Wednesday, October 15, 2014

BRITTANY MAYNARD, VIKTOR FRANKL, AND FATU KEKULA



Brittany Maynard is a 29-year-old Californian who has an inoperable brain tumor, has moved to Oregon in order to take advantage of its assisted-suicide laws, and has created and invited a media frenzy by setting the date of November 1st (or thereabouts, it now appears) to kill herself.

She (very understandably) wants to avoid more suffering and pain. She wants to choose the day and the hour, go upstairs to her bedroom, put on some music she likes, and surrounded by family and friends, "die with dignity."

The neurologist and psychiatrist Victor Frankl survived the Nazi death camps to write the spiritual/existential classic Man's Search for Meaning. Frankl was hardly a believer in quack healing, facile answers, or miracle cures.

He endured and survived the most grotesque, most evil, most carefully plotted and planned atrocity of the modern age.

In The Doctor and the Soul, another of his books, Frankl considered the subject of euthanasia.

"In life the opportunities to address oneself to this or that group of values vary from hour to hour. Sometimes life demands of us the realization of creative values; at other times we feel it necessary to turn to the category of experiential values. At one time we are called upon as it were, to enrich the world by our actions, another time to enrich ourselves by our experiences. Sometimes the demands of the hour may be fulfilled by an act, at another time by our surrendering to the glory of an experience. Man can be "obligated" to experience joy. In this sense a person sitting in a streetcar who has the opportunity to watch a wonderful sunset, or to breathe in the rich scent of flowering acacias, and who instead goes on reading his newspaper, could at such a moment be accused of being negligent toward his obligations.

The possibility of realizing in a consistent series and in an almost dramatic manner all three categories of values was open to a patient the last phase of whose life took the following form. A young man lay in the hospital, suffering from an inoperable spinal tumor. He had long since had to abandon his profession; paralysis had handicapped his ability to work. There was for hi therefore no longer any chance to realize creative values. But even in this state the realm of experiential values remained open to him. He passed the time in stimulating conversations with other patients--entertaining them also, encouraging and consoling them. He devoted himself to reading good books, and especially to listening to good music on the radio. One day, however, he could no longer bear the pressure of the earphones, and his hands had become so paralyzed that he could no longer hold a book. Now his life took another turn; while before he had been compelled to withdraw from creative values to experiential values, he was forced now to make the further retreat to attitudinal values. How else shall we interpret his behavior--for he now set himself the role of adviser to his fellow sufferers, and in every way strove to be an exemplar to them. He bore his own suffering bravely. The day before his death--which he foresaw--he knew that the doctor on duty had been ordered to give him an injection of morphine at night. What did the sick man do? When the doctor came to see him on his afternoon round, the patient asked him to give him the injection in the evening--so that the doctor would not have to interrupt his night's rest just on his account.

Must we not ask ourselves now whether we are ever entitled to deprive an incurably ill patient of the chance to "die his death," the chance to fill his existence with meaning down to its last moment, even though the only realm of action open to him is the realizing of attitudinal values--the only variable the question of what attitude the patient, the "sufferer," takes toward his suffering when it reaches its climax and conclusion? The way he dies, insofar as it is really his death, is an integral part of his life; it rounds that life out to a meaningful totality. The problem we are touching on here is that of euthanasia, or "mercy killing." Euthanasia in the narrower and original sense of the word--providing an easy death--has never been a problem for doctors. That the doctor assuages the agonies of death by medication is taken for granted; determining the point at which such medication is indicated is merely a matter of tact and insight and needs no discussion of a basic and theoretical nature. But in addition to this, the attempt has repeatedly been made in various quarters to legalize the ending of lives supposedly no longer worth living.

In answer to such proposals we must first of all reply that it is not the doctor's province to sit in judgment on the value or lack of value of a human life. The task assigned to him by society is solely that of helping wherever he can, and alleviating pain where he must; of healing to the extent that he can, and nursing illness which is beyond cure. If patients and their near and dear were not convinced that the doctor takes this mandate seriously and literally, they would never trust him again A patient would never know whether the doctor was still coming to him as a helper--or as an executioner.

This position rests on principle and admits of no exceptions whatsoever. It applies to incurable diseases of the mind just as well as to incurable diseases of the body.


--Victor E. Frankl, M.D,, The Doctor and the Soul

At the middle of all this is a beautiful 29-year-old woman with an inoperable brain tumor. My first reaction is to say, "Oh my God, that is so awful, that is so hard. I'm so so sorry. That sucks." Personally I would not bear that bravely. I would bear it messily, with unspeakable fear. Still, as my friend Rita (whose husband has suffered for years with Stage 4 liver cancer) said, "Setting a date to kill yourself? There's no...vibration in that."

