I find this story poignant and important. A Time in a Life for Pie and Beer
You’ve heard the one about the old man who was dying? He smelled cherry pie baking, so he roused himself from bed and staggered into the kitchen. He was reaching for the pie when his wife swatted his wrist away. “No!” she barked. “That’s for the funeral.”
Back in 1978, as a resident I helped care for an ICU patient who had leukopenia. Hematology had tried everything available at that point, and recommended supportive care. Infection control placed him on reverse precautions.
I remember talking with him about his illness. He accepted his impending mortality, but had one request. He wanted to see faces and he want to hug loved ones. He did not want masks and gowns in his hospital room.
He understood that he might die sooner, but verbalized clearly that he was not concerned about the day of his demise, rather he cared about each moment being under his control
My father died last year at age 85. Over two decades, as his health declined, I cooked for him when I could. It was hard to find foods that weren’t literally deadly for him. What made it harder was that only one of us cared.
It’s not that Dad had given up hope. Paradoxically, he loved life more as he grew sicker. And the happier he became, the more he indulged in things that were bad for his health. Alcohol was dangerous, given its interactions with his many medications, but he became devoted to a daily cocktail or beer. Though his blood sugar soared, he stopped saying no to sweets.
Because his heart was failing, salty food made fluids pool in his body. But the soups he adored were oceans of sodium, prompting hospital visits and the need for powerful diuretics. Even while threaded with intravenous lines, he’d poke at his food and ask for salt from the cafeteria.
After a lifetime of hard work and moderation, my father simply wanted to enjoy himself. He had come to live — and eat — entirely in the moment. I wanted to join him there. I wanted to bake pies with buttery crusts and bask in his delight. Yet I was stuck not in this moment, but in the next: the one where we were about to lose him.
This man clearly saw his life more clearly than did his daughters. He understand that life is lived in the moment, not in an unspecified future. He had lived a wonderful life, but wanted to enjoy a few more moments.
This story gives us a useful anecdote about informed patient decision making. He knew that diet and alcohol might be "bad" for him, but given his context he rejected that opinion. He valued the positive impact on his momentary quality of life from a beer, a pie or a salted soup as much greater than the impact of dying soon. He had already won the game, living to 85, and just wanted to enjoy the last inning.
