Timshel (Thou Mayest)

I have a patient who knows the names of all the staff who come into her room. She chats about books and pets and her stint as a missionary in West Africa. She can't wait for her discharge transfer to a nearby hospice facility because she will "enjoy every moment of the air and the sun." She smiles and laughs despite her breath being stolen more and more by growing cancer in her lungs. She is a patient who knows how to die; Beautifully. 

I won't forget her for that reason. Because here in America, we aren't allowed to die. We will battle it out right through Stage IV, but we won't put down the frozen pizza and diet coke. We will show up for dialysis three days a week for hours if it means a few more years... months... or whatever, but we won't take advantage of a perfect day to get our legs hiking up a hill trail we live minutes from. We will take 23 different meds from little pop-open plastic boxes labeled with the corresponding time of day and day of the week, but we won't throw our social cigarettes down the toilet. We compromise *quality* of life for *length* of life at all medical treatment costs, but reject the daily maintenance required to keep our bodies thriving. I am guilty of all of these things... and find myself increasingly fearful that we are all heading for care on 14L.

So the peaceful, content, resolved patients like her are few and far between... and they mean a lot to those who typically see death play out in less consummate guises. Her impact was further confirmed to me just yesterday at a super bowl party when I bumped into the EMT who had transferred her from our care to hospice a few weeks ago. There have probably been 50 patients between us since then, but both of us were quick to recall that patient's uncommon grace; quick to recall a woman dying beautifully.

"But the Hebrew word, the word timshel- 'Thou mayest' - that gives a choice. It might be the most important word in the world. That says the way is open. That throws it right back on a man. For if 'Thou mayest' - it is also true that 'Thou mayest not.' Don't you see?...

...I have a new love for that glittering instrument, the human soul. It is a lovely and unique thing in the universe. It is always attacked and never destroyed - because 'Thou mayest.'" 

(John Steinbeck, East of Eden)