Columns Jeffrey Weiss: My Way to the Egress Opinion

Why considering ‘not to be’ makes me smile

(RNS) Not long ago, I had a conversation with a friend who is struggling with a different set of medical problems. Maybe they’re treatable and maybe not.

At one point in our kibitzing, he went through the possibility of losing his quality of life and becoming a burden to his family and those who love him. If that happened, he said, he’d check out. His consideration of suicide came across as depressing to him.

I told him that the possibility of my eventual checkout actually cheers me up. The conversation reminded me of how I first came to a direct feeling like that: a wonderful book by Walker Percy, “Lost in the Cosmos: The Last Self-Help Book.”

My medical issue is not trivial. I’m more than six months into a diagnosis of glioblastoma, a brain cancer. The median survival is about 15 months. I may last somewhat longer and I may not. At the moment, though, my quality of life remains pretty good.

Fatigue? Yep.

Short-term memory issues? Yep.

Some struggle remembering words? Yep?

Loss of some physical strength? Yep.

Short-term memory issues? Heh.

I’m on chemo and a hefty cocktail of prescription and nonprescription pills recommended by my expert and aggressive neuro-oncologist. I have no idea how much help any of it will offer.

But at the moment, I’m still capable of doing many things I find satisfying.

And this is an unusual fatal illness: Many people who are diagnosed stay in reasonably good shape until shortly before they hit their Egress. So I could remain in a mentally strong condition, without pain, until it’s clear that my path is near its end. In that case, I intend to consider not waiting for the suffering. Like my friend said he’s thought about, I intend to flip my own “off” switch.

But that possibility is the opposite of depressing, for me.

Percy was a Southern Catholic who wrote fiction and nonfiction. His first novel, “The Moviegoer,” won the National Book Award in 1962. He died in 1990 and the New York Times obit said, “Mr. Percy, who grew up in Alabama and Mississippi, said his favorite theme was ‘the dislocation of man in the modern age.’”

“Lost in the Cosmos: The Last Self-Help Book” by Walker Percy. Image courtesy of Creative Commons

Percy converted to Catholicism before he became a writer. And he followed the Catholic teaching that opposes suicide. He died of cancer without pushing the timing.

Published in 1983, “Lost in the Cosmos” folds dark humor and satire with serious questions about where we should sit, intellectually and spiritually, in the cosmos.

What should we do? How should we decide? Are there choices that are inevitable?

The book is, no kidding, a fun read if you have any interest in the topics he approaches — a great ride with many more questions than answers.

One section starts with this:

“Thought Experiment: A new cure for depression: The only cure for depression is suicide. This is not meant as a bad joke but as the serious proposal of suicide as a valid option. Unless the option is entertained seriously, its therapeutic value is lost. No threat is credible unless the threatener means it.”

His personal bottom line is that he’s opposed to suicide for himself. But for others? A potential bonanza.

“Now notice that as soon as suicide is taken as a serious alternative, a curious thing happens. To be or not to be becomes a true choice, where before you were stuck with to be.”

Stuck with “to be” means stuck with however much suffering there will be until the unavoidable end. Having the choice means you get to decide how much suffering will be acceptable.

As I told my friend, thinking about that now is not signing a contract with Satan, where you will have no choice at the end. If the level of suffering I fear now turns out not to be as bad as I’d feared, then I need not check out as early as I have considered.

Maybe I’ll end up with an all-natural path? That will be up to me.

Percy ends this section with a description I’ve never forgotten and it’s helped me subconsciously every day since last December when my surgeon told me what he’d pulled out of my head.

Here’s how Percy compares those who have and have not considered controlling their exit:

“The non-suicide is a little traveling suck of care, sucking care with him from the past and being sucked toward care in the future. His breath is high in his chest.

“The ex-suicide opens his front door, sits down on the steps, and laughs. Since he has the option of being dead, he has nothing to lose by being alive. It is good to be alive. He goes to work because he doesn’t have to.”

It is good for me to be alive. I’ll stick with it smiling, inshallah, as long as that’s true.