Another story broke last week: the story of Liberian student nurse Fatu Kekula whose family of five fell sick from Ebola, who pled in vain for medical help, who went out and bought boxes of plastic trash bags, plastic rain boots and dime-store medications and, against every voice around her that told her to save her own life, who told her she was crazy, cared for them herself. Only one--Alfred Wennie, 14, a cousin who the family had taken in--died.

After surviving this dreadful siege, the response of Fatu's mother was to mourn: “I cried. I said ‘It’s a shame on me, because I took somebody’s child, a relative’s child, and he died in my hands.’”

From an October 6, 2014, LA Times piece by Robyn Dixon:

[Kekula said]: “Doctors called and told me to leave them right alone and not go anywhere near them,” the 22-year-old nursing student said. “I couldn’t. They’re my only family.

“When your family get ill, you know that the virus is deadly. But your family is your family”...

“No one came near me. No one! I were all alone, all alone,” she said...

Around the clock, one or the other of them would be weakly calling Fatu for help. She dozed 15 minutes here, 30 minutes there.

“It was a bit difficult for me to sleep because all the time they would call me, maybe two of them would call me at the same time. Every time I would go into a dangerous room, I would dress up,” she said.

“The whole virus thing, it’s like carrying a baby in your hands, because it turns them into a child. You have to be sorry for them. You have to put yourself into the shoes of that person and ask yourself, ‘What if it were me?’”


You don't have to "believe" to see there is a world of difference between the attitudinal values-the approach to life and to death--of Brittany Maynard and Fatu Kekula.

But you'd have to be a liar to claim there is no difference.

And you'd long ago have to have killed your own soul to claim that the difference doesn't matter.






5 comments:

  1. Thank you Heather.

    This made me think of 2 things: 1) the quote from Pedro Arrupe, S.J. (1907-1991), the 28th Superior General of the Society of Jesus (1965-1983). "Pedro Arrupe wrote this after he suffered a debilitating stroke, the effects of which he patiently endured for the final ten years of his life:

    More than ever I find myself in the hands of God.
    This is what I have wanted all my life from my youth.

    But now there is a difference;
    the initiative is entirely with God.

    It is indeed a profound spiritual experience
    to know and feel myself so totally in God’s hands. " http://thinkjesuit.org/717/

    and

    2) Rainer Ptacek, a blues musician who died of brain cancer in 1997 but made extraordinary music right up until he died (his music is really well worth checking out!) http://www.rainermusic.org/

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  2. Thank you, Heather, and thank you, too, Paul Higgins, for introducing us to Rainer Ptacek. I'm exploring the website now, and am so sorry that I never got to hear him in person. I live in Bisbee and Tucson is only a 2 hour drive. God bless you.

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  3. Frankl is a treasure. So are you.

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  4. This is an area of struggle for me... As a veterinarian, I have seen the pet whose life is miserable, who sees nothing from his pain, whose family anthropomorphizes and refuses to let go of him. Certainly this is a value of love, of deep care. But what I often want is for them to stop the suffering. This dog as much as he may love his family, no longer wills to live. To be true to him, would it be better for the disease to destroy him or to interfere and rather than allow life to work its horrors--say enough. A woman who can speak and think for herself, she has seen the writing on the wall. She knows how she will die, and she says no. I will not let life do this to me. I would rather die than to allow my body be destroyed and then die. She removes herself from the game. She desires a "beautiful" death (pain free, aesthetic, and in a state of clarity) more than additional time and a "horrible" death (wracked by pain, suffering, and all the things that end of life is made of). I cannot blame her. How often do I wish that my horrible chapters of my life did not have to be lived? I survived on hope. Hope that someday it would end. She obviously finds no hope nor meaning in the cruel twist of fate. She does not face it as a challenge to be bucked, that she should suck the marrow out of life until it sucks it out of her... I am not her. I cannot do anything but weep in the face of said sorrow... What does this say about us but that we desire pleasure over pain? That a painless death sounds less awful than a natural death? If I make the decision that I long to hang on til the bitter end before I resign my soul to purgation-- I like that I would have that choice. For a dictated law to say that my suffering is the meaning of my life sounds fatalistic and frighteningly abusive. But that I can choose to make my suffering have meaning, that is a gift. Brittany has taken a road that says I will go on my terms, not because suffering cannot be beautiful, but because I do not desire my death to be a death of suffering. I salute her bravery in the face of calamity, and if I was her family, I would treasure her... I would plead with her to stay for selfish reasons... But I would not pretend that my values should dictate hers, and I would respect hers... Suffering basically sucks. I suck at knowing what to do about it. It just makes me want to weep for those who suffer and ask them what they want to do about it. If they desire death... My sense of righteousness feels feeble... Why does life have to be so damn hard?

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