Terminal

When I was in elementary school, my pediatrician advised my parents that she thought that I might have an illness that required special expertise beyond her own to treat. I was good enough at masking my symptoms, though, that my need for a specialist didn’t become imperative until I was in high school.

This illness has caused me immense suffering – suffering that for long stretches of my life has felt unbearable. I have a chemical deficiency that, if death certificates were filled out more honestly, would be listed as a secondary cause of death for many. I don’t think it would be going too far to call it a terminal illness for some – and you can very seldom tell who the terminal cases are until it is time for a post-mortem.

A member of my extended family told me that I had this illness because I didn’t have enough faith – that clearly I had not prayed about it, or it would no longer be a problem for me. I don’t suppose she would have said that if I had leukemia. Instead, I suffer from chronic depression. It is indeed “all in my head” (or at least mostly in my head) – “but only if by that you mean that your brain is in your head,” as a doctor of mine once put it. “Your head is still a part of your body, you know.”

There are many ways in which chronic depression contributes to the deaths of individuals – depression makes it very difficult to care adequately for one’s body (which can lead to malnutrition, obesity, substance abuse, and more), and makes some sufferers careless and inattentive (which can lead to otherwise avoidable accidents – some fatal.) But the cause of death most linked with depression in most people’s minds is suicide.

Many people who suffer from depression never make a “serious attempt” at ending their lives, but almost anyone who has suffered from depression has, from time to time, seen suicide’s appeal. You see, depression doesn’t just make a person feel sort of vaguely sad. The emotion goes beyond sad — depending on the person and the stage of the illness, it can range from intense bursts of the deepest sadness and alienation you have ever felt, to the inability to feel any kind of pleasure for weeks on end. It can make a person exhausted. It affects a person’s abilities to imprint memories. It can make ordinary activities seem impossible to achieve. It can even make a person’s body ache, physically. And worst of all, it feels like it will never end.

Some people find the right meds, and get better – some of these people get better forever, and others get better for a little while at least. Other people get better without medication at all. Still others go from medication to medication, and from therapist to therapist, with seemingly no end in sight. I cannot imagine how excruciating that must be.

I have been fortunate, after a fashion. Over the years, I have found treatments that have brought me into remission, sometimes for as much as 2 years at a time. Other treatments have taken away the worst of the symptoms, and left me with a low level pain that has allowed me to function for many years at a stretch. And I have lived with the illness long enough to recognize now when I am starting to slide towards the bottom – to go get help for myself before I am so far gone that I need someone else to get help for me.

But this place I am in now – this ability to recognize and manage my illness – is one that took three decades to reach. And I didn’t reach this place on my own – it took a great deal of willing and competent assistance. If, in the first fifteen years of dealing with this illness, a doctor had suggested that it was perfectly acceptable to opt out of intolerable suffering with their help – if, in other words, euthanasia had been offered by a trusted authority figure – by some expert who decided to share with me that some people never find a successful treatment – on a vulnerable enough day, I wonder if I might not have taken them up on it.

Of course, doctors don’t offer suicide as a solution to people with depression. In fact, in the United States, any kind of suicide is essentially illegal in most states, and any person with a mental illness who is judged to be “a danger to themselves” (who is credibly at risk of killing themselves) will be held against their will in a psychiatric facility. They may even be escorted to said facility by a policeman armed (oh irony!) with a deadly weapon. There they will be rehabilitated to the limits of the law and insurance, and released when they feel merely terrible again. This is not a great solution, but it could be much worse.

The Netherlands has had an assisted suicide law in place since 2002. In that country, an individual can go to their doctor and get their help in order to die quickly, painlessly, and reliably. At first this was only available to a person if they were “suffering unbearable pain with no hope for a cure.” Any kind of unbearable, incurable pain, that is, besides the pain that accompanies mental illness. Until they did start including some mental illnesses, as well as dementia. And now they’re looking to extend it to folks who are simply old and feel that they have “completed life.” How much longer until people like me, chronic depression sufferers, are included in the list of people whom it is acceptable for doctors to kill, with the state’s blessing, in the Netherlands? (UPDATE 10/14/2016: So, apparently it is not a question of “how much longer until…?” A friend on Facebook pointed out to me that it is happening already.)