(Jeffrey Weiss writes the RNS column “My Way to the Egress”)

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  • With the advances in pain management, you probably will never, ever need to use that as an excuse to ask someone to murder you. You, believe it or not, are valuable to someone until you take your last breath. No only will you be endorsing by your actions, killing people the state feels are unnecessary, you are depriving yourself of the love of your family at your side, and the help they will receive in allowing you to die and not be murdered by someone who has convinced you that you are a burden, or a quick way to save someone else’s tax money.
    You have worth and value.
    Canada, at present, is trying to decide whether mentally ill people should be “euthanized”. I’m not sure what they have decided with teenagers.
    You, if allowing this travesty, will be an unspoken endorsement for when seniors get too ill, or too old, to “euthanize” (murder) them to save precious tax dollars. Don’t laugh. No one ever believed precious mentally ill people would be in the running either.

  • Nope. I’m far less worried about simple pain than I am loss of sight, hearing, ability to speak, to understand others speaking, etc etc etc. What the power of the brain does. And I’m not necessarily going to need to get help exiting. It’s not murder, in any case, from my POV. You don’t want the option? Fine by me. But I do object to you wanting to limit my choices.

  • The reason I would limit your choices, and would if I could, is because I spent 6 years loving a sister as she died. She, with all that she went through – blood transfusions every few days – the whole nine yards…..she was worth loving and caring for. So are you. There is more to your life than your pride.
    There are people who love and cherish you and a look from you – even if you couldn’t speak, or understand, is worth more than anything else. Just to hear you breathe and rest their head against you is worth more than you could imagine. You aren’t doing anyone any favours – including yourself.

  • Sorry, but your comment conveniently ignores the point about choosing or not choosing one’s end. Murder and (involuntary) euthanasia are not chosen by the dying. That would seem to be the very definition of murder.

    It’s true a dying person’s (possible) mental illness (or drugged state) does complicate the issue of a free, rational choice. But then, mental illness complicates any question of choice or judging anyone, even ourselves. The argument has often been made that any one who chooses to die automatically qualifies as mentally ill. The counter-argument goes that anyone who’d force another to prolong his or her suffering is being cruel, whatever the high-minded motivation.

    Here, I don’t detect any sense of depression or dementia in what Jeffrey’s written. Neither is he desperate. In fact, that would seem to be the whole point of the column. He is eminently clear-headed, even relieved. Having differed with Jeffrey before on issues, I’ve often suspected this has all been a carefully crafted illusion to make his arguments more persuasive than they actually are. But in this case, that would only be further proof of his coherence. He can make a convincing argument. Ergo, he’s condemned to being reasonable.

  • Except today, there is no pain suffering. If the suffering you are concerned about is only for yourself, that’s a bit selfish. Murder me because I don’t want to be a burden, is pure BS.
    One is not clear headed when asking to be killed. Euthanasia is murder.
    It deprives those that love that person the most, the last minutes that God is willing to give them with that person and that is selfish to take any of that from them.
    Convincing someone they are a burden is heartless, and murder, period.

  • If she chose to last as long as possible, I applaud it. In my case, I hold somewhat different personal standards. Every possible moment does not necessarily hold value. For me. I’m not considering out of ignorance. Nor, as I pointed out, am I claiming my current opinion on where I’ll choose the exit won’t be open to change.

  • Jeffrey, I will again, pray for you concerning this matter. I’ve been privileged to have been with my mother, and sister until the Lord chose to take them home and would not have given up one minute of that time. Think about how many times they will wish they could have had ten more minutes with you, to to look into your eyes one more time, before you make that decision. You are worth something, no matter what condition you are in.

  • I’m sorry, Ms. Luckins, but you’re not actually refuting my points or countering them – you’re mostly insisting and repeating your beliefs. My father spent years dying of Alzheimer’s, complicated by prostate cancer, and I can assure you there certainly was pain, not only his but his family’s. And if ever I am in his state and can still think and act rationally, I would be painfully aware of the suffering I was causing.

    Don’t get me wrong. I don’t begrudge my father a moment of his life, I wish I could have done more to help him and wouldn’t want him to choose death just to ease his family’s burden. But that would be his choice. As I would hope it could be mine. You keep talking about asking someone else to ‘murder’ you. Murder, once again, is acting against someone else’s choice, it deprives a person of choice. I have signed a medical power of attorney document indicating to my survivors and doctors what I would prefer in the event that I’ve completely lost reason or consciousness – and I’m granting them the legal authority to act for me. While still healthy, conscious and marginally rational, I’ve been able to make that choice now. Whether they fulfill my wishes or not, well, that would be their choice as well.

