Thursday, December 31, 2009

Untimely v "Timely" Death?

We each encounter deaths that we all refer to as "untimely" or "premature" - what makes it so? And why does it matter?
It seems that a "timely" or non-premature death is one that doesn't have much emotional impact outside the circle of loved ones. Inside that circle, it's debatable whether one type of death is better/worse than any other; it's always a shock, one is never 'ready' and the ensuing void is palpable and brutal.
But "untimely" or premature deaths carry emotional punch that extends beyond that circle. Most if not all of us have a visceral reaction to hearing of the death of a child or young adult.

So where is the line? When are we "supposed" to die? If it's by the numbers, then anything younger than the average life expectancy is premature. Is it degrees by age?

And then there is us --- here "us" is my club; people who survived something against great odds. By the numbers, I certainly should not be ringing in 2010. With my 'event' the survival rate is 2% and it's not driven by clinical risk factors --- it's geography. Where are you when it happens?

So as I prepare to say farewell to 2009, and not a fond farewell at that, I wonder -- by the numbers, I should not be here. But I have had high risk experiences in my life before this event and even a couple near-death experiences. (both scuba diving). After those events, I knew I was lucky, I knew I had survived something that could easily have ended differently, but they were both so different. Why? Is it the 2%??

Probably it's that this event, this cardiac arrest, was not precipitated by risky activity on my part. Scuba diving is risky, heading down to 130' in Belize's Blue Hole is risky --- but the cause of that problem was not the Blue Hole, it was not 130', it was nothing I or my buddy did --- it was pure equipment failure. (Yes, I had properly serviced the equipment, etc.). Somehow even though that event was not predictable, it was less threatening as time passed than this cardiac arrest.

This is a rambling post and not well written. Happily, I can edit tomorrow with a clearer head. My central question is about when "should" we die? When is it OK for us to die? When we engage in high risk behavior? When we hit the average life-expectancy number? Ever?

And of course, for this pragmatist, why does the question matter? I think that once you face mortality this way... you have to do some work to put it in its place, to not have it center stage each and every day. Maybe the difference between this event and the scuba events was, to quote the eloquent and gracious Elizabeth Edwards "I now know what will kill me". Maybe I know that and maybe I don't. Cancer of her type is a progressive illness, on a path with twists and turns to be sure, but a path nonetheless. My case has no path. It's a bimodal situation; it will happen again or it won't - ever. And I can find nothing to predict that.

maybe I'll edit this post and maybe I'll delete it.

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