All my friends knew my intentions. They would not suffer when it came time to die, medical license be damned. When I became ill, they realized they needed a plan B. I might not be around to do the final deed.
I have always been a strong believer in the right to die with dignity. Everyone on my care team needs to know my wishes. Please, if you have not made an advanced directive, do it now. It is a nasty business. No one wants to do it, but it must be done.
Now I feel I am reaching the end of my road.
I thought dying would be easier than this.
I imagined I would savor my favorite indulgences—lemon meringue pie, sticky caramel apples, the quiet embrace of a warm, empty pool. I pictured gentle comforts, the kind reserved for popes and royalty. Instead, all I want is to be alone and moan.
No one wants to hear me moan. But it helps. It is a kind of vibrational meditation - primal, almost sacred.
There is no sharp pain. Just a deep, diffuse weakness, a hollowness that makes even basic functioning feel out of reach. Still, I am repeatedly asked if is there any pain, as if that were the only metric worth measuring. Yes, there is pain, both physical and psychic, though neither with clear edges.
I struggle to read. Writing feels like groping in fog. My bowels are out of whack. My clothes do not fit - bloating has changed the contours of my body. Even coffee and matcha, tiny joys, sometimes taste like nothing, only a means to get caffeine.
The sounds of life outside feel distant. The ocean calls to me less and less. I do not want to be seen. When the air raid sirens wail, I drag myself into the sealed room—not because I fear missiles, but because it is what we do here. A grim routine.
I am not the version of myself that I knew.
Is that pain?
Months ago, I worried about gravesites. In Tel Aviv, there is no room for burial – one is entombed between the walls of a big mausoleum. Now I do not give a shit where my physical body is interned.
I worried about memorial benches. I already ordered one at Doctors Park in Milwaukee. Since the massacre of October 7th there are no longer memorial benches for purchase in Tel Aviv, due to high demand. Israelis flock to memorials. I need to find a place for people to go.
When our 16-year-old dog and soulmate Marley was crippled and struggling, we called a veterinarian to our home. It was a cold December morning. We knew it was time. The vet shared an algorithm that I have never forgotten, the Quality of Life Scale.
Yesterday I tested myself and had a score of 46. Damn, too healthy. Marley was headed to the rainbow bridge, but in a most peaceful way. We miss her so much. What amazed me was how dignified her death was. Save this chart. You might need it someday.
A good friend in Australia recalled her mom’s palliative nurse saying, “leaving this world takes as much energy and effort as being born into it.” Who knew? I naively believed that I would know the time and have the means to just do it. Even for pets, it is not so simple. There are criteria one must fit. One is compared to others in a similar situation – rather than to one’s past self.
So I keep going. I have noticed how much less I want to talk, to offer advice, or to go outside into the chaos of motorcycles, cigarette smoke, honking, and shouting.
I feel like a burden to those around me. I wonder how people in worse physical shape manage. I need to be me and to be accepted for who I am.
I'm heading to bed now. This article has been sitting on my computer for days, waiting for some clever insight or nugget of wisdom to land.
The other day, I told my daughter that for me, I feel like I have carte blanche—full freedom to do (or not do) whatever I choose. Without missing a beat, she grinned and said, “You have Cate Blanchett.”
Feel free this week,
Dr. Anna 🌸🎗️
May your memory be a blessing. 🙏
Wow, Anne. Keep doing what works for you. Sending love from glendale Wisconsin. Your story matters, every minute of it. Peace out.