It’s my blog so I guess I can write about whatever I want. I usually write about healthcare and investing and entrepreneurship, but today I’m writing about life: my life and that of my family. It has a healthcare bent in a way, and is an abject lesson about doing what is right and being a good person and remembering who matters when it comes to end of life planning. And I hope you read it, as I don’t usually get quite this personal in this space.
My grandfather died on May 17, 2017. He was 101 years old. Damn! You might say, he lived a long time. And you are right. But it actually wasn’t his time to go, at least the way I see things. He didn’t succumb to some chronic disease after years of suffering. Not even close. At 101 he was remarkably healthy with some problems, but entirely cognitively there, getting along living in his long-term home (with a caregiver most of the time), and still reading the New York Times every day as he had done since elementary school. What happened was this: my grandfather lived in a retirement community in Fort Lauderdale/Sunrise, Florida. His place was along a canal and if you know Florida, you know that it is jam packed with weird wildlife, including the pretty super-sized lizards that hang out in the tree outside his back window. One managed to find its way inside the house and scared the caregiver. So my grandfather, ever the gentleman, tried to chase the lizard out, and in so doing broke his damn hip.
When I got the call from the caregiver, my heart sank. I already knew that meant the writing was on the wall. Sadly, the statistic goes like this: if you are elderly and break your hip, your odds of dying within a year are more than tripled; as many as 1/3 die within a few months. I called my sister, expressed my concern, and then spoke with the surgeon who felt strongly that surgery was warranted because, “the guy has a lot of living left to do, clearly.” The surgery went fine but was followed by the usual parade of old person post-broken hip maladies, including pneumonia, a heart failure episode and then the second bout of pneumonia-like symptoms, which ultimately killed him two months after the initial “successful” surgery. Imagine here the string of expletives you know I am thinking very loudly.
My grandfather was a real force of nature. He was a conservative Rabbi and worked as such until he was 98 years old, driving all over the place to do services. He even met my grandmother at a funeral over which he was presiding, asking her post-service if she was single. They married when I was 9 and he was the only maternal grandfather I knew. Rabbi David Gordon was a powerful and influential clergyman and received so many honors and awards that the Internet doesn’t have room for me to list them (great article about him HERE written 20 years before he died so it really only scratches the surface). But he was known for a couple of things in particular.
My grandfather fundamentally believed that all religions were valid and as he got older he became more inclusive and open-minded, working alongside all manner of other clerics from all sorts of faiths. He loved to read and he had a massive library of books, which he freely sent to people all the time. If you visited him in person, he insisted you leave with a few books. He loved jokes, particularly silly punny ones, and he handed out his own handmade copies of them to people everywhere – at the temple, at the grocery store, you name it. And lastly, he loved to sing. I recall watching my daughter sing with him willingly as a small child, less willingly as a teenager. On his last day alive he sang with a Rabbi who came to visit him. He could barely talk but he could sing and nothing short of death was going to stop him.
My sister and I spent most of the last two weeks of my grandfather’s life with him in Florida figuring out what to do next, then next, then next. We learned first-hand about some of the end of life issues I have talked about before but haven’t experienced quite as intensively. We also learned that there are 17 different wings restaurants within a 5-mile radius of my grandfather’s home, which suggests to me there is a meaningful chicken end-of-life opportunity to be had for any entrepreneur looking for their next gig and able to figure out the business model.
My grandfather considered my sister and I his closest family since his wife (my grandmother), my mother (who was his step-daughter) and his son had already died; thus we were responsible for ensuring that his final wishes were carried out, which is what he had asked of us. We were so fortunate that he had already attended to most of this in detail, leaving a very clear living will, plan for his funeral, and everything related. He was also entirely lucid until the very end, and thus we could ask him questions such as, “Would you prefer to be at home rather than in this hospital?” (his answer: a very polite form of “duh”). And despite this, it was still brutal, largely for two reasons (though there were others, including learning that his so-called lawyer had botched his will and trust – caveat emptor in the lawyer department).
First, despite his having left clear instructions about how he wished medical crises to be handled (e.g., when it was appropriate to remove life support, that he wished to be at home, etc), the process of carrying out of those decisions was heart-wrenching for my sister and me. Watching the nurse remove the IV and knowing that he could not swallow and thus could not eat or drink was knowing that he would soon succumb to dehydration and starvation. Even though we knew it was almost impossible for him to recover from his current medical state, it was a stark realization to have any role in assisting that process, inevitable as it may have been. Thankfully we knew we were doing what he wished, but that didn’t make it a whole lot easier.
Secondly, he had some extended family – nieces and nephews from siblings whom my sister and I had never met or heard much about to be honest—who were far more religious than my grandfather on the continuum of how Jewish can you be. As Orthodox adherents to the religion, versus my grandfather’s Conservative take on it, they felt that certain funeral arrangements must be adhered to and a few of these individuals were aggressively adamant about it, actually to the point of harassment. This was despite the fact that he was himself saying that he did not want certain ritualistic things (remember, he was lucid and cognitively unimpaired til the end and a Rabbi for about 75 years, so pretty familiar with his options). His will clearly stated his precise funeral wishes, which he had conveniently documented and pre-paid, believe it or not. His other relatives were unmoved by this and would have changed so many things if no one had been there to advocate for his specific plan.
