by Bruce Kramer, Ph.D. on Thu, 2013-05-23 05:00
|Editor’s note: In a conversation with Bruce Kramer on May 22, he emphasized that this blog is “not a critique of Susan Spencer-Wendel or Dudley Clendenin, but a critique of how society looks at disability and at ALS in particular.”
|Bruce Kramer, Ph.D.
Sometimes, the choices presented by ALS’s complexity are overwhelming. This past couple of weeks have presented this reality, and while it has not been difficult to write, it has been difficult to write in a way that might effectively communicate the complexity at hand. This is my latest attempt, and if a little bit of anger peeks through, I hope you will be forgiving and know how hard I tried.
I just finished Until I Say Goodbye by Susan Spencer-Wendel, a journalist from South Palm Beach, Fla. In 2011, she was diagnosed with ALS. She is brave, with chutzpah and bravado, and has that most human of desires to remain independent, to choose her own path even as ALS paves the road ahead of her. I get this attitude. It is incredibly difficult to make space for dependence in our lives, especially when we are used to the independence that we believe defines who we are. It reminds me in some ways of journalist and fellow Person with ALS (PALS), Dudley Clendenin.
You might remember Clendenin. Diagnosed with a particularly aggressive and virulent form of ALS, he wrote “The Good Short Life,” a column first published in The New York Times detailing how in the face of “Lou” he would seize his own death. While not revealing the manner by which he would kill himself, he was very clear about his need to take responsibility for the act. He expressed the same independence that I cannot help but read in Susan Spencer-Wendel’s book.
Spencer-Wendel has decided to kill herself also, albeit in her own way. She does this through a year of “living joyfully,” rejecting all medical treatment and, if she is to be believed, any willingness to help others through participation in trials or other such things. Her manner of suicide is not a gun or hanging or overdose or the other usual suspects. Instead, she accomplishes a hastened death through extended travel to see among other things the northern lights, Budapest, her favorite beaches, and the island of Cyprus in search of her birth family (she was adopted as a baby). Sometimes, she travels with her family but mostly without, clearly in tune with her own needs to make meaningful memories before she dies.
I need you to understand that I have no problem with a person with ALS exercising as much control over his or her own life as possible, even if it means hastening his or her own demise. Until you face ALS and own it as your own personal disease, I don’t see how you can judge such words and actions. Until you face ALS, agreement or disagreement is purely speculative. And therein is a seed of understanding why I have had such difficulty and anger in writing about a fellow PALS.
When Dudley Clendenin wrote about his decision to off himself, it was because he did not want to become a “conscious but motionless, mute, withered, incontinent mummy of my former self.” Aside from the fact that incontinence is not usually a side effect of ALS, Clendenin only expressed the fear that all of us with ALS secretly or not so secretly carry — that somehow we will become “locked-in,” trapped in our bodies with no way out. At that time, the columnist David Brooks seized this imagery as a shining example of how those of us who are in a permanent state of incurable illness, should realistically address our responsibility toward lowering the cost of health care.
Like Clendenin, Spencer-Wendel also expresses such fear, and like David Brooks, mainline journalists respond from their own able-bodied frameworks. In an Amazon.com interview with Cokie Roberts, Spencer-Wendel is asked, “Many people with your diagnosis would either crawl into a cave or go from doctor to doctor trying to survive a little longer … ”
She answers: “The problem with a cave is it has no windows. And the problem with knocking on umpteen doctor doors is that there is nothing behind the door … I am not giving up. I am accepting … Also a major factor is my husband. I so want him to have a chance at another life. Not saddled with the weight of an invalid wife.”
Scott Simon of National Public Radio, in his Weekend Edition interview with Spencer-Wendel declares, “This book is so funny,” immediately after asking Spencer-Wendel’s husband how he is doing, receiving the following answer: “Well — difficult. Every day I wake up, I feel sad. That’s my first emotion. And then I roll over, and I look at Susan. And I realize that she’s not allowing herself to feel that way, so I can’t — and I don’t.”
I think my greatest disappointment is in the not-so-subtle ratification that a life framed in disability is so easily judged to be less than living. From an able-bodied perspective, the storyline reinforces a Temporary Able Bodied myth long on issuing a hall pass for terminal living — no responsibilities, no problem — and short on looking at the consequences of such easy assumptions. It reinforces singular focus on the person with disease and conveniently disregards the family, friends and colleagues also affected. It reinforces the idea that life with massive disability is life not worth living, unhappy and unfulfilling, meaningless and unengaged. As Ev says, “Spencer-Wendel and Dudley Clendenin are journalists, and by virtue of that fact anything that they publish becomes authoritative.”
They do not speak for me.
I know another story of blessings and complexity and empathy. In 2009, Eric Lowen of the folk rock duo Lowen and Navarro, participated in a New York Times perspective called “The Voices of ALS.” Listen to his words.
“The hardest part for me is the pain I bring everybody. The fact that my children have to deal with it and my wife, I wish I could disappear quietly. But it doesn’t work like that. That’s the most horrible for me.”
“I thought at first I was going to live every day to the fullest and not let anything stand in the way, but then I got a hangnail, then I got a stomach ache … life is pretty much the same no matter what, and the thing that has helped me the most is a quote from a friend of mine. She said, ‘We’re all on a journey. You just have a better map.’ I think that’s the way it is.”
I so get this that it makes me hurt.
What seems to get lost in able-bodied frameworks is the message that life goes on, that ALS can be a life sentence, not just a death sentence. And while we cannot all be poets, Eric Lowen sang ALS in such a profound way until he could not perform any more, engaging in new life even as ALS slowly eroded the old life that was his.
He wrote in Lowen and Navarro's song "Learning to Fall":
“And it’s beautiful how new blessings unfold in ways I could never have known,
but I’ve still got some time on my hands,
I’ve had to run, I’ve had to crawl, been rich as a king and had nothing at all,
still raisin’ hell and tearing down walls, I know where I stand, I’m learning to fall.”
There is a postscript to all of this. Dudley Clendenin, a man who could not see himself living with ALS, prolonged his life, even agreeing to a feeding tube. Why? I cannot be completely sure, but he was offered a book contract to tell his remarkable story. The book contract offered him the opportunity for re-engagement with humanity on terms he was able to quasi-define. He died in May 2012 with his boots on, having sent the galleys of his new book to his publisher.
And that is the real point. We can either die while we are dying or live to the fullest. But massive disability is not the determinant. It’s learning how to fall into new blessings.
Originally posted May 3, 2013
Note: For those interested in more discussion of this topic, see two op-eds in the Minneapolis Star Tribune:
About the Author
Bruce Kramer, Ph.D., was diagnosed with ALS in December 2010. An educator for his entire life, he served as the dean of the College of Education, Leadership and Counseling at the University of St. Thomas in Saint Paul, Minn., until October 2012.
Since March 2011, he has written the Dis Ease Diary, reflections on living and dying with ALS, and is featured in Minnesota Public Radio’s Living with ALS series.
Kramer is married to Evelyn Emerson, a teacher, and he has two sons, two “daughters-in-love,” and a grandchild on the way.