An Unconventional Living Will

Her name was Mrs. Carberry, but her readers knew her as Mary Margaret. Two months earlier, she suffered a debilitating stroke that took away her vibrant life. Previously a prolific writer of advice columns and opinion pieces, the blockage of blood to her brain dammed the steady flow of wisdom to her innumerable fans. They never again would benefit from the words of this intelligent, feisty, and self‐proclaimed Cranky Catholic. Unfortunately, I would not know Mary Margaret for her words, but only her numbers: her vital signs, her urine output, her tube feed residuals.

Not able to communicate with us, we wondered did Mrs. Carberry want this tracheostomy that was placed? Did she want this peg tube that fed her continuously? And even if she would have initially agreed to them, would she still want them now? Especially given she was not improving and had little hope for a meaningful recovery.

We posed these difficult questions to her two sons. One son believed that his mother would want an end to these aggressive measures. The other son disagreed; he said his mother would want to make every effort to stay alive.

In the end, Mary Margaret's voice found its way to us and provided us with the answer. She did not tell us in the conventional manner via a lawyer or a living will. Her friends did not come forth and let us know about serious conversations during their afternoon lunches. Instead, Mary Margaret penned it to her audience of devoted readers in a newspaper column written 14 years earlier. Mary Margaret's poignant words were revealed to her doctors by her son who understood its undeniable significance.

Mary Margaret was an essayist in Chicago whose pieces filled many major newspapers and magazines. She had strong opinions on matters large and small, writing articles addressing topics ranging from her Catholic beliefs to gender‐based inequities in the workplace. One article in particular addressed sickness and death and provided her sons the answer they sought. Having witnessed illness strike two loved ones, it was only natural for Mary Margaret to write about it. Her very personal essay was entitled Tough Questions on Life, Death and a Dog Named Bamboo. The words, resurfacing years later, and now having direct meaning to her own life and death, may have been some of the most profound and prophetic words of her career:

Tough Questions on Life, Death and a Dog Named Bamboo

I sat with her that evening while she was dyingrubbing her back, smoothing her head, whispering that I loved her, trying to be of some small comfort as she snuggled closer, looking up with her mysteriously accepting, somehow understanding brown eyes.

Adjusting herself once more, she half rose, then toppled sideways and simply stopped breathing. She died as a lady ought to be able to diequietly, as easily as possible, in her own bed. In my bed actually. She was Bamboo, my Shar‐pei, and it is difficult to write this even several months later without tears starting to roll.

It was not just that last day, of course. For a bit more than a week, Bamboo had been giving signs of a serious problema heavy doggie cough indicating severe congestion and a firm, stubborn decision not to eat. The kitchen offered a parade of small bowls of her favorite people foods with which I hoped to restore her appetite when she determinedly ignored her regular dog food. She had her choice of cottage cheese, scrambled eggs, ground sirloin, cheddar chunks, ice cream, buttered rice and morea virtual buffet for ants.

After I set each dish out, she would go over to look and sniff admiringly, even wag her tail, but then rather reluctantly return to her favorite resting place, a small rug at the top of the stairs to the front door.

She would only drink a lot of water, bowl after bowl, in which she did also get her medicine, mashed and melted. Late on that last afternoon, however she stopped the drinking, too. I couldn't get her to sip even when I brought the water dish to her or offered the ice cubes she once loved to lick. In her own way, she was saying No.

Lately I have been reflecting again on the experience as a result of having heard some discussion about the death of a woman with whom I once shared friendly commuter chitchat as we trained together into the Loop.

Following a stroke, she had been unconscious, vegetative, tragically for almost as long as I had enjoyed the eight years of Bamboo's delightful companionship. Her husband, I learned, had ultimately gone to court and had been granted permission to remove the feeding tube and let nature take its course. A counteraction to prevent this was filed by some well‐intentioned people; but what I believe as good human and legal sense prevailed. So without the tube feeding, this nice long‐suffering woman finally slipped away to God.

People who oppose the dying being released this way argue that they are being starved to death without the feeding tubes. But I don't buy that, especially after having watched Bamboo decide by some deep natural instinct that it was time for her, first, to stop eating even the treats she loved and, finally, to stop drinking while she waited patiently for what was to come, what was inevitable.

