The Grid

In the past five weeks I’ve helped assist five people in their conversion from one form of energy into another.  All of them were dear to me, and each was unique and interesting.  Because I did not meet them until they entered dementia care in the last chapter of their lives, I knew them in simplified form compared to their former selves. They were all old by any sort of reckoning.  Their bodies were like cars you couldn’t get parts for any more.  We knew their carburetors or fuel pumps or batteries would fail soon, and we could not prevent it.  Our job was what is called palliative care, which is basically the alleviation or mitigation of suffering during the process of physical death.

Many people pretend that living is something different and separate from dying.  To me living and dying walk hand in hand as best friends in permanent companionship.  It’s just the process of using the machine. With each bath or shower, we cast off millions of dead cells.  We take in fuel and pass exhaust.  The mental and invisible process works that way too.  We learn new things and old ideas and concepts get thrown away.  We’re always recycling and working out new paths for the flow of sensations and understanding.

Before I became familiar with the specific process of dying I held a number of misconceptions.  Perhaps you do too.  When someone enters the active dying process, their various biological drives begin to ramp down.  They do not hunger as much or as often.  Their menu preferences might shrink to a few items like pudding, popsicles and applesauce for example.  They do not thirst in the same way as before, though they may wish small amounts of water or juice just for the pleasure of tasting it.  Their mouths get drier because they stop swallowing, so we use little sponges on sticks to moisten them.  A variety of discomforts may occur.  It may become difficult to breathe.  Because the immune system begins shutting down, opportunistic infections sometimes take hold.  We have to keep an eye on their temperatures and levels of congestion.

Dying people may experience comfortable and uncomfortable sorts of hallucinations.  If a person begins holding pleasant conversations with their long-dead friends and relatives, we don’t consider it uncomfortable.  On the other hand, we are not averse to administering anti-psychotic medications for people who imagine enemies and demons are entering the room to drag them to hell.  As the brain begins shutting down, they become unable to speak and are bed-bound. We watch for non-verbal pain indicators like grimacing.  We shift their positions in bed to prevent pressure sores from immobility.  Our overall effort is to address obstacles as they occur, not to cure because it’s too late in the process for that, but to do what we can to make people comfortable.  There’s quite a lot that can be done with medications to manage pain and make breathing easier.  Our presence and loving company do much to alleviate the fear some dying people experience.

I got an unexpected day off in which to write this.  A truck driving out the main road caught a low-hanging wire and pulled down a power pole and some transformers.  No one was injured, but it knocked out power to the Urgent Care clinic (my other job) for a day.  The crews didn’t replace the pole.  They strung up new cables across a different path.  The nearby café I frequent served breakfast by flashlight thanks to their propane-powered kitchen and backup generator.

I thought about how we are animated by the electricity of our consciousness.  At some point we will experience power loss.  Sometimes it will get interrupted in a trauma, like with the truck and the wire.  Sometimes the equipment will just wear out and expire, like with the dementia care patients.  The power still exists.  The cables get strung up along a different path.  I still feel the electricity of the relationship I had with those who died.  Part of their voltage is humming through my grid now.


Filed under Emotions, Ethics and Morality, Metaphysics, photos, symbolism

26 responses to “The Grid

  1. Mikey, it’s been too long. It’s kind of overwhelming and reassuring at the same time to realize that the process you describe happens to every single life that is not abrubtly cut off. Strange, I was holding our new baby yesterday and, noticing how absolutely helpless and reliant she is on some external OTHER for her continued existence, I remarked to my wife what an odd thought it is that every single human being that has ever been — everyone we know and all people we have ever seen anywhere or heard about — all started out as one of these. Thanks for the post.

  2. I do hope you write more! Particularly moving and good one. I’ve missed you a lot. I’m sorry for the loss, though expected. You’re a wonderful person.

    Hurray, we can tweet you now!

    • I hope I’ll be able to also, Lisa. I have several topics I haven’t had time to write out yet. I’ll be cutting back my work hours beginning in November. And yes, I turned on the “share” buttons even though I have no idea how that works, since I don’t have a twitter account.

  3. Mike,

    These are very interesting observations of the dying process. I love your sense that “the power still exists.”

    In Buddhism, it is believed that a very subtle level of consciousness or pure awareness exists and continues when the body dies. It isn’t harmed or touched by dementia or any other illness for that matter. The physiological processes you describe are also consistent with the stages of outer (body) and inner (subtle level) dissolution that occur during the process of dying. It’s interesting how this has all been mapped out quite clearly for centuries already. Medical doctors are also well aware of the signs that typically proceed death but not to the same degree.

    I appreciate you and your keen awareness. Thanks for writing about this here. I’m glad death is not a taboo topic for you!

