Mr. K had been sick for a long time. Although he had dementia and thought Nixon was president, he did remember that he has had Multiple Myeloma for 14 years. That is a long time for a disease where the average life expectancy is 3-4 years.  Few people live more than 5 years.

We had tried to call his surrogate decision-maker, his sister, but there was no answer at her home. Over the next few days, we reached Mr. K’s nephew who told us that his mother, Mr. K’s sister, had died just that week. He knew that Mr. K was sick and he agreed to a DNAR order but asked us to try to turn things around since there had been too much death in the family in these last few days.

I tried to call the nephew to let him know that his uncle was much worse and we needed to transfer him to the palliative care unit. We could get no answer on the phone. Later that morning we got word that he had had a flat tire on the way and had to turn back but he would be on his way soon. Mr. K did not wait but died in the early afternoon.  When the nephew finally made it, the nurses stopped him at the station.  I brought him to my office and told him his uncle had died about an hour earlier. He seemed stunned with too much death but said he knew that his uncle had been sick a long time. I asked him if he wanted to come into the room to see his uncle’s body, but he seemed unsure as I walked him to the door.

Usually, it is the women of the family that come to the bedside. They shed tears, kiss the forehead, and stroke the hands gently. However, surprisingly, the nephew spoke warmly to his uncle.  He firmly and friendly punched his uncle’s upper arm and vigorously rubbed his forearm.  He kept his arm between him and his uncle as he reached over in a clumsy embrace. This seemed to be the way men often greet each other. He told Mr. K that he was now in heaven with his sister, parents and other family members.  Quickly now, the nephew was ready to leave. It was time to go and make “the arrangements” for the body. I wondered what he would choose.

Lately, I have been reading Wendell Berry, who has been writing about rural Kentucky for more than 70 years. In the past, he has been called a Luddite but now seems prescient if not prophetic in his skepticism of the superiority of the new ways.

Testament

Wendell Berry

3.

 So  treat me, even dead,

As a man who has a place

To go, something to do,

Don’t muck my face

With wax and powder and rouge

 As one would prettify

An unalterable fact

To give bitterness the lie.

Admit the native earth

My body is and will be,

Admit the freedom and

Its changeability.

Dress me in clothes

I wore in the day’s round.

Lay me in a wooden box.

           Put the box in the ground.

4.

      Beneath this stone a Berry is planted

     In his homeland, as he wanted.

I have long said that I did not want to be embalmed or put on display. Cremation seemed a better way.  Cremation though is not the way of my people. It would be more consistent with my heritage to be buried without toxic chemicals, wrapped in a cloth or simple box deep in the ground where I would join the generations that came before. I wonder if they even allow this now; to be buried simply in the ground?  I have not told my family of these thoughts.  I suppose I should but I would not want to make things hard, to ask for special care of the dead body when I have struggled so long to change the way we care for the living body.