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Do not despair, Julian Barnes, ageing matures the soul

We must not dreary pessimism drive us towards acceptance of suicide

By on Wednesday, 30 January 2013

Man Booker Prize

A friend has written to me as a result of reading my blogs on the Liverpool Care Pathway. She draws attention to another aspect of this debate which concerns not the actions of doctors but the behaviour of relatives. She writes, “You have rightly highlighted the danger of sick and elderly patients being placed on the Pathway without their knowledge or consent and against the relatives’ wishes, and even when they aren’t actually dying. But there is another danger too, possibly more common than you would think: viz. when the patient is comatose but revivable – and yet their relatives are insistent on as speedy an end as possible.”

My friend continues: “Our youngest daughter is a nurse. She was very keen on the LCP when she took up her first hospital job. When a patient was thought to be in extremis, the ward sisters called in a team of specialist nurses to carry out a thorough assessment of the patient’s condition. If these specialists recommended continuance of treatment, that is what the doctors did. If they confirmed that death was imminent, the patient was placed on the LCP and given the best nursing care possible. As my daughter explained, nurses are there to be a “line of defence” around the patient.

“However, she witnessed a case where this defence was battered down by a patient’s angry and distressed relatives, who were convinced that the treatment their elderly mother was being given was causing her pain and needlessly prolonging her suffering. The specialist nurses were called in and concluded that she was not dying and could very well get better, and advised the doctors of this. But during the night the shift changed and another doctor took over; and the relatives badgered him to withdraw all medication immediately. He did so, with the result that the elderly mother’s health was irreversibly damaged by the following day. When the original nurses came back on duty they were deeply upset by what had happened and sought explanations. But by then it was too late to save the elderly lady and she died the next day. My daughter said it was a real eye-opener on what can go wrong with the LCP when relatives manage to get round the defensive line of nurses in this way. And she remains adamant that the LCP, when implemented properly and as intended, is infinitely better for patients and staff than the previous haphazard practices.”

This letter teaches one that it isn’t always the doctors or nurses who are the chief culprits when it comes to these medical scenarios. It is a minefield – and not just because there are disputes between doctors, patients and relatives but because of conflicting views about what a life is worth. I read my friend’s letter before reading an article in the Telegraph last Saturday in which the Booker prize-winning novelist, Julian Barnes, was giving an interview. In it he stated baldly that “I’ve always been in favour of suicide. I always thought it was every human’s right to kill yourself if you want to and I think it’s terrible that people have to go to Switzerland and have their relatives threatened with lawsuits or criminal prosecution when they are obviously of sound mind but terrifyingly unsound body.”

Barnes added that previous generations of doctors had a different approach: “Doctors used to knock people off all the time.” He went on to say he supported the LCP – giving the impression that he sees it as a quick and convenient way to despatch a person who has become “terrifyingly unsound” in body rather than as my friend’s daughter describes it: a caring way to manage the actual dying process. Barnes’ views do not surprise; he has some form in this area. His book Nothing to be Frightened Of describes the bleak, almost perfunctory, deaths of his parents, who were atheists like himself. He wrote in that book, “For me, death is the one appalling fact which defines life.” His 2011 novel, The Sense of an Ending, which won the Booker prize, is centred on a mysterious suicide.

We all ponder death, our own and those of our friends and relatives. For people like Barnes it is something to be frightened of because it means final extinction, an often undignified departure from the only life there is – a life that is thus clung to desperately until the moment one decides to knock off or to be knocked off; when it’s no longer worth the candle. For Christians, as I have written in other blogs, death is not about discarding “a terrifyingly unsound body” for an abyss of nothingness; it is the gateway to eternity, a sacred transition that is accompanied by consoling, ancient, hallowed rites of passage.

Fr Ronald Rolheiser’s column in the Herald last week offers a wise and reflective rebuttal of Barnes’s dreary ruminations. Citing a book on aging by James Hillman entitled The Force of Character and Lasting Life, he writes that “The last years of our lives are meant to mellow the soul and most everything inside our biology conspires together to ensure this happens. The soul must be properly aged before it leaves. It’s a huge mistake to read the signs of aging as indications of dying rather than as initiations into another way of life. Each physical diminishment is designed to mature the soul.” I like the way this makes the frailties of age sound like the maturation process of fine wine.

