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Ronald's story

Ronald was vulnerable because he couldn’t marshal the resources he needed.

By every objective standard, Ronald was a powerful man. An Order of Canada honoree and corporate CEO, he was widely respected in business and philanthropic communities. He lived comfortably and with privilege in a large and beautiful rural home on a large acreage with extensive gardens which were a source of great pride and loving and perpetual labour.

Ronald died of cancer in 2007. He retained his faculties and was fully competent until the end of his life. His pain was severe but intermittent, and managed with fast-acting morphine. A few months before his death, when it became apparent that he was no longer able to manage all of his physical self-care, he was admitted to the local hospital. I was told that the decision was his, and I have no reason to believe otherwise. I do not believe that he protested at all.

When I arrived at the hospital, and encountered him alone in a room at the end of a long corridor, I was horrified. The room was dim and depressing, with one very small window, too high to see out of. The contrast between this room, and the vibrant colours, gorgeous light and breathtaking views of my Ronald’s home, was unbearable.

Ronald‘s physician, a rural family doctor, confirmed that there was no medical reason for him to remain in hospital, if arrangements could be made for appropriate care at home. With his full agreement, we quickly made those arrangements. We hired private caregivers and obtained a scooter so that Ronald could continue to enjoy full access to his beloved gardens (and, incidentally, to plan for next year’s garden). He lived for two more months, during which he spent at least three hours outdoors every single day until the day before his death. He died comfortably, in his own home.

The dingy hospital room had been a place of surrender. It was a place to die. What shocked me to the core from my father’s end-of-life experience is that such a powerful and affluent man, once afflicted with some measure of physical incapacity, had utterly relinquished command of his life. It was a momentary relinquishment, as we soon learned. Once back at home, he took charge again, with his characteristic cheerful confidence directing which belt should be worn with which trousers, which drawer should hold his wallet and notebook, which refreshments should be served his guests.

But when confronted with dependence, this powerful man had succumbed to helplessness. Although he had all of the resources necessary to enjoy two more months of meaningful life, he was unable to marshall those resources, or to imagine the possibility of doing so. Autonomy, it seems, will ebb and flow. Perhaps we are most vulnerable when we fail to appreciate that fact.

 

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