The Unprepared Death

He was a vigorous seventy-eight-year-old until last November. Then he experienced a fall, and another, and swiftly lost his motor skills. In the space of just a few weeks he quickly went from cane to walker to wheelchair to bed.

My friend can’t turn himself or sit up on his own effort. Two months in bed will do that to a person. He lost his ability to swallow and a feeding tube was implanted. More heart-rending, he lost his ability to speak, to form words, to communicate beyond thumbs up or thumbs down gestures, and grimaces, groans, and tears. He cannot say the rosary aloud. Once it marked his mornings and his evenings, bracketing his days with a comfort a Lutheran (as I then was) would not understand.

His mind is slower, slowing, taking longer to process responses to questions, most of which center on his level of comfort. His frustration is sometimes obvious.

Becoming an Object

When I was an active parish pastor, I watched parishioners — and their families — go through trials of this sort, patience and hope dried to the breaking with one setback following another. What has always struck me most is the loss of personhood. The patient becomes less than him or herself, and becomes an object about which decisions must be made.

It is inevitable, I suppose. “Real” people have volition and will; they can decide and make choices and express their will. But when they become objects, it is we who make the choices. That happens at the beginning of life as well as at the end. Embryos chosen for their stem cells and the elderly leaning into death cannot do that, make choices. They become “other,” no longer of “us.”

Once I remarked on this to the patient herself, a woman locally renowned for a sharp, sarcastic wit. She had undergone amputation of a leg from circulatory troubles. In my judgment it was unnecessary surgery; administer ample pain medications, comfort, and let her go gentle. But surgeons, well, they have their wiles. She was prone, in bed, the family standing around discussing what to do now.

I leaned down to her and said, “They all act like you’re not here.”

“Nothing different about that,” she said. “They always act like that.” She died eight days following surgery.

These deaths are painful. I found them excruciating as a pastor. I hardly ever knew what to say, what I would want said to me. I relied on a prayer book. It sometimes prevented me from saying stupid things.

Deliver Us, Good Lord

I happened once upon a petition from an old, old version of the Great Litany: “From an unprepared and evil death, deliver us good Lord.” I suspect any notion of a “prepared” death has gone out of fashion. Most of us would no longer regard an “unprepared” death as evil. Most of us, my guess, would prefer a sudden, relatively painless death, altogether unexpected and unanticipated. Go to bed one night and wake up dead; hardly a problem.

One can avoid lot of troubles that way. We would not, it comes to me, burden our loved ones with pestering questions around the “end of life” choices they may confront. But it was exactly such choices the Great Litany seemingly demanded.

We may pray only as the psalm has it. “Teach us,” the psalmist begs, “to number our days aright, that we may gain a heart of wisdom.” And then, not unnaturally, the very next verse: “Relent, O Lord! How long will it be? Have compassion on your servants.”


Russell E. Saltzman, a former Lutheran pastor, entered the Catholic Church in 2016. He writes a regular column for First Things and for Aleteia, and was the long-time editor of The Forum Letter. A version of this first appeared on “First Thoughts,” the website of First Things.

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