by Jacob Dahlke, Bioethics Program Alum (MSBioethics 2012)
Our society tends to put on pedestals the celebrities among us, particular upon their deaths. For author Oliver Sacks, it is no different except that he is not yet dead. He did, however, recently announce in the New York Times that metastasized tumors were found in his body. His diagnosis is terminal in the near future. There is an ease and confidence with which he declares, “It is up to me now to choose how to live out the months that remain to me”. These are not the words of a man who plans to rage against the dying of the light, he simply plans to confront (as Hume did) the difficulty “to be more detached from life than I am at present.”
We could certainly expect – from his own energetic accounts – Dr. Sacks to plunge aggressively into treatment. He describes himself in the NY Times piece with powerful, vivid words, a “man of vehement disposition, with violent enthusiasms, and extreme immoderation in all (his) passions.” One might presume that such a person, when faced with the prospect of a terminal illness such as Dr. Sacks’, he would opt for Thomas’ strategy. And yet, when given the opportunity to consider his path, he has chosen differently. Dr. Sacks decided to forgo aggressive treatments – choosing the quality of his life over its quantity. His path is not the one less traveled, but rather one recently reflected in the perspectives of healthcare providers and patient alike.
What is so striking about Dr. Sacks’ writing, then, is how he elucidates the transition from a life with one set of goals and purposes to another set, with goals and purposes all their own. People outside the shadow of a terminal illness may see this transition as a loss of will to live out their remaining days – hence the outcry over such stories as Brittany Maynard, or of the recent news in Canada about assisted suicide. But Dr. Sacks cut through such presumptions with surgical precision: “This is not indifference but detachment.” It is not a loss of the will to live, but instead a loss of the will to live as before. It’s not that issues like global warming are no longer important; they’re just not important to him individually anymore.
It is as though Dr. Sacks’ life as a public figure is a sort of hat. Something worn, but not entirely revealing. And now that he is nearing home, his hat has become less useful. It is, perhaps, time to take his hat off.
I am not sure we will hear much more, if anything, from Dr. Sacks from now until his death in the coming months. He decided to focus on those close in his life, and that is certainly to be respected and praised. But Oliver Sacks’ potential withdrawal from the public sphere is a loss for our society as a whole. It remains difficult to translate the thinking about end of life decisions well, and his experience and skill, his work does that with such clarity.
His accomplishments are many, but for health care professionals whose patients approach death’s door, this short piece will be perhaps the most useful. These health care professionals themselves wear many hats, and, increasingly, one of these pushes patients, families, and the public to confront what it means for their light to fade. Of course, they may choose to fight to the very end. But the brutal honesty of Olivers Sacks’ reflections opens a space for these patients to say (and for their families to hear) that they, like Dr. Sacks, have decided not to rage. Instead, they have chosen to look back and say: “Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.”