How Can I Help You So That You Can Help Me?

                       The Ratchet Manifesto, part two

I was sitting on the couch, next to my dying mother, talking to her hospice worker.

                                        Uhhuh...

It didn't matter that mom was right there, her memory was so far gone with Alzheimer's, and the cancer was eating everything else.  So the hospice worker makes the point to me: hospice care involves making the patient as comfortable as possible while her body is shutting down during the death process.  Losing her appetite is a normal part of dying, and so, the hospice people are not going to force her to eat, or give her meds to make her hungry, if she is not hungry.  If organs are slowing down in preparation for death the hospice people are not going to try to speed the organs back up.  They're just going to help her be comfortable while she is shutting down in preparation of death.  It's normal.

I hear you.  I understand the story you are telling me and I am ready to continue listening.

So, a person has depression.  Depression is that person's cancer or alzhiemer's, it's that person's disease.  Depression is the depressed person's disease.

                            Right.

And you can treat it for a while, but eventually treatment loses and the disease wins.  Just like my mother's stomach stops wanting food, the depressed person stops wanting things that they used to want before the disease took over.  And you can't help them.

                     So what do you do?  Or don't do?

Well, they gave my mom pain killers, but the problem didn't go away, new side effects manifested themselves, and eventually she lost anyway.

                                And?  With depression?

Well, if you see something that you can do for the person, that's one thing, but it's not the main thing, and eventually the main thing, the depression, will win.  And they will die a natural death for a person with that disease, with depression.

                           Suicide.

Right, suicide.  It's a natural death.  I know people have been debating the morality of it for thousands of years, all the way back to that Egyptian guy at least.  But the point is: diseases have outcomes that result in death.  Heart disease leads to the death that looks like it came from heart disease.  Cancer leads to the death that looks like it came from cancer.  Depression leads to the death that looks like it came from depression.

What you are saying is interesting.  I will be thinking about what you have said.

                       That makes three of us.

                   And your mother, she died of the cancer then?

                           It says metastatic on her certificate.

              But compared to.... who cares, you know?  That's not the point.

                And with the Alzheimer's she didn't remember anything?

                           The last question she asked me...

                 Was how my wife could have killed herself...

   She wanted to know how something like that could have happened...

                              So she did remember something.