At a luncheon for supporters of Capital Hospice yesterday, talk turned to Terri Schiavo and how interest in the "end of life" issues raised by her case in March seemed to have died almost as soon as she did. Such is life in attention-deficit- disordered America, I suppose.
There are hurricanes to watch now and wars clamoring for attention, but you'd think that such events would make us more aware of how precarious life is, not less, and prompt us to better plan for the inevitable.
"Americans continue treating death as if it's an option instead of a reality," said Carlos Gomez, associate director of the Institute for Education and Leadership at Capital Hospice, which is based in Fairfax County. How true.
It's okay with us if our government hides the coffins of dead soldiers returning from Iraq and tries to censor images of floating corpses in New Orleans. We are told that this is done out of respect for the dead and their families. Perhaps. But it also perpetuates the fantasy of deathless death, which is a hallmark of the virtual reality where so many spend so much time.
About 50 concerned Washington area residents had gathered at the home of April and John Delaney in Potomac to hear Gomez speak of the challenges facing hospice caregivers in a society that's in denial about death.
African Americans, I'm sorry to say, seem to be especially disconnected from this reality. There is a popular saying among our church folk: "Everybody wants to go to heaven, but nobody wants to die."
But die we do -- in droves. African Americans have the nation's highest mortality rates for every preventable deadly disease in the book. With so many of us not caring how we live, it appears we don't much care how we die, either -- even if inattention to matters such as wills and health insurance cause untold suffering for those left behind.
Capital Hospice cares for about 600 patients a day throughout the Washington area. They include AIDS patients whose families did not know how to care for them and whose government would not care for them and Latino immigrants, many of whom do not have health insurance or who were afraid to seek treatment because of their legal status until their illnesses became terminal.
There are others in hospice care who had the foresight and courage to get with family members before a crisis and make their last wishes clear -- in writing.
They wanted to die with dignity, without pain, and at home surrounded by loved ones. They did not want to leave their family members unduly burdened by expensive yet useless medical treatments, nor did they want them ridden with guilt and shame from wondering whether they had done enough or had pulled the plug too soon.
Hospice, by the way, is a strategy for care in the final stage of life. Physicians, social workers and clergy, among others, focus on the medical, psychological, spiritual and financial needs of the patient and family members. It is not only, as so often described, a place where sick people are sent to die.
"My father, who was a doctor, died of pancreatic cancer," Gomez said. "But he was clear about what he wanted done and not done. No hospitals, no invasive surgeries. He had a living will, which is like a narrative of your life that you get to finish. It was his legacy -- what he wanted to leave his family: emotionally, financially, spiritually."
That would have been impossible without an acceptance of death's inevitability and the reality that even if we take care of ourselves to the best of our ability, we can't live forever.
The family feud over the removal of Schiavo's feeding tube managed to turn a brain-dead Florida woman into a poster child for death without dignity. The spectacle did prompt many people to obtain living wills, and a national discussion about who gets to decide who dies -- and when and how -- got underway, if ever so briefly before fading away.
But that did not mean the questions got answered.
"For every 27-year-old woman in a persistent vegetative state," Gomez said, referring to Schiavo, "there are hundreds of anonymous 90-year-olds whose families are facing the same gut-wrenching issue: 'What are we going to do?' "
Better to have given that some thought before the time comes.