There used to be an advertising slogan: It's not nice to fool Mother Nature. If you believe in God and the promise of eternity, perhaps it is equally not nice to fool dying human bodies into a semblance of living when nature is poised to move them beyond the rim of this life. Nature or God, I mean, and absolutely never, of course, a manipulative Dr. Death.

I don't think my puppy was starving those last few days so much as simply stopping. Simply letting herself be folded into an immutable process. At least this is something to ponder in terms of the will of God overwhelming the hopes of man. I am awed and rather apprehensive and yet somehow comfortable with this conclusion.

A couple of months tops with the tubes and no other reasonable hope, I think I'll tell my kids.

Mary Margaret's words struck a cord with both her sons. Her wishes, neatly laid out in a dusty newspaper, were respected. Mary Margaret entered hospice and died peacefully 2 weeks later.

(Tough Questions on Life, Death and a Dog Named Bamboo originally appeared in the The Catholic New World on July 16, 1993. The article was reprinted with their permission.)

Postscript: The author of the essay (my mother) passed away after a week in hospice care and 7 weeks in hospitals following a stroke. She was a published writer for more than 60 years. For her 61st birthday, my brother and I decided to buy her a wrinkly little puppy to keep her company and bark at anyone who came to her house. It ended up being a terrific watchdog as well as my mom's best friend. The last days with her puppy were translated into the essay, which also helped guide me during my mother's final days. My hope is that she and Bamboo are enjoying the promise of eternity in each other's company.

Patrick Carberry

Her name was Mrs. Carberry, but her readers knew her as Mary Margaret. Two months earlier, she suffered a debilitating stroke that took away her vibrant life. Previously a prolific writer of advice columns and opinion pieces, the blockage of blood to her brain dammed the steady flow of wisdom to her innumerable fans. They never again would benefit from the words of this intelligent, feisty, and self‐proclaimed Cranky Catholic. Unfortunately, I would not know Mary Margaret for her words, but only her numbers: her vital signs, her urine output, her tube feed residuals.

Not able to communicate with us, we wondered did Mrs. Carberry want this tracheostomy that was placed? Did she want this peg tube that fed her continuously? And even if she would have initially agreed to them, would she still want them now? Especially given she was not improving and had little hope for a meaningful recovery.

We posed these difficult questions to her two sons. One son believed that his mother would want an end to these aggressive measures. The other son disagreed; he said his mother would want to make every effort to stay alive.

In the end, Mary Margaret's voice found its way to us and provided us with the answer. She did not tell us in the conventional manner via a lawyer or a living will. Her friends did not come forth and let us know about serious conversations during their afternoon lunches. Instead, Mary Margaret penned it to her audience of devoted readers in a newspaper column written 14 years earlier. Mary Margaret's poignant words were revealed to her doctors by her son who understood its undeniable significance.

Mary Margaret was an essayist in Chicago whose pieces filled many major newspapers and magazines. She had strong opinions on matters large and small, writing articles addressing topics ranging from her Catholic beliefs to gender‐based inequities in the workplace. One article in particular addressed sickness and death and provided her sons the answer they sought. Having witnessed illness strike two loved ones, it was only natural for Mary Margaret to write about it. Her very personal essay was entitled Tough Questions on Life, Death and a Dog Named Bamboo. The words, resurfacing years later, and now having direct meaning to her own life and death, may have been some of the most profound and prophetic words of her career:

Tough Questions on Life, Death and a Dog Named Bamboo

I sat with her that evening while she was dyingrubbing her back, smoothing her head, whispering that I loved her, trying to be of some small comfort as she snuggled closer, looking up with her mysteriously accepting, somehow understanding brown eyes.

Adjusting herself once more, she half rose, then toppled sideways and simply stopped breathing. She died as a lady ought to be able to diequietly, as easily as possible, in her own bed. In my bed actually. She was Bamboo, my Shar‐pei, and it is difficult to write this even several months later without tears starting to roll.

It was not just that last day, of course. For a bit more than a week, Bamboo had been giving signs of a serious problema heavy doggie cough indicating severe congestion and a firm, stubborn decision not to eat. The kitchen offered a parade of small bowls of her favorite people foods with which I hoped to restore her appetite when she determinedly ignored her regular dog food. She had her choice of cottage cheese, scrambled eggs, ground sirloin, cheddar chunks, ice cream, buttered rice and morea virtual buffet for ants.

