits have in India; the NYT story isn't about Dalits, though.) As I read the stories, I found myself wondering what I would do if faced with these situations. What would you do? It's easy to show up at church in America and sing about our loyalty to Jesus and how wonderful it is to be a Christian. The worst opposition we face is usually our own sin and self-preoccupied narcissism. But what if we faced what these Indians face? What would we do? Check these excerpted vignettes, or read the entire story here:

The family of Solomon Digal was summoned by neighbors to what serves as a public square in front of the village tea shop.

They were ordered to get on their knees and bow before the portrait of a Hindu preacher. They were told to turn over their Bibles, hymnals and the two brightly colored calendar images of Christ that hung on their wall. Then, Mr. Digal, 45, a Christian since childhood, was forced to watch his Hindu neighbors set the items on fire.

“ ‘Embrace Hinduism, and your house will not be demolished,’ ” Mr. Digal recalled being told on that Wednesday afternoon in September. “ ‘Otherwise, you will be killed, or you will be thrown out of the village.’ ”

...

Here in Kandhamal, the district that has seen the greatest violence, more than 30 people have been killed, 3,000 homes burned and over 130 churches destroyed, including the tin-roofed Baptist prayer hall where the Digals worshiped. Today it is a heap of rubble on an empty field, where cows blithely graze.

Across this ghastly terrain lie the singed remains of mud-and-thatch homes. Christian-owned businesses have been systematically attacked. Orange flags (orange is the sacred color of Hinduism) flutter triumphantly above the rooftops of houses and storefronts.

...

[A] Hindu mob in the village of Nuagaon dragged a Catholic priest and a nun from their residence, tore off much of their clothing and paraded them through the streets.

The nun told the police that she had been raped by four men, a charge the police say was borne out by a medical examination. Yet no one was arrested in the case until five weeks later, after a storm of media coverage.

...

A few steps from where the nun had been attacked in Nuagaon, five men, their heads freshly shorn, emerged from a soggy tent in a relief camp for Christians fleeing their homes.

The men had also been summoned to a village meeting in late August, where hundreds of their neighbors stood with machetes in hand and issued a firm order: Get your heads shaved and bow down before our gods, or leave this place.

Trembling with fear, Daud Nayak, 56, submitted to a shaving, a Hindu sign of sacrifice. He drank, as instructed, a tumbler of diluted cow dung, considered to be purifying.

In the eyes of his neighbors, he reckoned, he became a Hindu.

In his heart, he said, he could not bear it.

All five men said they fled the next day with their families. They refuse to return.

What would you do?

Eat Food. Not Too Much. Mostly Plants.

I don't normally read books about food, nutrition, or diets. After 50+ years of life, I feel like I've heard it all. Caffeine is good/bad for you. Margarine is better/worse than butter. Saccharine will/won't give you cancer. The Atkins diet will/won't make you thin, but at some/no cost to your heart. The grapefruit diet does/doesn't burn fat. And on it goes, endlessly. You could add to the list.

My basic approach to food over the last few years, as I've seen my metabolism slowing down, is to control portions and eat no more calories than what I expend, to go easy on saturated fats, and otherwise to eat a bit of everything but not too much of anything. That's been working reasonably well for me, though any doofus would know that adding regular exercise to all the above wouldn't be a bad idea.

My skepticism at dietary advice met an unexpected friend in Michael Pollan and his book, In Defense of Food. I first encountered Pollan in a lengthy interview on XM Radio's Bob Edwards Show. (You can download a podcast of an shortened version of the interview here.)

Pollan is a professor of journalism at UC Berkeley and shares my skeptical approach to much of life. In his book, he asks why a country so obsessed with nutrition and health food can simultaneously be the fattest nation on earth. What are we missing? His common-sensical analysis is eye-opening, and his writing is consistently engaging.

I had intended at one time to post excerpts from each chapter of his book on this blog, but there's just too much. I would have ended up retyping most of the book. His basic conclusion about nutrition is the title of this blog post, but there's a wealth of data and research (much of it historical rather than nutritional, surprisingly enough) that leads to this simple seven-word summary.

As a result of reading this book, I've changed some aspects of my diet to favor whole foods (fruits, vegetables) and items which only have ingredients whose names I can pronounce and which can be created somewhere other than in the chemistry lab. I'm still not a purist, but I've made a few changes. (Oh, and I drink wine a lot more often, but that may have more to do with Trader Joe's coming to town and making oceans of plonk abundantly available.)