  • I have never loved someone so much, I wished them dead.
    People are valuable enough that I want every last minute with them – at some point, I think everyone realizes they are being loved.
    Murder is murder.

  • Let me ask the always-unspoken question that accompanies Jeffrey Weiss’ articles.

    Three seconds after you die (whether naturally or — God forbid — via suicide), what will happen to you?

    According to the Bible, your soul will still be alive, you’ll be still conscious and aware of your surroundings, just like you are now. You can still talk, think, feel. And actually see and hear God plainly, and experience God’s judgment.

    “Just as people are destined to die once, and after that to face judgment.” (Heb. 9:27)

    So is your “Egress” going to be like that beautiful drawing at the top of the article, all pretty and pastoral and serene and heavenly — or will your “Egress” be, well, umm, not so much??

  • If you literally believe any sacred text from any religion, you have specific guidance you are likely to follow. I ain’t there.

  • Serious question: What if your loved one looks at you and communicates that s/he is ready for the exit? Would you assume that is mental illness? (I suspect that your close family members likely would not get to that point, if they share your faith and values. Which I am not challenging.)

  • I would cry until they changed their mind. I would cry for anyone who felt they lacked that much value.

  • I think most of us who have followed your journey thus far realize that, but it can’t hurt to seriously, and I mean seriously, consider every potentiality that awaits you on the other side. I believe that’s floydlee’s point. It’s sort of like Pascal’s Wager with a very important side bet.

  • If nothing else, though I’m concerned about your lack of curiosity with respect to the afterlife and what it may hold for you, good or ill, I thank and congratulate you for your willingness to engage those who have chosen to comment. That is a rare gift.

  • Not to be pedantic (but then again maybe so), I’m fairly certain that I’ve heard suicide defined subjectively as “self-murder.” My own definition describes suicide thus: “The Nexus of physical courage and moral cowardice.” As one who has often struggled with suicidal thoughts absent physical maladies, I am not un-empathetic.

  • Indeed, Edward has summarized and explained my post better and more concisely.

    Sincere thanks to both Jeffrey Weiss, and Edward B, for their responses.

  • I’ve always raised an eyebrow at Pascal’s Wager as a Christian argument. Just for conversation, imagine this: A Christian who went that direction because of Pascal’s suggestion dies. Turns out the deity is more like Adonai or Allah or Brahma or, heck, Zeus. And s/he says “Why did you go for such a dumb religion as Christianity? Because of that, you’ll be forced to live in Eternal Suburbs instead of a Celestial Penthouse.” What makes that a less logical possibility than the Pascalian claim that the Jesus thing is worth going for to avoid the risk of failure after death? But again, I’m not knocking others who make their own religion-specific call in a situation like mine.

  • Which means you refuse to accept the POV taken by others in this regard, even if you love them. That is because you believe you personally are following God’s eternal truths, yes? I’m not saying you should not stick with what you want. I am suggesting that others respectfully disagree.

  • Life is a gift from the Lord, Jeffrey. (edit)
    Yes, I would cry for anyone who held no value for themselves and wished to die having convinced themselves they are a burden to their family, or been convinced. We have value. We have worth.
    With my mom, it was that I could lay my head on her stomach and feel her breathing – something I didn’t receive from her in life. It is a period that allows for wounds to be healed, people to make amends, and to learn that one is loved, even if they cannot fight back.
    I cannot accept anyone’s point of view that they are worthless.
    God bless you.

  • Well some visions of the afterlife do not encompass the concept of Hell, so if they are correct, one would still be ahead of the game. But if the New Testament model is correct, the consequences of wagering incorrectly are dire. Based on my own (non-scholarly) studies of various world religions and non-religion, I’m wagering that Christianity is the most coherent and rational as a system, and I believe that Pascal, a brilliant mathematician, took the same view. And I only mention as an aside, that the evidence is compelling to me, even as to you it’s evidently non-existent. I merely suggest in as kind a way as I can that you continue to evaluate its merits even as you might have to wrestle with it culturally and intellectually.