After I set each dish out, she would go over to look and sniff admiringly, even wag her tail, but then rather reluctantly return to her favorite resting place, a small rug at the top of the stairs to the front door.

She would only drink a lot of water, bowl after bowl, in which she did also get her medicine, mashed and melted. Late on that last afternoon, however she stopped the drinking, too. I couldn't get her to sip even when I brought the water dish to her or offered the ice cubes she once loved to lick. In her own way, she was saying No.

Lately I have been reflecting again on the experience as a result of having heard some discussion about the death of a woman with whom I once shared friendly commuter chitchat as we trained together into the Loop.

Following a stroke, she had been unconscious, vegetative, tragically for almost as long as I had enjoyed the eight years of Bamboo's delightful companionship. Her husband, I learned, had ultimately gone to court and had been granted permission to remove the feeding tube and let nature take its course. A counteraction to prevent this was filed by some well‐intentioned people; but what I believe as good human and legal sense prevailed. So without the tube feeding, this nice long‐suffering woman finally slipped away to God.

People who oppose the dying being released this way argue that they are being starved to death without the feeding tubes. But I don't buy that, especially after having watched Bamboo decide by some deep natural instinct that it was time for her, first, to stop eating even the treats she loved and, finally, to stop drinking while she waited patiently for what was to come, what was inevitable.

There used to be an advertising slogan: It's not nice to fool Mother Nature. If you believe in God and the promise of eternity, perhaps it is equally not nice to fool dying human bodies into a semblance of living when nature is poised to move them beyond the rim of this life. Nature or God, I mean, and absolutely never, of course, a manipulative Dr. Death.

I don't think my puppy was starving those last few days so much as simply stopping. Simply letting herself be folded into an immutable process. At least this is something to ponder in terms of the will of God overwhelming the hopes of man. I am awed and rather apprehensive and yet somehow comfortable with this conclusion.

A couple of months tops with the tubes and no other reasonable hope, I think I'll tell my kids.

Mary Margaret's words struck a cord with both her sons. Her wishes, neatly laid out in a dusty newspaper, were respected. Mary Margaret entered hospice and died peacefully 2 weeks later.

(Tough Questions on Life, Death and a Dog Named Bamboo originally appeared in the The Catholic New World on July 16, 1993. The article was reprinted with their permission.)

Postscript: The author of the essay (my mother) passed away after a week in hospice care and 7 weeks in hospitals following a stroke. She was a published writer for more than 60 years. For her 61st birthday, my brother and I decided to buy her a wrinkly little puppy to keep her company and bark at anyone who came to her house. It ended up being a terrific watchdog as well as my mom's best friend. The last days with her puppy were translated into the essay, which also helped guide me during my mother's final days. My hope is that she and Bamboo are enjoying the promise of eternity in each other's company.

Patrick Carberry

Her name was Mrs. Carberry, but her readers knew her as Mary Margaret. Two months earlier, she suffered a debilitating stroke that took away her vibrant life. Previously a prolific writer of advice columns and opinion pieces, the blockage of blood to her brain dammed the steady flow of wisdom to her innumerable fans. They never again would benefit from the words of this intelligent, feisty, and self‐proclaimed Cranky Catholic. Unfortunately, I would not know Mary Margaret for her words, but only her numbers: her vital signs, her urine output, her tube feed residuals.

Not able to communicate with us, we wondered did Mrs. Carberry want this tracheostomy that was placed? Did she want this peg tube that fed her continuously? And even if she would have initially agreed to them, would she still want them now? Especially given she was not improving and had little hope for a meaningful recovery.

We posed these difficult questions to her two sons. One son believed that his mother would want an end to these aggressive measures. The other son disagreed; he said his mother would want to make every effort to stay alive.

In the end, Mary Margaret's voice found its way to us and provided us with the answer. She did not tell us in the conventional manner via a lawyer or a living will. Her friends did not come forth and let us know about serious conversations during their afternoon lunches. Instead, Mary Margaret penned it to her audience of devoted readers in a newspaper column written 14 years earlier. Mary Margaret's poignant words were revealed to her doctors by her son who understood its undeniable significance.

