The mandate to “Get Better”

In American society, if you are sick, you are expected to GET BETTER.

As soon as you are diagnosed with any malady, you are given your marching orders: fight this thing and win. Get better. Never give up. Show’em who’s boss. Get back on the horse. It doesn’t matter how old you are, how crappy you feel, how unlikely you are to be cured, or how tired you are of waging the hundreds and thousands of battles we fight in a lifetime. Acceptance is unacceptable. You have to get better.

I’m not sure why anymore.

While you are fortunate enough to be young and healthy, you ARE likely to get better. Once you’re cured of whatever ails you, you ARE reasonably able to concentrate on bettering your already good health. Diet, and you will lose weight. Exercise, and you will build muscle. Take antibiotics, and the creepy crawlies that swim in your bloodstream or pile up in smelly tonsil boulders will be killed, like so many infidels in a swarm of crusaders. Then, you WILL feel better… actually, you’ll feel like a million bucks!

But when you reach a certain age, it becomes more complicated.

Maladies don’t strike on their own. They come to you in succession and they tend to overlap. That means you won’t be finished fighting one battle when you’re asked to suit up for another. Catch a flu, and it will suddenly morph into pneumonia, or congestive heart failure. Take drugs to fight the swelling this condition causes, and find out that all your washers in your personal plumbing loosen and become leaky. Drink less to minimize leakage, and you’ll see this causes dehydration, which leads to muscle spasms. Take potassium for that, and learn you are now destroying your kidneys. Mix yourself a strong gin and tonic so you don’t think about all this crap, and watch your liver go batshit crazy. Go batshit crazy yourself, and become dependent on mood stabilizers, which make you fat.

Needless to say, you wake up one morning, feeling like shit, and realize you begin each day by taking a handful of pills, many of which are simply necessary in order to fight disorders brought on by the others.

My friend Paciencia ran out of her rather expensive pills last week, and decided to go cold turkey for a couple of days. That’s right. She stopped taking steps to “get better.” It was a conscious decision, and one that she acknowledged was irrational and counterproductive.

Within a day or two, her ankles started to swell, her legs became nearly too heavy to move, her breathing turned wheezy, her scalp turned itchy, and her sleep apnea told her cat to relax; it would keep her up all night.

Her husband and children noticed that she was even less sprightly than usual, and when they realized she was “off her meds,” they threw a fit. “What are you thinking about, woman? How could you stop taking your pills? DON’T YOU WANT TO GET BETTER???”

And then it struck her. Yes. She wanted to get better. Really she did. But she wasn’t going to. Those pills aren’t going to make her any better. Neither will diet and exercise. At her age and in her condition, nothing is going to make Paciencia any better. The best any of it can do is to keep her from getting worse too quickly.

That’s when her mind filled up with questions. Is she compelled to fight EVERYTHING, or can she merely concentrate on fighting the few battles she has a chance to win? Is it permissible to ignore those maladies which are annoying, but unlikely to get any worse?

Will there be a moment where Paciencia will feel justified in saying, “damn it, I’ve fought as long and as hard as I care to; now let me deteriorate in peace?”

I’m going to ask my friends who work with hospice patients: is there a point where refusing to continue the fight brings on relief? And when does this become justifiable?

Meanwhile, Paciencia will continue her adventures in pharmacology… and I suppose I’ll do the same.

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