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If I cannot give consent to my own death, whose body is this? Who owns my life? ~ Sue Rodriguez (42-year-old woman with ALS)

In my work as an advocate for those who are facing death and wish to have choice on how they will die when death is imminent, it helps to be walking the walk myself, to understand on a visceral level what we all are facing. After all reasonable measures to extend life have been exhausted, there is a point where fear of dying and facing the ultimate grief can kick in and heroic measures may be utilized to keep the body alive at any cost. Some of these measures include: intubating the trachea for ventilation, CPR, inserting a nasogastric tube that goes through the nose into the stomach for short-term nutritional support, and a gastrostomy, a feeding tube that is placed surgically through the stomach wall for long-term nutritional support. (I heard a doctor who personally had this procedure say that intubating the trachea is one of the most painful procedures one can have.)

Heroic measures is a legal term that to me is anything but heroic when utilized in avoidance of facing the inevitable, when a person is in the dying process. If these procedures would improve the person’s health or a person chooses this for themselves regardless of the outcome, I would completely support that personal choice. However, utilizing these procedures to avoid feeling the feelings that facing death evokes can actually prolong physical suffering and support our cultural fear of death. I’m not sure what is heroic about that. Often people feel compelled to do something, because feeling powerless is excruciating. I’ve been there with beloveds. It is not easy.

In order to dispel our cultural fear, talking about one’s impending death with our beloveds is essential. It is surprising how many people don’t. If the family can be courageous enough to face death straight on, which requires feeling our feelings and being vulnerable together, we can enter the Sacred together.

Many states have passed a law granting a person who is dying the right to choose how they can die to avoid needless suffering. The difficult discussions many people are having when facing their own mortality, or the mortality of a loved one, now includes the consideration of using MAID, medical aid in dying, if they meet the rigorous criteria for eligibility for this medication. Considering this choice can be less ambiguous when one is dying from an acute condition than when the condition is a progressive, degenerative neurological illness when end-of-life suffering can have a very different quality. With an acute condition like cancer, there is a more predictable trajectory depending on the aggressiveness of the particular cancer. With more chronic conditions such as COPD, ALS/MS, or others, there is more of a gradual decline, but during end-stage can have what seems like endless agony.

A DNR, or do not resuscitate, also known as no code directive for allowing a natural death, in my opinion, is a necessary paper to consider for anybody who chooses to exercise choice at a time when they are most vulnerable. I would consider it mandatory if you have a chronic illness that might require a 911 call and your autonomy is as important to you as mine is to me, where quality of life is more important than quantity. Most EMTs know to look on the refrigerator for a DNR. Many people don’t realize they can choose the level of suffering they have to endure. It takes a lot of Presence to be with an emergency in the moment and, if life-threatening, to move through it consciously. It is a big ask if one has not taken the time to contemplate our impermanence before things become emergent.

There is no right or wrong in my opinion. One must process through this rigorous part of the journey the best they can. At a certain point I decided I had lived in a victim framework long enough and I took my power back and got into the driver’s seat of my life, metaphorically. I began to realize that though I have much life force and a clear mind, my body was declining considerably and I needed to come to terms with the inevitable. It helps that I have a strong belief that our physical life is temporal and our soul is eternal. This understanding was hard earned. For some, letting go and letting doctors or family members make the decisions might be exactly what they need to do. It is not for me to determine what sort of death other people need.

Nobody who really knows me would say that I am a quitter.

Once I realized in 2007 that I was going to live alone with this degenerative, life-threatening illness in this harsh and magnificent desert town in Colorado, I gathered my resources, internally and externally, and began the sacred art of creating my life how I want it to be. Living alone for 18 hours a day and only being able to move from the neck up requires much creativity and fortitude, for myself and the caregiver. We have done it with Grace and much humor. It’s been a joy and a joint adventure with my caregivers and my family.

A few months ago, in a circle of women I had been meeting with for over ten years and with whom I have had a profound level of intimacy, I stated without fanfare that I felt complete. It was a strange sensation and a communication that came from an inspired, deep place inside mySelf. In a way, it felt like a proclamation. I was sharing my feelings about having the prescription that will release my body from the accelerating suffering. I realized that making that decision will take all of the courage I have inside me and, to me, that is true heroism.

Ironically, my digestive system began shutting down soon after this talk. (You know it’s bad when the hospice nurse cries for an hour giving you the diagnosis of gastroparesis.) I felt shock and grief stricken and wondered what happened to the part of me that felt complete. It’s like amnesia set in and my emotions took over. All of my human grief from living a full life arose: all of my attachments to the most important people to me arose, as did my attachments to my identity as a person of service to love, and even my attachment to this beautiful, struggling body; it all surfaced to be processed once again.

As I am writing, an adolescent mule deer peeked into my window. First, I saw velvety antlers and then a little face looked inside, curiously. It can’t be an accident that this young deer came at this moment, so close to my home, and peered into my window while I am writing this essay. The shamanic symbol for deer is that of gentleness, unconditional love, and kindness. The male deer, the buck, represents independence, purification, and pride. People have sought to identify with them ceremonially, wearing antler headdresses and imitating the deer’s leaping grace.

If you by chance connect with me in Spirit, you might notice me leaping gracefully through the clouds in ceremonial Joy. Rest assured that I will be finding a purer way to connect more deeply and in service to LOVE.
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Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. more...

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