A blessed advantage: my grandfather had presided over so many funerals that the funeral director and he were close buddies; thus there was no mistaking that what he wanted he was going to get. But fight that they did, those relatives we did not know, and they even tried to get the funeral director to change the plan behind our backs. It wasn’t pretty. At the funeral itself one of them was loudly complaining during the service that certain prayers should not be said because the situation didn’t meet what the Torah would require for them, at least according to his reading of it. I actually had to tell he and his wife to shut up and stop arguing during the service while we all stood 10 feet from the grave, and as the Rabbi who had known and loved my grandfather was reciting the prayers he felt perfectly appropriate to the occasion.
As the saying goes, you can pick your friends and you can pick your nose, but you can’t pick your family. I am grateful we knew what my grandfather actually wanted so we could keep reminding everyone that we were going to honor his wishes no matter how often or loudly they complained that we all were, in effect, doing religion wrong. Oy vey, as my grandmother would say.
You may have surmised that I am not a religious person and, while I do have my own self-made form of spirituality, it’s not something I really spend a lot of time on. Call me shallow, but I think a lot more about shoes and ice cream flavors and friends and my immediate family than I do about what passes for God or what happens after you die. My grandparents were Jewish but I always say I am Jew-ISH. My closest brush with true spirituality, however, has come with the passing of my grandparents. My grandmother died in 1999 and there are few people I love as much as her. She was fun and vivacious and hilarious and smart. She relished the naughty story, the practical joke, the good laugh at one’s own expense. She loved to gamble and the last time I saw her in real life was when I told her that I was so tired, it being 2 am, that I could not play blackjack with her anymore, but had to leave the Flamingo Resort casino floor to return to my room. She laughed at me and called me weak and went back to the game. She died several months later before I could see her again. I still think about her nearly every day.
My grandmother loved my daughter more than anyone on earth and the love was mutual. My grandfather told me that every single night the last thing my grandmother did before she went to bed was to kiss a photo of my daughter to say good night to her. My daughter was, at the time of my grandmother’s death, 3 years old and somewhat obsessed with monarch butterflies due to the classic “grow a butterfly from a caterpillar” project they were doing in pre-school. My grandmother literally called and asked her for a monarch progress report every single day. As a person who does not feel any sort of spiritual presence at cemeteries, I was forever changed by one particular moment when my grandmother died. As they lowered her coffin into the ground, an actual giant monarch butterfly seemed to fly out of the grave and hover over my family, flying in circles, for several minutes. We were dumbstruck by it. It seemed so like my grandmother had taken my daughter’s favorite form (and yes, if you are a fan of the movie Ghostbusters, you know what I mean), and was telling us it would be ok.
Wild as it was, over the last 18 years my sister and I always said that on the rare occasion we saw a monarch butterfly it was just my grandmother checking in on us. If either of us ever saw one we would text each other about it. And on the only day my sister and I ventured outside for a quick walk in the Florida heat to take a break from tending to my grandfather, no sooner had we walked out the door than a big fat monarch butterfly literally flapped its wings right into us on the path. We laughed and said it was grandma telling us “don’t worry girls; I’ve got this.”
But here’s the kicker. When we were leaving my grandfather’s funeral, misery-fest that it was, and were walking back to the car, all of a sudden two monarchs appeared in the sky right in front of us, separated by about 10 yards. For real. I have witnesses. They flew separately for a bit, then joined up and disappeared. And my sister and I and our husbands, who knew the whole story, stood there and tripped the hell out. We experienced it, in the face of all that religious conflict and family drama and our own basic lack of a religious ideology and felt that, in fact, my grandmother had come to take my grandfather to that winning blackjack table in the sky, or wherever butterflies go, and that whatever your religion or lack thereof, there must be something out there. Because. That. Was. Crazy. And awesome. It led to the first smile I had on my face in weeks. The second one came later, over large pours of scotch, as we relived the story at a bar near the beach.
For the record, it took me a several days after my grandfather’s funeral to really cry. I had coincidentally started a refresh of my will and advanced directive before my grandfather got ill. It was time to do so, my kid having grown up when I wasn’t paying attention. With all that I experienced through my grandfather’s last two months of life, I realized far more clearly what was important to me in re-writing my own end of life wishes. And when I returned to act on it, about five days after the funeral, I just lost it. Cried and cried –a full snot-running-down-the-face, can’t breathe, choking to death kind of cry.
I know exactly what unleashed the crying Kracken – it was the thought of how hard it was to remove my grandfather from the last form of life support even though it was clearly what he wished, knowing we did the right thing, but still feeling so sad and conflicted about it. The reality of it all was a poignant exclamation point on the whole experience and it broke my heart to think that someday my husband or my sister or my daughter might have to make that decision for me.
Doing what is right for someone who is dying is not the same as doing something easy or doing what you want them to do. But you must do what they wish, not what seems right to you. It is our duty as humans to honor each other’s last wishes and not to try to impose what we want out of selfishness or self-pity. And if you love your relatives and friends, it is your duty as a human to help them by telling them what you wish those last wishes to be. I encourage you to do so, clearly and in writing. You can start your conversation here by answering these five questions my lovely friend Alex Drane so conveniently and lovingly put together through Engage with Grace. Then find a good lawyer (emphasis on good and thorough), and get real. Don’t wait too long or it might be too late. And watch out for the butterflies – they play a mean hand of blackjack.