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Reaching End

Early in his book Being Mortal, Atul Gawande refers to this story by Tolstoy as a teachable moment for doctors and understanding what mortality about. I took a detour from the Gawande book to read the Tolstoy story and it was so worthwhile. The themes in the life and death of Ivan Ilyich are timeless and Gawande touches on many of them in his book about mortality. 

All of this made me think about all the people in my life that I love and care about that are over retirement age - friends and mentors I first met a few decades ago, family members who have known me since birth. In the years to come, many of them would be faced with complicated health conditions, some already do. In each case, their family members would process the situation differently and it would impact the quality of life of the person suffering. 

There would be the denial of others, self-denial, resignation of others and of their own - maybe some toxic combination of all that. Irrespective, in may cases the end would come with many surprises and disappointments along the way. As Gawande describes, the modern day death may be like a downward slide down a hill with patches of recovery but overall downward trajectory but it not like falling off the cliff as it used to be in the past. 

Ivan Ilyich did fall off the cliff in the end over the course of three days when he decided to end living the lie about his illness being passing instead of terminal. 
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