  • Um, just because it’s been called ‘self-murder’ doesn’t make it so. It could just as easily be defined as ‘letting go of suffering.’ A more Buddhist perspective, perhaps, which sees all life as a form of suffering. As for the question of ‘moral cowardice,’ enduring years of pain and expense and indignities may indeed take a form of strength and endurance, providing you’re not bankrupting your family so you can express all that moral courage. Or increasing health insurance for the rest of us by having doctors and hospitals go to extraordinary lengths to keep you alive. But I don’t necessarily see that as any more ‘brave’ than choosing to obliterate yourself and everything you know or remember, everything you are … basically, you know, you.

  • Emphasizing the increasing costs “for the rest of us” is the worst and scariest point you can make. My arguments about suicide are framed less about those in a particular health category, but about the creeping encroachment of arguments advocating suicide on its own “merit.”

  • Edward, my husband firmly believes that in Canada, they will soon be “euthanizing” (murdering) infirm, elderly and that will trickle down to just plain seniors over time. I tend to agree with him.
    They’ll use the excuse of tax money, or whatever else they can, that they think the public will accept.
    As I stated earlier, they are contemplating mentally ill people at this point in time. The whole issue is extremely sad.

  • I’ve no doubt that the “rationalists” are thinking just that way. A notorious member of that community is Peter Singer, a so called “ethicist” at Princeton University.

  • I was a full time religion reporter for more than a decade and off-and-on for several years. I’ve written about many faith traditions. From Baptist to Brama Kumari. In every case– Jewish, Buddhist, Catholic, LDS, etc etc etc — I met people who explained how their faith’s theology had carried them over doubt and into happiness and satisfaction with their lives and their prospects of eternity. All sincere. All worthwhile to them. I also know some folks outside any tradition with a similar and apparently valid claim about the effects of their beliefs — or non-beliefs — on them. May they all have taken their best paths to their Egresses!

  • Let me offer one other item, from my own interfaith dialogues. (Folks from Judaism, Islam, JW’s, Unitarians, LDS, Buddhists, gay MCC, etc.)

    I’ve noticed that all of our sincere (and interesting) truth claims, our “best paths to the Egress”, can’t all be true at the same time. They negate each other at non-negotiable points. So somebody is taking the wrong path to the Egress.

    (And if Hebrews 9:27 is even remotely possible, then the Egress is the one place in the universe where NO human can afford to get it wrong.)

    “Satisfaction”? Well, maybe. (Sometimes the atheists get a little shaky, but oh well.) But everybody quietly talks like they understand this situation.

    So I’ll just stop there. “Multitudes, multitudes in the valley of decision! For the day of the LORD is near, in the valley of decision.” (Joel 3:14)

  • I totally agree they can’t all be right. But there’s no logical way to determine who is wrong. Depends on faith. Which people choose based on different factors. Who is right? Only way to find out for sure is the Egress.

  • I have extensive experience with this so called “burden on family” attitude when a member become physically unable to take care of themselves. Please understand that this burden is also a BLESSING and a source in which family can experience the most deeply felt love for the sufferer, as well as become intimate with God.

    When I was 19, my father had a brain aneurysm in which he was operated on but hemorrhaged afterwards which left him physically, mentally incapable to take care of himself. He could not be left alone,ever, but we as a family took care of him at home for 20+ years. It was beyond devastating when it happened, but I still got to be with my father, watch movies, sports, laugh, cry, have a relationship. I still miss him even in his disability.

    My oldest brother would develop liver cancer at 38yo. We went for treatments three times a week and I saw him turn into a skeleton except for his bloated liver. We went through hospice for two years giving us the support he and the rest of us needed. When he went into a coma shortly before he died, my mother and I were there to care for him at home, provide needed pain medication, and when he passed at 41 we mourned. It was after his death that I was able to look back and see the blessings, see where God was during this time, and know that all was done for him. This experience while difficult I would not change, nor did I ever wish he would just die to save us, US, from taking care of him. My father would go through hospice two years later, and I was there at the end as well.

    Do not think that hastening ones death will “save” family from a “burden”, because there is a life affirming, profound moments of true love and sacrifice that will actually be a comfort when the time comes naturally. You are their father, they want to show you their love and commitment to you. They want to help you in any small way they can, and allowing them to walk with you through this not only brings them closer to you but to each other that will last a life time. When they remember those last days they will know you got the best care, that you felt their love, there will be no regrets, no I hope he know I loved him, no I could have done more/better. They will be walking with God, praying to Him, feeling His love and security, learning that love is what this life is about and how can anyone be a burden when you love them. Don’t believe that ending it on your terms saves your family any heartache in the end.

