On the Threshold of Death

This is not a topic for sensitive individuals or close friends. This is for people who are either in the same boat as myself, or who seek a brutally honest assessment of life on the threshold of death. This is me, from the inside, no filter.

I'd had a rough week. It started out nicely enough: a good friend took me out to lunch at our favorite restaurant, which I'd not been to for a couple of years. But it was all downhill from there, as I spent the next several days suffering fits of gut-wrenching, uncontrollable sobbing. This is depression such as I've never known.

Some people ask what brought it on, and there's no answer. Those who likewise suffer chronic depression understand all too well: there's no cause. It just happens. And some people assume it's over my imminent death. It's not. If anything, I'm sad for my friends as they watch me die, a little at a time and, like me, not knowing when, but knowing it's relatively soon. But in my case, it's just me: I've become hyper-emotional.

Most readers know why I'm preoccupied with death; for the few who don't, I was diagnosed with terminal heart disease in 2020. The cardiologist could not provide an estimate of my time remaining, understandably, but he did say, simply, "You've got years." Pretty vague: Two? Twenty? Technically they're both "years."

So, as I'm wont to do, I went home and did some research (and not by consulting whacko-websites, but legitimate sources, such as published research papers from the likes of the Mayo Clinic and the American Heart Association). First, I found that over 90% of people with my numbers—specifically my heart's ejection fraction, or measure of its performance—are dead within a year. Then, another study revealed that the vast majority of cardiologist overestimate their patients' survival window. Well, I prefer the truth: I can take it. I don't need lies to make me feel better.

I'm now two years out from my diagnosis, so clearly my cardiologist must have been right. But in truth, I'm just on the cusp of being a statistical outlier, and statistics are merely averages. Plus, my cardiologist based his encouraging prognosis on my doing everything he wanted, which included getting heart transplant or installing an auxiliary mechanical pump. But those were not options, for multiple reasons.

First and foremost, I'm all about quality over quantity: I'd gladly forfeit an extra decade of life—the average for heart transplant patients—to avoid taking dozens of medications every day, making regular trips to the hospital and, in the case of a pump, maintaining a battery pack permanently tethered to my gut for the remainder of my days, etcetera, etcetera. Not to mention the fact that I'd need at minimum $30,000 in the bank before a specialist would even talk to me—assuming I was declared fit for the procedure.

There's a difference between living and surviving, and I'll take months of the former over years of the latter. But it's a touchy subject, as I've learned, since a friend of mine became a former friend. His brother had a heart transplant, and he carried on endlessly about how well he's doing, and how stupid I was for refusing it. I'm glad for his brother, honestly. But I think he was the stupid one for making the subject a condition of our friendship. That I couldn't have it done even if I wanted it didn't matter to him; that I didn't want to was all he could hear.

At the end of the day, it's my choice. And therein lies the enormous philosophical divide between myself and the majority of others. It makes me wonder: are those people who are adamant that I subject myself to such procedures really thinking about me, or themselves? Aren't they being somewhat selfish for insisting on having more time with me? Can they not respect my decision to allow nature to take its course? It's one thing to refuse the treatment of a common illness or injury, such as a flu or a broken arm; it's quite another to refuse a costly, highly invasive procedure involving many risks and potential complications, in order to artificially extend one's life.

Granted, there's no hard line between such extremes of healthcare, and that line can be a battleground: think about Jack Kevorkian—someone I admired and respected, perhaps not surprisingly. He believed, as do I, that it should be up to the patient to draw that line. And I've drawn that line. And I even have it in writing: I have a DNR (Do Not Resuscitate) document.

It mystifies people. Doesn't everyone want to live forever? Simple answer: No. Do I cling to the thought of another day on this earth? Again, no. For one thing, there's nothing left I need or want to do. I've lived a full life, seen and done enough for several lifetimes, contributed (occasionally) to the "greater good" (for all that's worth) and, with the exception of my friends, I increasingly loathe the company of humans. Especially given what they're doing to our Mother Earth, not to mention to each other. Nor am I the slightest bit afraid to die. Indeed, death will actually be something of a relief for me, as I'll be spared the worst that's yet to come.

At the risk of being branded insane, I'm not only unafraid of death, but increasingly intensely interested in it. I often wonder what the process would be like. I've had surgery often enough to know what it's like to slip into unconsciousness: those last few seconds sliding into oblivion have always fascinated me. Thing is, I can only relate the experience in retrospect, after I'm awake again. And that fade back into the real world, slow but intriguingly strange, comes straight on the heels of the trip under. What's most captivating about it, in my imaginings, is what it's like to take that ride down, but not the one back.

To my knowledge, no one has been able to relate this. Those who have "died" and "come back from death" surely must have had the same experience as someone going under general anesthesia: there's no "experience" while you're unconscious, so the trip back to life must therefore immediately follow on the heals of the trip down. Any tales of "seeing angels or a deity" and so forth are relating a delusional period when the brain is right on that threshold, and that's somewhere I've been: I was nearly overcome by paint fumes one day back in my 20s, and it is quite a wild ride down. So that has become my only reference for what death is like: a drug trip you will never remember.

Well, I did warn you this was going to be tough material to take. So if I haven't totally freaked you out yet, then you might just be as curious as I am about all of this. And perhaps you're not afraid of death, either. Good for you. Fear of death is a coward's way to live.

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