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Confronting mortality is essential: A local man makes the most of his final days

Editor’s note: Henry Wilmer, 69, of Lincoln, is a retired school teacher and former member of the Lincoln School Board. He offered this insight into the dying process.
Ashby gave me cancer in 1962. She was the first girl to show any carnal interest in me. She was also a smoker, so I took it up, too. I wanted to look cool, and friends had warned that, unless you smoked yourself, kissing a smoker was like licking an ashtray. Even after this relationship cooled, rather quickly as it turned out — I wasn’t that interesting, carnally or otherwise — my desire to smoke burned on. I believed, albeit subconsciously, that I was immortal, a common affliction among the young. Add a touch of adolescent rebellion and a not-yet fully developed frontal cortex, and this particular teenager began a 5-year smoking career: Two packs a day during the last three when I consumed endless unfiltered, self-rolled, black tobacco cigarettes that looked like joints.
I finally quit the day I got married. My future stepfather-in-law (it’s complicated) had clipped two $100 bills to the refrigerator. He explained that my future wife and I could each have one, if we quit smoking before we got married. (Smokers often marry smokers, perhaps due to the ashtray effect or just some sort of unconscious behavioral synchronicity.) I had my last cigarette in the acolyte’s room just off the apse, then opened the door, and strode directly to the altar as my bride began to walk down the aisle. The total of $200 might not sound like much today, but in 1968, it was a significant sum, the equivalent of $1,300 today — much needed for kids right out of college who would be starting their first ever year-round jobs the following Monday.
The day we started those jobs, I returned to sports and began running longer and longer distances. Soon I was as addicted to exercise as I had been to smoking. Hooked on endorphins and a new self-image, I ran and then later rode and raced bicycles, not because I wanted to, but because I had to. Nevertheless, I was healthy, and later in life I saw cycling as my key to an active old age.
Now it’s 2014, a perfect time to have cancer: I am retired, more in love than ever with my wife, proud of my children and grandchildren, comfortable in a secluded mountain home with streams and mountains all around, wealthy enough to cover needs and even indulge some whims. I now have no long-term responsibilities, I don’t sweat the small stuff, I eat all manner of evil foods, I watch endless sports, I sleep late, I ride my new motorcycle, and I’ve traveled to the Caribbean and visited family in North Carolina. I am doing all I can to prevent the future poisoning the present.
Nonetheless, the future looms. As it shortens and chemo takes its toll, I can envision death as a welcome escape from a long and painful decline spent as a skeletal vestige of my former self, mentally absent, flat-eyed or in fitful sleep.
Amelia explained that it doesn’t have to be that way. She and her team from palliative care at Dartmouth Hitchcock Medical Center can see me through to a comfortable exit of my choosing. As we discussed end-of-life options, Amelia did not seem to fit Sarah Palin’s description as a member of a “death panel,” an assemblage of bureaucrats who “decide, based on a subjective judgment of [a patient’s] ‘level of productivity in society,’ whether they (sic) are worthy of health care.”
Despite the support of mainstreamers who should have known better, like Speaker John Boehner, former speaker Newt Gingrich, and Sen. Charles Grassley, Ms. Palin’s comments seemed… whacky! The provision for “end-of-life counseling,” which Republicans had demonized as “government-sponsored euthanasia” and duly stripped from the Affordable Care Act, was exactly what I needed. All my fearful fretting was born of uninformed speculation about my foreshortened future.
I am actually fortunate to have a “death panel,” an advisory council consisting of my oncologist and teams of palliative care and hospice professionals. They don’t deny medical care because I am terminally ill and at a low “level of productivity,” nor do they suggest I do everyone a favor and just check out. These caregivers help me navigate the uncharted mental and emotional landscape ahead. My inner control freak wants to know how and how fast I will die, what palliative care and hospice can do to ease my final weeks and days, and how these professionals could arrange support for my spouse, who has been my principal caregiver since this journey began.
To the great frustration of this particular Type A, my caregivers remind the more rational me that uncertainty is a part of dying, just as it is part of living. Nonetheless, they describe some likely scenarios leading up to my death and the care I might need along the way; we also address the medical interventions I do not want, like intubation, resuscitation, and other measures that would merely keep me alive in name only. So, maybe the end will not be so bad after all, though I will reserve as Plan B Vermont’s Act 39, the right to die with medical assistance.
Fortunately for me, end-of-life counseling is available as part of the comprehensive care I have received at Dartmouth-Hitchcock. For others, insurance may not cover such services, thanks to Ms. Palin and her followers.
In the end, the lessons are simple:
1.  Smoking is bad.
2.  “Death panels” are good.
3.  Those who sow fear and anger threaten rational decision-making in public policy.

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