  • Allow me to put in a plug for one of my extracurricular specialties: the end-of-life advanced care directive. If the question is choice, as Jeffrey Weiss has so skillfully written, then the best way to exercise that choice is to put down in writing one’s wishes regarding a path to the Egress.

    As a trained advanced care planner and certified spiritual director, I have counseled and taught many on the options available. Many, if not most, physicians and hospitals now offer this in terms of what medical care to give patients with terminal illness. However, an EOL advanced directive can encompass so much more, including the options described here. For information, I suggest starting at the National Institute on Aging, part of the National Institutes of Health. https://www.nia.nih.gov/health/publication/end-life-helping-comfort-and-care/planning-end-life-care-decisions#information

    As to what my friend and colleague Jeff discusses here, I remain conflicted about the choice. I don’t have the courage to end my own life actively, but I won’t allow any extraordinary procedures to obstruct my death. At the same time, I know that my choice isn’t that of everyone, and so if I wish to have a choice, I must allow the same choice for others, even when it offends my personal faith and ethics.

    A final personal note: As a COPD sufferer, my mother thought she had prepared well for her end of life. Her wishes were clear: she didn’t want to be in pain and she didn’t want to be hooked up to machines. Unfortunately, she failed to execute the one legal document that would have made her final wishes possible: an Out-of-Hospital Do Not Resuscitate Order. Consequently, the paramedics who attended her COPD collapse were required by law to revive her, which they did 20 minutes after she stopped breathing. So she failed to achieve her final path to the Egress; she wasn’t in pain, but she was attached to machines for three days after she, in effect, had died. So if you wish to control your way to the Egress, please be sure to touch all the legal bases.

  • I 100% support you making your own choices about how you feel about this. I will note only that we are all mortal. Every ending has its potential price to survivors. Leaving a little sooner may not increase that price. But it’s your call for your choice!!

  • Thank you for reading my comment. I will hold you and your family in my prayers during this very difficult time for all whatever choice you make. May you and your family find peace, love, healing in the times ahead.

  • Of course, it’s the worst and scariest. It’s the slippery slope toward ridding ourselves of people who are simply inconvenient. The primary reason I made it was to indicate that deciding to go ahead ‘bravely’ with one’s pain and deteriorating mental and physical states instead of taking the ‘cowardly’ way out – as you see these choices – has its costs as well. That choice does not occur in a vacuum.

  • to continue “Worth allowing them to consider their own choices, of whether they are a burden and should be allowed to live.” We are all valuable – if only in God’s eyes. He knows when He wants us to come home.

  • very true, Jeffrey….my desire is that they get over that and begin a journey to Heaven. I appreciate you speaking with us though.

  • I use the term advisedly, but from a philosophical perspective it means one who purportedly arrives at all his/her conclusions using a “rational” thought process. To some “Rationalists,” this precludes any consideration of the spiritual, or the existence of God, because (they argue) God can not be proved “rationally.” Extreme rationalists generally tend towards atheism. On the issue of life, some who deem themselves “rational” are prepared to support social policies that they believe will lead to the collective “good” of humanity, and the individual be damned. Rationalists often come from privileged backgrounds, lacking sympathy and empathy for their fellows because Rationalists believe themselves to be superior beings quite often. Of course that charge is made quite often about Christians as well. Certainly Karl Marx fits the textbook definition of a rationalist. Pardon me as I strap on my helmet and wait for the brickbats to come flying in.

  • Not at all, I took it as an honest query, perhaps I overthought the question.

  • Jeffrey… I noticed that you’ve not mentioned Ken Wilber’s “Future Spirituality: why it must be Integral”. Not advocating that you do — its a bit above my pay grade but I can follow his intent if its in an audible format — reading him is impossible for me.
    He’s more of the yes/and school rather than a yes/but! Ken Wilber he has mitochondrial something so his egress comes with expiration dates and he’s also accompanied his wife transitus… so his got standing in the topic.
    Would appreciate your thoughts on his ponderings, as you have more conscious skin in the game than I do.
    amen

  • “The quality of my eternity will not be put to a popular vote”… it was a gift of a thought and one that keeps counsel with my heart.

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