Three weeks ago my grandmother was in the hospital because of complications from a congested heart. She was fading in and out of consciousness and the doctor asked my mother if my grandmother, (Blanche), had ever let them know her feelings about respirators and heart-lung machines. He was told that she had filled out a “Do Not Resuscitate” order a year earlier, the last time she was in the hospital with the side effects of a bum heart. The family believed her wishes had not changed in the intervening year. The doctor said that it was best to hear such things from the patient herself and he began to gently shake my grandmother’s shoulder and call out, “Blanche. Blanche. It’s Doctor Smith. I have to ask you a question. Can you hear me?”
My grandmother gave an almost imperceptible nod, so the doctor continued. “Blanche, I have to ask you an important question. If we get to the point where we need to use machines to keep you going, do you want us to go ahead and do that? Do you want us to use a respirator to keep you alive?”
My daughter, Isabel Lorraine, is named after my wife’s favorite grandmother, Lorraine Isabel. We used to have a picture of Grandma Larry on the wall of Isabel’s room and Isabel saw this picture from the first day of her life. When she was old enough to become curious, she asked, “Where is Grandma Larry?” We told her that Grandma Larry was dead.
As a result, death has been a topic Isabel has been interested in since she was two years old. Through her name, she had a direct connection to someone who was already dead, and this link seemed to fascinate her.
I can remember walking to New York Pizza in Trumansburg and passing by a semi-flattened squirrel on the side of the road. Isabel, from her vantage point in the stroller, got a close look at the dead creature. She asked me to stop and then got out of her stroller to take a closer look at the now-inanimate animal. She could see that the body had something dreadfully wrong with it and was no longer working.
She had a lot of questions about the squirrel: “What will happen to the body? Where is the part that was alive? How long before it is just a skeleton?” All of the questions really came down to one: “What is death?”
When we passed by cemeteries Isabel wanted to know what was happening to the bodies in the ground. The physical process of decay was hard for her to wrap her mind around—the idea that living people who were active and thinking and loved could be put in a box and covered with dirt by the people who loved them did not make a lot of sense at first. We told Isabel about some peoples’ belief in an afterlife and this also provoked many questions. I don’t believe in a soul that continues on after the body is dead and I told Isabel about my doubts concerning heaven and hell. She merely took in all the information and chewed on it for a while.
When my mom called to keep me updated on Grandma Blanche’s condition a few weeks ago, Isabel overheard my side of the conversation. She could tell something was wrong, both by the tone of my voice and the questions I asked. When I hung up she asked right away, “Is Grandma Blanche going to die?” And because death was not a new topic to Isabel, I was able to sit down with her and tell her the truth and she was able to hear it without freaking out.
My wife and I hadn’t planned on how we would address the subject of death with our daughter, but in retrospect I am very happy with the way we approached it. From early on we presented death as a physical process that happens to everything and everyone. We talked about decomposition and turning back into dirt in a way that made perfect sense to Isabel, since she saw it happen all around her all the time with leaves, plants in the garden, and dead animals.
Now that Isabel is six she is starting to develop her own ideas about the existence of a soul and the reality of heaven and hell. She is convinced that there is a God, that creatures have souls, and that these souls continue to exist even after the body has turned back to dirt. But underlying all of these beliefs is the concrete knowledge that peoples’ bodies stop working and then they die some day. In her own way, Isabel is OK with that idea. She doesn’t like it, especially when it is Grandma Blanche who is the one dying, but she understands it and I believe this comfort with the fact of death will serve her well as she grows up.
Remaining completely in character, despite the pain of illness and the fog of medicines, my Grandma Blanche opened one eye, took a second to focus on the doctor’s eyes, and croaked out an unmistakably clear response: “Hell no!” It was clear she did not want to be kept alive by machines.
Blanche Michaels was ready to die. She was tired of living in a body that betrayed her more than it served her lately.
We went to her funeral and it turned into a celebration of Grandma Blanche’s life, with her four children, fourteen grandchildren, and fourteen great-grandchildren all in attendance. Isabel was sad that Grandma Blanche was gone, but she was able to be there and join in the celebration. At the cemetery I was able to say goodbye as the coffin was readied for burial and the beginning of the return to dirt, and Isabel was able to say goodbye to Grandma’s spirit as she saw it getting ready to leave the body and fly up to heaven. Isabel, Erica, and I walked to our car holding hands, happy we had come.