You could buy the book - and there are certainly worse ways to drop $13 - but if you read this lengthy essay by Pollan that appeared on the NY Times website in January 2007, you'll get the gist. You can also read the first 26 pages of the book on Google Books here.

Viral. Contagious.

I must be about the last person on earth to see Matt Harding's "Dancing" video. I first heard about it today on the NY Times website . After reading the article, of course I wanted to see the video, which is here:



This video has nearly 5 million views, and over 23,000 people have rated it (with an average rating of 5 stars).

On the face of it, this is just a video of a guy doing a goofy dance. With some beautiful music for the soundtrack. But for me, and I'm guessing for a few million others, this strikes a deeper chord, even a sense of longing, or yearning. What do people see in this? What do I?

• Community?
• Acceptance?
• Joy?

Matt Harding's web site is here.

Having a Ball in Rome

I wasnt' too impressed with the Spanish Steps in Rome. But I wish yesterday's events had happened when I was there in October . . . it would have changed my opinion. Check out the video below. For more info about what's going on here, the New York Times has a writeup.

News You May Have Missed: Murder Rate Hits 90% in U.S.

I've been reading lately about abortion practices in India and China, where it's a well-known practice to abort baby girls (er, female fetuses), because parents are constrained by law or economics to have only one child, and boys are more valuable to the family. Girls are merely money pits. This practice is technically illegal, but it happens, it's no big secret, sonogram manufacturers knowingly provide the equipment for it, and nobody ever seems to be prosecuted for it.

India and China didn't invent eugenic abortion, however. The Nazis didn't either, but during their Reich it was public policy, not something done in secret, to eliminate imbeciles and cripples. The picture you see here, which I found on Wikipedia, is from that time period. It promotes a forced euthanasia program; clearly, the regime would have supported eugenic abortion, as well. Translated, the poster says, "This person suffering from hereditary defects costs the community 60,000 Reichsmark during his lifetime. Fellow Germans, that is your money, too." Why waste money on worthless persons? Eliminate them for the benefit of all.

Peter Singer at Princeton is (in)famous for advocating something similar, but I've always considered him to be a fringe idiot, not someone in the vanguard of public thought.

Maybe I was wrong.

In today's NY Times on-line, I read the following:

Sarah Itoh, a self-described “almost-eleven-and-a-half,” betrayed no trace of nervousness as she told a roomful of genetic counselors and obstetricians about herself one recent afternoon.

She likes to read, she said. Math used to be hard, but it is getting easier. She plays clarinet in her school band. She is a junior girl scout and an aunt, and she likes to organize, so her room is very clean. Last year, she won three medals in the Special Olympics.

I am so lucky I get to do so many things,” she concluded. “I just want you to know, even though I have Down syndrome, it is O.K.”

Sarah’s appearance at Henry Ford Hospital here is part of an unusual campaign being undertaken by parents of children with Down syndrome who worry about their future in the face of broader prenatal testing that could sharply reduce the number of those born with the genetic condition.

Until this year, only pregnant women 35 and older were routinely tested to see if their fetuses had the extra chromosome that causes Down syndrome. As a result many couples were given the diagnosis only at birth. But under a new recommendation from the American College of Obstetricians and Gynecologists, doctors have begun to offer a new, safer screening procedure to all pregnant women, regardless of age.

About 90 percent of pregnant women who are given a Down syndrome diagnosis have chosen to have an abortion.

Would you have guessed 90%? I'm flabbergasted. . . Particularly because this statistic comes from the NY Times, which is not exactly known for its pro-life advocacy. Elsewhere in the article we read such tidbits as:

Genetic counselors, who often give test results to prospective parents, say they need to respect patients who may have already made up their minds to terminate their pregnancy. Suggesting that they read a flyer or spend a day with a family [to learn what Down syndrome children are really like], they say, can unnecessarily complicate what is for many a painful and time-pressured decision.

So once again, the value of a human life comes down to the degree upon which it impinges on my own. We wouldn't want to "complicate" a "time-pressured" decision, would we? Somebody might have to miss a concert or a party or a business trip if forced to read a flyer or learn something more about the life they're considering terminating. How intrusive.

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I don't have kids and probably never will. But you don't have to have kids to know that something about killing people to improve the gene pool and personal convenience is very, very wrong.

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I encourage you to read the entire NY Times article (you can register for free). There's actually a positive spin to what's happening, in the form of parents with Down Syndrome kids getting the word out that these are human beings worthy of love. I'm just sorry it's come to this.