I just hope Barnes will come across this book and learn from it before he gets to the despairing stage of wanting to be knocked off himself.

 

  • Don Camillo

    I am sometimes tempted to wish these pagans would bump themselves off as soon as possible- but I suppose it would be more proper to pray for their conversion!

  • Peter

    It all boils down to belief in a Creator.  If there’s a Creator then everything is possible.  As it says in the Cathechism, if the Creator can create everything out of nothing, he can give life to the dead (CCC298).

    The latest scientific theories suggest that creation began out of nothingness – as preached for centuries by the Catholic Church – in the face of constant opposition from those who said creation had no beginning.  The Catechism says that creation was drawn out of nothingness by God’s command, that this was how time began (CCC338).

    Stephen Hawking demonstrates how creation emerges spontaneously from nothing, and then wrongly concludes that there is no need for a Creator.  That is because he does not understand Catholic teaching.  The Catechism says that God did not create from pre-existing matter (CCC296) There was no blue touchpaper to light, no kick-start pedal to kick. The God simply called creation into existence out of nothingness.

    The fact that for centuries the Church has taught the supernaturally-inspired truths that creation had a beginning, that it began out of nothing and that it marked the beginning of time itself, ought to convince even the most hardened atheist of the existence of a Creator.

    And if such a Creator who can create from nothing is deemed to exist, then he is deemed to have control over life and death, so that even death is not the end, but just the beginning of a second phase of existence.  Atheists must think twice with this in mind before considering their own precipitated deaths.

  • Jonathan West

    It seems to me that your previous rants against the LCP were misdirected. If properly implemented it is, as your correspondent’s daughter says, “infinitely better for patients and staff than the previous haphazard practices”.

    I hope that you will in future restrict yourself to condemning abuses of the LCP rather than the LCP itself.

  • Cestius

    But nothing will convince those that are determined not to believe.

  • awkwardcustomer

    Here is Gandalf’s response to the despairing Denethor who, having lost all hope of victory, intends to kill both himself and his son Faramir.

    ‘Authority is not given to you, Steward of Gondor, to order the hour of your death,’ answered Gandalf.  ‘And only the heathen kings, under the domination of the Dark Power, did thus, slaying themselves in pride and despair, murdering their kin to ease their own death.’

    From ‘The Return of the King’.

  • Peter

    Then atheists, who profess to bow to reason and evidence, are hypocrites.

  • JabbaPapa

    Death merchants such as yourself are preachers of evil.

    I have no idea why your unacceptable blasphemies are allowed by the moderators.

  • OldMeena

    Physics is only my second subject, but I understand enough to know that the “nothing” that Stephen Hawking, Lawrence Krauss and others talk about is not the “nothing” of your Catechism.
    Wasn’t it rather St Augustin who wrote that it was clear that something could not be created out of nothing – in the common-sense meaning of that word?

    It is foolish and ill-advised for religious apologists to attempt to justify or support their supernatural beliefs by recourse to science. If they do, they will be caught out in the future, as they have often been in the past (and present times).

  • OldMeena

    I think you are looking at this through the wrong end of your telescope.

    It is surely the religious person who is determined to hold her or his supernatural beliefs – in the absence of any evidence (in the normal and usual meaning of the word “evidence”).

    I am in no way determined not to believe. I have searched (and to some extent still do search) into religious beliefs looking for some reason why any of it should be thought to be true. In one way it could be said to be a bit of a disappointment to find no such reason – but in another way it is a bright, life-enhancing discovery.

    The Catholic Church is what it is (at its best) today as a result of its past behaviour. Under pain of mortal sin and damnation in Hell it has regulated the actions of its members – and removed from them (until recent times) the opportunity to inform themselves through wide reading and study.

  • Peter

    “but I understand enough to know that the “nothing” that Stephen Hawking, Lawrence Krauss and others talk about is not the “nothing” of your Catechism.”
    By what authority do you make the above assertion?

    “If they do, they will be caught out in the future, as they have often been in the past (and present times).”

    Again you have no evidence, and therefore no authority, to make the above statement, since Catholic doctrine has NEVER been proved to be wrong.

