She was led in by two young care givers. She sat on the nearest seat so heavily and with such finality that I knew she wasn’t going to get up again unless she was ready to leave. We were at a small gathering of old acquaintances. I was nonplussed at what I saw. The person I once knew was an active woman; active in church, active at the Lagos Chamber of Commerce, active among friends in her social circle. The body I was now looking at had degenerated to the point that it couldn’t function on its own and had become almost completely dependent. This woman was definitely not the confident, independent woman I had known for years and last saw a few years ago. What has happened to her? As uncomfortable as the question was, I couldn’t resist asking. She told me that she was lucky to still be alive; that her kidneys had packed up and she was being kept alive through dialysis. She said it candidly, without soliciting pity or emotion. I then wondered how much effort it took to make the outing given her state. This made me to admire her courage the more. She seemed to have read my mind. When it was time for her to leave, she said to everybody and to no one ‘I am glad I came. I am glad to have seen you guys again’. But the statement was, on further reflection, pregnant with meanings. Was she sending a coded message? Would we still see her again or was this her last heroic act? Her swan song? Would her outings henceforth, be dictated by sheer necessities and not pleasure as this was?

It was food for thought. No one at that gathering was a spring chicken. And there in her shoes, but for the grace of God, goes any one of us. Life in old age is not funny. The journey of life has its landmarks and body degeneration is the most noticeable signpost for advancing years. It starts with sight, then hearing, then memory. Mobility rears its ugly head somewhere along the way. These physical and mental impairments are usually accompanied by muscle and joint aches. This is not discounting acquired ailments like diabetes and high blood pressure which slowly but surely deplete body and soul. My mother, God bless her soul, used to call it ‘death by instalments’. Rare is that 60 year- old who doesn’t have underlying conditions. These conditions get more accentuated as we age. Then life becomes visits to the doctors instead of visits to friends and places of fun. The outdoor becomes a source of vitamin D rather than an opportunity to hang out. Care givers become the people you relate with instead of buddies. They regulate your life. Some are friendly, some are curt, some are exploitative. Most are magisterial. Your movements from the bedroom to the living room or balcony are dictated by the sun and the need for fresh air. Otherwise, you are left on your back in the bedroom, to stare at the ceiling with unseeing eyes as you negotiate with bed sores. The spouse is probably gone at this stage and the children, if they are still around, spend two hours with you every fortnight. Those who are not physically around, spend about the same time on long distance calls. The visits, like the calls, are almost always predictable, automated even. They center on whether you are taking your drugs and eating well. It is now about existing; about surviving from day to day. The only meaningful conversation being on what the last doctor said. The question that hangs in the air between you and the children is no longer ‘if’ but ‘when’. The bags have been parked and many of life’s luxuries and fun have been left behind. You are already at the airport lounge waiting for the final flight for to be called. The flight is being delayed by life support medications. So, is it better to live for six more years in this condition given the rising costs of medicare or for six more months – just enough to tidy up and leave the world? It is an ethical question. Moral even. But it is also a practical question.

I know someone who chose the latter option. And he wasn’t even old; just in his 60s. He was diagnosed with a stage 4 cancer and given a year to live. He chose not to fight it. He believed his family needed every penny in these hard times and fighting it would be chasing good money after bad. Not everybody in the family agreed with him. But it was his life and he earned their respect at the end of it all. More importantly, he went with a peace of mind only a few have. He knew the end was coming and he prepared himself for the inevitable. Another person, a medical doctor, spent about two decades in a trance-like existence supported by tubes and fluids. By the time he died, he didn’t recognize anybody, not even the wife he had shared a room and a bed with. A lot of money had been spent. A lot of emotions had been drained, including dressing him up for a daughter’s wedding introduction. A lot of decisions had been put on hold. Yet, it was a relief when he breathed his last. Another incident took a different, more ominous turn. Back in the 80s, a friend’s father took ill suddenly and was degenerating fast. It turned out to be a protracted illness. The children had left home and the wife had become companion, nurse and care giver. This took a heavy toll on her and the stress ended her life earlier than her sick husbands’. Nobody had the courage to tell the man until the burial date was announced because of what it would mean to him. Their worst fears were realized. He lamented that he should have died instead of his wife. Was he right? In any case, he gave up shortly after and the children became orphans within a month.

The issue for me is really what the better alternative is. Is it to hang on to life with drugs that merely prolong existence without considering the quality of life, the toll on emotions and the toll on the purse strings of dependents? Or is it to let people with terminal illnesses depart with dignity even if it means leaving guilty pangs on the conscience of relatives who do not have the time or money to spend to make this final stage livable and lovable? Which is the better end-of-life approach? The jury is out.

•Muyiwa Adetiba is a veteran journalist and publisher. He can be reached via titbits2012@yahoo.com

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