Ducks in a Row

It's stopped snowing, for the moment, though both my cello lesson and my Feldenkrais class have been cancelled-- leaving me a blissfully long day with nothing scheduled. And since I'm nearly two weeks past my last chemo day, I can really enjoy it.

This morning, Robin (my walking partner of (gasp) something like eight years) and I did our first mall walk, ever. It's not just that the cold makes walking outside really unpleasant for me these days, because the chemo makes me very cold-sensitive; but the combination of ice and snow underfoot makes it really pretty hazardous, no matter how young and healthy you might be. So there we were, hiking from Sentry Foods to Sundance theaters and back again, over and over, our take-out coffee and green tea in hand! I'm sure we'll be there again, if this weather keeps up. And why wouldn't it keep up? It's winter in Wisconsin, whatever the calendar says.

I've been thinking about this "Ducks in a Row" post, and anticipating writing it, for a long time. Though I realize you might find yourself less eager to read it than I am to write it-- especially if you're the sort of person who quails at the thought of wills, do not resuscitate orders, and the like. But I long ago-- at least as early as last summer-- decided that this fall I was going to get all my ducks in a row, and then, once they were, I could live another ten years, or ten months, or ten weeks-- whatever-- without worrying about details related to death and dying. Then in mid-September, when I had serious breathing problems (before I started this round of chemo), all the ducks took on a kind of urgency they hadn't before. I decided that once I got everything pretty much in order-- and I figured it would take me most of the fall, which it has-- I would tell people about the process and what was involved, not so much so you know what I've done for myself, but so you can consider what you might want/need to do for yourself. Because (like avoiding treacherous sidewalks), you don't need to be old or ill to pay attention to some of these things.

Like a will. Everyone should have one. In fact, I did have one--but it was written after my divorce, some 20 years ago, when my sons were still minors and I hadn't published a single poem. It needed to be updated. And I needed to decide what would happen to my papers--journals, unpublished poems, the other detritus that crowds my study. People encouraged me to see if the Historical Society would be interested in them. I was skeptical; it seemed the height of hubris to assume that they would be. But they were! So now I'm in the process of refining and signing a letter of intent to donate all this stuff--in the not-so-secret hope that a hundred years from now, some poor grad student in English will be looking for a dissertation topic and will discover me for posterity!

And what the funeral industry calls "pre-arrangement" or "pre-need planning." My father had done this, and it was a great comfort to my sister Susie, his wife, and me after he died to pull out the card in his wallet with the phone number we should call. Although he'd made his plans with (and paid the bill to) a funeral business in Pittsburgh, where he lived, he died in Madison. The person who answered our phone call referred us to a local funeral home, which took care of the details of the plain and simple cremation, just as he desired. Before I called to make an appointment with someone from that same funeral home, I had to talk to the rabbi of our congregation. I wanted to know why, traditionally, Jews oppose cremation, and whether, if I were cremated, she would be willing to conduct the rather non-traditional service that I prefer. Obviously, not everyone chooses (as my father did, and I will) the least expensive, no-frills option. But if you can bring yourself to think about this, and make the choice--believe me, it will save your heirs some difficult moments. Just watch a few episodes of "Six Feet Under" if you need further convincing!

Other "ducks"-- choosing (or in my case, updating) a health care power of attorney and financial power of attorney-- are also things you can and should do, however young and healthy you may be. When my father died, one of the things we learned was how important it is to designate someone to make decisions about your care--according to your wishes--if you are unable to make them. Dr. Norman Fost, the former head of the ethics committee at University of Wisconsin Hospital, says this is even more important than having a living will, which can never cover every possible circumstance. My dad had a living will, which I was proud to be able to find in my safe-deposit box. It clearly stated circumstances under which he did not want to be resuscitated. I brought it to the hospital; as a consequence, I thought he had a DNR (do not resuscitate) order. But he didn't. And he was resuscitated after his heart failed. His brain had been deprived of oxygen for a relatively long time, we were told. It took us a long, difficult day, and a meeting with Dr. Fost, to get the hospital to remove him from life support systems that we--my sisters, his wife, and I--all knew he did not want.

I was telling this story to the social worker in the oncology clinic when I learned that in Wisconsin and seven or eight other states, there's a law that distinguishes between a DNR order that's effective in the hospital, and one that an EMT has to honor, if someone calls 911. So one of my ducks--really the most difficult for me, emotionally--was to get a non-hospital DNR order. This isn't something everyone would want. But I do. As one of my oncologists said, even if someone with advanced cancer is resuscitated successfully, the consequences are not so pretty. So now I wear a silver bracelet that should alert any EMT to my wishes.

I also contacted hospice to learn about their services-- and talked to my oncologist to see if it was time to be admitted to hospice, which it isn't. (Medicare puts you on a different track if you're a hospice patient, and they wouldn't pay for my very expensive chemotherapy if I were receiving hospice services.)

And finally--and this turns out to be the "fun duck"--I'm doing an inventory of every room in my house. On the advice of my attorney, I'm making a list of specific items that go to specific people. But I'm also writing down the provenance of certain items--who made what piece of artwork, or gave me certain pieces of jewelry, or where I bought the obi that decorates my bedroom window. (Duh, Japan, of course.) I'm not much of a materialist, and I don't have as many "things" as a lot of people, but it really is fun to think about the objects that surround me in terms of when and where and how they entered my life.

OK, enough said. Or written. Time to go live life-- or at least have supper!