  • JabbaPapa

    She deludedly thinks metaphysics are like a subset of physics.

  • Peter

    “I have searched (and to some extent still do search) into religious beliefs looking for some reason why any of it should be thought to be true”

    Are you not impressed that the centuries-old doctrine of creation having a beginning was vindicated only last century?

    Or are you part of the incredulous “lucky guess” brigade? 

  • Jonathan West

    Well, if we are going to quote the utterances of fictional characters as part of the argument, then how about this passage from the Tale of Aragorn and Arwen in Appendix A, which rather supports Julian Barnes’ position. This is Aragorn speaking with Arwen of his own imminent death.

    “Lady Undómiel,” said Aragorn, “the hour is indeed hard, yet it was made even in that day when we met under the white birches in the garden of Elrond, where none now walk. And on the hill of Cerin Amroth when we forsook both the Shadow and the Twilight this doom we accepted. Take counsel with yourself, beloved, and ask whether you would indeed have me wait until I wither and fall from my high seat unmanned and witless. Nay, lady, I am the last of the Númenoreans and the latest King of the Eldar Days; and to me has been given not only a span thrice that of Men of Middle-earth, but also the grace to go at my will, and give back the gift. Now, therefore, I will sleep.

  • JabbaPapa

    Yours is a very forcible interpretation.

    The passage illustrates the departure of the soul — NOT the self-destruction of the body.

    It is derived from various Chritian (Catholic) hagiographies where the Saints involved are so close to God in their souls that they have the grace of this manner of departure.

  • Jonathan West

     “The grace to go at my will”

    He is clearly choosing (willing) the time and manner of his death. Nobody is forcing him, he is willing it.

  • JabbaPapa

    It is a motif of mediaeval hagiography that Tolkien reprised for that piece of writing.

    There is no violence in this death, simply the soul letting go of the flesh — it is in fact no death at all, but the passage from this life to the next life.

    The evocation of elderly melancholia and the loss of youthful vigour is there to provide a poetic feeling of poignancy.

    To read it as a suicide note is to understand NOTHING about the passage.

  • Susanreibelmoore

    A wonderful reflection, Francis Phillips.  It’s late, and I’ve had a very tough day battling with road bureaucrats who’ve made bad errors, yet again, on car use.  Your words of wisdom have cheered me: a lovely antidote to exhaustion. 

  • Jonathan West

    It seems to me that your previous articles against the LCP were misdirected. If properly implemented it is, as your correspondent’s daughter says, “infinitely better for patients and staff than the previous haphazard practices”.I hope that you will in future restrict yourself to condemning abuses of the LCP rather than the LCP itself. 
     

  • Jonathan West

    I said nothing about violence, I was speaking of the will. Stop putting words into my mouth.

  • Peter

    There are probably many seriously suffering people who would wish that they could simply give up the ghost, but that is NOT the same as taking active steps to terminate one’s life.

    When one approaches death one can fight it or simply give in, which is a million miles from terminating one’s life well before that point is reached.

  • JabbaPapa

    Quite.

  • JabbaPapa

    The LCP is the deliberate provision of industrialised death.

    Why should it be free from condemnation ?

    It is inherently evil.

  • Jonathan West

    Have you actually read what it is, o have you restricted yourself to commentaries about it from Francis Phillips and those of similar viewpoint? If the latter, you almost certainly have as distorted understanding of it as you do the views of Richard Dawkins.

  • JabbaPapa

    It is a method whereby the elderly are deliberately deprived of solids and liquids and pumped with narcotics until they die from this ill treatment.

  • Jonathan West

     As I thought. You don’t know what it is.

  • JabbaPapa

    http://liverpool-care-pathway-a-national-sc.blogspot.fr/2012/11/liverpool-care-pathway-missing-link.html

    Looks pretty straightforwardly coherent with my description to me …

  • Jonathan West

    There are probably many seriously suffering people who would wish that they could simply give up the ghost

    If their wish can be granted, why should it be refused, prolonging their suffering?

  • JabbaPapa

    Because murder are suicide are evil.

  • Jonathan West

     I’ll agree with you about murder. But suicide? Even the catholic church has stopped regarding suicide as a mortal sin and will bury suicides in consecrated ground.