Mary Margaret was an essayist in Chicago whose pieces filled many major newspapers and magazines. She had strong opinions on matters large and small, writing articles addressing topics ranging from her Catholic beliefs to gender‐based inequities in the workplace. One article in particular addressed sickness and death and provided her sons the answer they sought. Having witnessed illness strike two loved ones, it was only natural for Mary Margaret to write about it. Her very personal essay was entitled Tough Questions on Life, Death and a Dog Named Bamboo. The words, resurfacing years later, and now having direct meaning to her own life and death, may have been some of the most profound and prophetic words of her career:

Tough Questions on Life, Death and a Dog Named Bamboo

I sat with her that evening while she was dyingrubbing her back, smoothing her head, whispering that I loved her, trying to be of some small comfort as she snuggled closer, looking up with her mysteriously accepting, somehow understanding brown eyes.

Adjusting herself once more, she half rose, then toppled sideways and simply stopped breathing. She died as a lady ought to be able to diequietly, as easily as possible, in her own bed. In my bed actually. She was Bamboo, my Shar‐pei, and it is difficult to write this even several months later without tears starting to roll.

It was not just that last day, of course. For a bit more than a week, Bamboo had been giving signs of a serious problema heavy doggie cough indicating severe congestion and a firm, stubborn decision not to eat. The kitchen offered a parade of small bowls of her favorite people foods with which I hoped to restore her appetite when she determinedly ignored her regular dog food. She had her choice of cottage cheese, scrambled eggs, ground sirloin, cheddar chunks, ice cream, buttered rice and morea virtual buffet for ants.

After I set each dish out, she would go over to look and sniff admiringly, even wag her tail, but then rather reluctantly return to her favorite resting place, a small rug at the top of the stairs to the front door.

She would only drink a lot of water, bowl after bowl, in which she did also get her medicine, mashed and melted. Late on that last afternoon, however she stopped the drinking, too. I couldn't get her to sip even when I brought the water dish to her or offered the ice cubes she once loved to lick. In her own way, she was saying No.

Lately I have been reflecting again on the experience as a result of having heard some discussion about the death of a woman with whom I once shared friendly commuter chitchat as we trained together into the Loop.

Following a stroke, she had been unconscious, vegetative, tragically for almost as long as I had enjoyed the eight years of Bamboo's delightful companionship. Her husband, I learned, had ultimately gone to court and had been granted permission to remove the feeding tube and let nature take its course. A counteraction to prevent this was filed by some well‐intentioned people; but what I believe as good human and legal sense prevailed. So without the tube feeding, this nice long‐suffering woman finally slipped away to God.

People who oppose the dying being released this way argue that they are being starved to death without the feeding tubes. But I don't buy that, especially after having watched Bamboo decide by some deep natural instinct that it was time for her, first, to stop eating even the treats she loved and, finally, to stop drinking while she waited patiently for what was to come, what was inevitable.

There used to be an advertising slogan: It's not nice to fool Mother Nature. If you believe in God and the promise of eternity, perhaps it is equally not nice to fool dying human bodies into a semblance of living when nature is poised to move them beyond the rim of this life. Nature or God, I mean, and absolutely never, of course, a manipulative Dr. Death.

I don't think my puppy was starving those last few days so much as simply stopping. Simply letting herself be folded into an immutable process. At least this is something to ponder in terms of the will of God overwhelming the hopes of man. I am awed and rather apprehensive and yet somehow comfortable with this conclusion.

A couple of months tops with the tubes and no other reasonable hope, I think I'll tell my kids.

Mary Margaret's words struck a cord with both her sons. Her wishes, neatly laid out in a dusty newspaper, were respected. Mary Margaret entered hospice and died peacefully 2 weeks later.

(Tough Questions on Life, Death and a Dog Named Bamboo originally appeared in the The Catholic New World on July 16, 1993. The article was reprinted with their permission.)

Postscript: The author of the essay (my mother) passed away after a week in hospice care and 7 weeks in hospitals following a stroke. She was a published writer for more than 60 years. For her 61st birthday, my brother and I decided to buy her a wrinkly little puppy to keep her company and bark at anyone who came to her house. It ended up being a terrific watchdog as well as my mom's best friend. The last days with her puppy were translated into the essay, which also helped guide me during my mother's final days. My hope is that she and Bamboo are enjoying the promise of eternity in each other's company.

Patrick Carberry