Of course, as a Christian, euthanasia troubles me. From the very beginning, Christians have asserted that every life is of value – beginning with decrying the Roman practice of abandoning unwanted infants to die, and establishing hospitals, for instance. Killing those who do not fit into our plans for a tidy, shiny happy society is unacceptable. Instead, what is called for is increased support, and improved and attentive pain management when all else fails. (Shout out to Hospice – I will be forever grateful for how they helped to manage my father’s last weeks on earth.)

But it is also true that, as someone who has lived a long time under the cloud of depression, euthanasia troubles me. I am profoundly grateful for all of the many people over the years who told me, in one way or another, “No matter how much you may feel that your life is not worthwhile, your life IS worthwhile. No matter how much you may wish to die, I want you to do your best to LIVE.”

At my lowest points, it has been just as helpful (and sometimes even more so) when a person has said, “I totally get that you want to die. After all, you are in a lot of pain. But I’m asking you to wait until next week, and see if it still makes sense to you then.” And so on, from week to week.

Depression is exhausting for the folks who live around it. From time to time, some folks have had to withdraw – have not had the energy to be cheerleaders for life in the midst of the thunderstorm I was letting loose on them. They did what they needed to do to take good care of themselves.

Once or twice, an exasperated individual did lose patience with me and say, “Go ahead and die then, if you’re so set on it.” But never once has anyone (ANYone! Much less my own trusted doctor) said to me, “Not only do I believe that you are miserable, but I believe that you are right to be thinking about ending your life. Let me help you with that!”

Thank God.

I am not one who believes that a person who commits suicide places themselves outside of God’s providential care. God’s love dwarfs any meager emotion I or any other creature can muster. I myself have so much love, and no condemnation, for those who do end up taking their own lives – who cannot find any hope or reason to go on living. Nevertheless, the loss of life in this way grieves me deeply – it is deeply sad anytime a person is stretched beyond their endurance.

But giving doctors the authority to help someone end their own life is dangerous and unconscionable. The longer a person endures their suffering, the more opportunities they are given to find moments of joy and reconciliation in the days that they gain, the more opportunities their community is given to care for them, the more opportunities God is given to speak through that person’s life.

These days, almost 4% of all deaths in the Netherlands are by means of assisted suicide. Who knows how many of these people would have found that they had not yet reached the limits of their endurance, if there had not been so many people willing to release them from a burden that was not yet more than they could bear?

Many thanks to Rev. Kara Slade, who brought The Telegraph’s article on euthanasia in The Netherlands to my attention.

Jesus, remember

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Detail from “Crucifixion with Two Thieves,” by Beato Angelico
Photograph by Asaf Braverman
Ark in Time via photopin cc

The Bible shows us so many ways of praying, so many circumstances under which we might pray. My father used to say, “The most honest prayer in the Bible is when Job told God, ‘God, come down here – I’m angry with you!” (It was years before I learned that God answered that prayer, and not with an apology, either.) But the Bible doesn’t deal in superlatives when it comes to prayer – as in so many other areas, the Biblical witness about prayer is varied. Anger is not absolutely more honest than any other emotion we can express to God – it was the most honest note that my father could sound, and he generalized from his own experience. The Bible can be like a Rorschach that way – we are revealed especially in the details that we notice.

About 10 years ago now, I was doing a unit of CPE, which is to say I was interning as a chaplain, at a state psychiatric hospital. I would pray as I walked between buildings, singing whatever rose up in me. Near the end of my summer there, I noticed that I kept coming back to the Taize chant based on Luke 23:42 – “Jesus, remember me, when you come into your kingdom.”

Why that one? Because it is plaintive sounding, and repetitive, which is comforting when everything seems strange and wrong? Because it is something to ask when I don’t know what to ask – notice me, see me, remember me? No, that didn’t really get at it.

I haven’t been writing lately. I have been ill. What we thought might be pneumonia turned out to be medication withdrawal – which has a much more uncertain course. I have gone six years without feeling so depressed for so long. Many days, it is hard work to simply convince myself that life is not pointless. I am reminded of the terminal nature of this illness.