  4. Hi Mikey
    Trying to type this whilst sharing the keyboard with one of my cats aint easy…so please forgive any tttttttttyping errors or expletives that may appear!I’ve just come across your blog via Tess the Bold and I can assure you I’ll be back. Love your writing style and the stories. The gentle way in which you described your job as a carer for those with dementia is so touching…it’s such an injust and horrible disease!

  5. Good day!This was a really magnificentsuper post!
    I come from endland, I was fortunate to come cross your blog in baidu
    Also I obtain much in your subject really thank your very much i will come every day

    • You are welcome any time, bet365, though I cannot promise to post new articles each day – yet. If you subscribe to the blog by email, you’ll get notice when I post.

      (Baidu is a Chinese search engine. I had not heard of it before this comment.)

  6. I’m happy to welcome you here, OB Woman. To me, the disease is neither horrible nor unjust. We live in machines (our bodies) and they wear out. If you live to be 90, and many more do these days, your chance for dementia is 1 in 10. I encourage you to visit or volunteer at any center for dementia care in your area. They are just people, though more simplified than perhaps they used to be. They still love to converse, and be hugged. Their reminiscences are honest and touching, and they still enjoy making new friends.

    • Thanks for your reply Mikey. I know what you mean about dementia being a type of wearing out of the old machine that we live in, but I still feel that it is unfair and unjust when it happens when the machine isn’t so old. My mum was only in her very early seventies when the symptoms of multiple infarct dementia started to ruin her life. She was an extremely independent and capable person who was aware of what was happening to her and she was very frightened. She died when she was 78.

      • I can see why you would feel very strongly about this subject. My reply did not properly validate the pain felt by family members, and of course all our own losses feel unfair. I am certainly in no position to estimate fairness or unfairness when it comes to diseases and who has them. One of our current residents is in her 50s and I have felt just as you did about your mum’s situation, even though we are not related.

        • No prob Mikey and thanks for your reply. I understand where you were coming from, and that you were talking about people in the more final stages. I really feel for that person who is only in her fifties. That is tragic. Your job is tough but I can see that it must be rewarding at times.

  7. Deborah

    This is a beautiful piece of writing, Mikey. I’m glad you’ll be writing more soon. I’m also glad we can tweet you now. (I just did so.)

  8. Look it! I got you featured on Dementia Daily by putting #dementia when tweeting your link.

  9. Hi, I saw this linked on FB by another visitor who commented above.

    This is very interesting, and I enjoyed reading it (not sure if enjoy is exactly the right word) because I don’t know a lot about people dying, but I do know about animals dying. I’ve been practicing palliative care with my cats and dogs ever since my first dog got cancer and I saw how it was assumed I would euthanize shortly. I did a lot of reading and said no, I will treat and work toward remission and when the time comes, see him to his natural end as long as I can relieve pain or suffering with medication and so on.

    Recently a cat passed away after a long illness and about 6 months decline, with the last few days clearly headed for death. Most of the things you write about here had me nodding–it’s not that different except for the popsicles, and I was constantly on alert for signs of pain and so on, so I could give medication when/if needed.

    Kudos to you for doing this very important job. I can only imagine what it’s like based on my experience with animals. Love the metaphor with the electricty–yup.

    • I’m glad you liked the post, Leah, and you bring up interesting points. I think there are many similarities between humans and other animals, especially other mammals. Different species have differing interests, but the functional machine aspects ought to be close so it makes sense that their dying process would be similar. The animals you noted all have nervous, respiratory and circulatory systems as do we. Those are the areas of bodies that tend to fail first. Humans appear to have more interest in and capacity for anticipating what will happen to them in future than the other animals, but I’m unsure this is always advantageous. I’ve had dying cats and dogs, and the fact that they don’t appear to be thinking about it means they have no fear about it either. To them it’s just “this is how I’m feeling now – and now – and now…”

  10. Absolutely love your perspective on living and dying. Your post brought a few tears to my eyes. Crying is so often seen as a sign of weakness, yet it is in essence a sign of being alive like at birth. Reading your post made me cry tears of awareness. Beautifully written as always.

    • I did think of you when I saw those downed wires. You live with some of your cables cut, but that doesn’t diminish or determine who you are. You had to get a repair crew out to find alternate routes for the electricity. Your chin-controlled mobility and computer interface are workarounds, and you continue to discover new paths in which the current may flow.

      As nice as you are to look at, and would be to touch, nicest of all is the fact that we can share understanding and by that means share the same power grid. That is the golden strand between all beings of similar intent. It can’t be cut.

  11. Pingback: 3 Great posts, 2 Useful Resources, and Water « Always Well Within

  12. i like the analogies you used and the way you arranged your words careful in this post, thanks Mikey:)

  13. Pingback: I worked in a specialized dementia care facility for nine months « kissesforelizabeth

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