During a past in-law health crisis, I read Steinbeck’s East of Eden. After a few days I noticed a voice, not my own, narrating the struggle of the human condition in my head. Days of witnessing the drama unfold, caused me to consider how Steinebeck would characterize the relationships between family members. Would he describe them with the disgust as an exhausted narrator, or would he portray them so the reader might become more sympathetic, or perhaps the characters would serve as mere instruments of pity.

This time, I’m reading David Sedaris. I enjoy the momentum of both writers, but Sedaris writes with a refreshing bluntness that emphasizes the acute balance of absolute insanity coupled with despair. I process fucked-upness with a grain of salt because the madness is seldom difficult to identify with anymore, and it is quickly congealing into the artificial well preserved flavor of normal.

The echo of Sedaris’s voice tolling around in my head makes the powerlessness more palatable, though it will never taste good.

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The business of enabling death is complicated. There is the legal side, the physical side and the compassionate side. By middle age, most of us have become acquainted with depressing terms such as living wills, and do not resuscitate (DNRs) orders. On the face of things, they seem to be straight-forward documents. If only it were really so.

In the case of the DNRs, there are levels to be considered. There is the meat and potatoes version that withholds everything. Food, water, artificial life support, antibiotics etc. There is also a tailored version in which you choose which specifically which comforts are to be extended in patient care and which are to be withheld. You might ask, what is the difference? In some instances, withholding hydration or nourishment, does not expedite the process of dying, it only makes it more uncomfortable, as the stomach acid causes pain while attempting to dissolve the lining. Some antibiotics, do not prolong death, but increase patient comfort. Pain medications can relax the body, alleviating the struggle for breath.

All situations are unique. Question your physician extensively before selecting the option that best meets the intentions of the patient for whom you are advocating. Projection is easy, but interpreting the will of the declining is not.