This morning is a good morning. Better than the new normal, anyway. I was in the shower, and I began to sing – first a song without words that I was composing as I went along, and then, “Jesus, remember me, when you come into your kingdom.” And as I sang it the fourth and fifth and sixth time, my mind was taken back to the cross, and I remembered the one who first prayed this prayer, hanging beside Jesus. A terminal case, wracked with pain and guilt (“we are getting what we deserve”), a man without hope, who reached out to Jesus at a time when faith in him was most absurd, when Jesus seemed least likely to be who he said he was.

This morning, it is the truest note I can sound: I am in pain, and God seems unlikely. That Jesus has not yet come into his kingdom seems self-evident. But I give thanks that I can pray into the not yet, “Jesus, remember me…”

A Blast from the Past

Last month, to celebrate her wedding anniversary, my mom looked through her wedding album. As my own 15th wedding anniversary approaches, I was reminded that my wedding photos are still in a cardboard box in the attic. I can’t remember when I last looked through them. My seven year old daughter has never seen them.

When I was a child, looking at old photos was an exciting event – whether looking through the two photo albums that spanned my preschool years, or munching on popcorn while looking at the many slides that my father took – especially of my parents’ cross country honeymoon roadtrip! Each photo was sorted into its proper place in its albums or carousel, and together they formed a comfortingly familiar narrative.

And so, on a mission to create this narrative for my daughter, I braved the wilds of the attic. Unfortunately, I did not remember that I had long ago put the wedding photos in their own box within a box, helpfully labelled “wedding photos.” So I sorted through envelope after random envelope of photos. And along the way, I found plenty of photos that were decidedly not from the era I was looking for.

I have deactivated my Facebook account, but nonetheless, I set aside a few photos that might be fun for “Throwback Thursday” – some friends at a college Christmas party, my sister preparing stuffed tomatoes in the sweltering railroad kitchen of one of my many not!air-conditioned college apartments, a friend in the prom dress she had made herself… and I stuffed a few photos back in the box, sorry I had seen them: an ex-boyfriend playing guitar while my kitten batted at the guitar strings, myself looking longingly over the edge of a cliff as my first husband smiled widely at the camera on our wedding day, my father looking angrily away from my thoughtfully teary eyed mother sitting beside him at my grandmother’s dining room table… Why did I keep those?

I used to feel like I had the obligation to keep every photo – that the mere fact of me having documented an event bestowed historical significance, and I had the archivist’s duty to maintain this tangible imprint of memory. Now I’m not so sure. Maybe “Throwback Thursday” is a Facebook holiday for people who don’t have an entire decade of their life that was chewed up by mental illness and bad decision making. Maybe us folks who have been tormented by demons of depression or anxiety or bipolar disorder or addiction etc etc should be allowed, on reflection, to toss away those old photographs without guilt feelings.

Naturally I want to toss every photo of me holding a cigarette before my daughter finds them. But mostly I am wanting to get rid of photos for myself. The people in the photos might look happy or hopeful, but each one carries a narrative that only I (and a handful of others) know – not just of my own failed first marriage, but the failed marriages of friends, of abuse and betrayal, of desperate self-deception, of fear and poverty, of broken confidences, of unrequited romantic obsession… all hidden behind those hopeful smiles. These photos lie to everyone but me – and perhaps to me as well.  And then there are the other photos that seem to speak the truth all too clearly, in the emotional dissonance between people made plain on their faces or in their postures. This hindsight is painful – what is plain to me now was not plain enough to me then to save myself and others from participating in their own emotional dismembering.

Re-membering – I don’t simply want to stitch together old memories haphazardly, leaving me with rotting bits reanimated – I do not want to let my fear of death (or forgetting) motivate me as it did Shelley’s Frankenstein. I crave resurrection – a new body, redeemed from sin for new life in Christ. Only God can re-member me correctly. Only God knows who I was and who I am, and only God knows the hearts of those I traveled with.

Even as my chronic anxiety has drawn my focus to a future of worst case scenarios, my depression has trapped me in a false past – a past of exaggerated wrongs and slights and failures, relived like a bad dream that I cannot wake from. Now, after fifteen years of increasing mental health and increasingly happy marriage, these old photos seem like demonic messengers, “assisting” me in returning to my mindset at the time I snapped each photograph. Next time I go into those old photo boxes, I am taking a trash bin with me – and a good friend.