God's Waiting Room

Photo by Edwin Chen on Unsplash

I was recently invited to attend an event at a retirement community that had independent living, assisted living, and nursing care sections. Although the event was to be at the "Village," I accidentally  went to the "Terrace," which happens to be the assisted living section. When I entered the front door, an alarm went off.  No one was sitting at the front desk, and so I waited there for a minute or two. The alarm kept going off, yet no one showed up. So I started walking down the hall a bit and saw a few residents lined up in wheelchairs. I turned around and went down a different hallway and spotted a staff person in scrubs standing at a computer desk in the hallway, like in a hospital.  That gave me some pause. I asked him where the event was, and he had no idea. After a few other people got involved in the conversation, they directed me to a different building which was the "Village," and I found where I was supposed to be.

I had a visceral reaction to my five minute encounter in that facility. I was recalling a chapter in Gawande's book, Being Mortal, in which he discussed the origins of the concept of assisted living. Initially, it was conceived to provide whatever it took for elders to be able to live independently on their own terms and achieving their own goals, with individually tailored assistance. This would support their autonomy while also providing dignity and the kind of privacy one experiences in their own home.

Krista Tippett ("On Being") interviewed Gawande about mortality and meaning -- it's a fascinating podcast, well worth a listen. Click here.

Gawande's observation, which was confirmed by this encounter as well as my earlier experiences going to such places, is that assisted living has become medicalized and corporatized. He writes convincingly that, although assisted living was initially developed with positive thoughts about what would help elders reach their own goals, it has now become something very different. The goal of such settings now is to keep patients under control while minimizing corporate liability. Medicines are dispensed, meals are prepared and served in a group setting, and staff come and go from rooms as they wish. Residents' autonomy is sacrified in the name of promoting patient safety. The image of a staff member wearing scrubs and standing at a hallway computer desk taking notes reinforced that conclusion.

It also struck me how the larger residential community (including the "Terrace" and the "Village") was situated down a quiet street, out of the traffic flow and away from the activity of the town. It felt like it was all "safely" tucked away, out of sight, and out of mind.

I was surprised at how impactful that five minutes was. it's been hard not to think about it since then. The event at the "Village" was very enjoyable, but even in that "independent living" section, it was clear that staff were overseeing and shepherding all comings and goings. None of the residents seemed to object, so perhaps it's more my problem than theirs. But I kept asking myself whether I'd be willing to live in such a place.

On the surface, it was a lovely place. The building and the grounds were nicely maintained, and the furnishings were quite tasteful. That said, the common areas looked more like a hotel lobby than an area in which real people actually lived every day. No noise, no music, no pets, nothing out of place. No one hanging out.

It took me back in time to a memory of when my parents lived in an independent living community with tiered levels of care. Although people lived in their own condo-like units, they ate dinner together in a common dining room. My parents always wanted to be among the first in line, so there was always a period of waiting for the rope to be moved aside to allow people into the dining room. One evening in line, I was chatting with friend of my parents. With a twinkle in her eye, she asked me if I knew what they called that place. I said no, not really. She said, "God's Waiting Room."

Well ... I certainly haven't forgotten that conversation from 25 years ago. How sad ... to feel that life has been reduced from one of vital engagement and active participation to perpetually being in a waiting room.  Is that the best we can hope for as we age?

Following Susan's passing, I re-wrote my will, power of attorney, and health care proxy. Although the health care proxy has some standard language about the conditions under which my proxy need not prolong my life (e.g., terminal illness with no hope of recovery), there are so many less clear situations that are not covered. I googled "quality of life," and found many sample "Quality of Life Statements," in which the person spells out their own terms and conditions for prolonging treatment or sustaining life, in as much detail as they wish. You can also describe the activities, abilities, and situations that constitute quality of life for you, and the conditions which you would find abhorrent. I won't go down that rabbit hole further (for now), but if you find this of interest, google "quality of life statement" for examples. I created and signed such a document and referenced it within my health care proxy. My attorney made sure I understood that it was not legally binding, but that it would provide written guidance to my proxies so that they didn't have to wonder what my wishes were.

Many people have a hard time talking about things like this. But one thing is certain: we will all exit this life.

I close with a beautiful and thought-provoking poem by Mary Oliver, "When Death Comes." A much different thought than marking time in God's Waiting Room.

When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse

to buy me, and snaps the purse shut;
when death comes
like the measle-pox;

when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

And therefore I look upon everything
as a brotherhood and a sisterhood,
and I look upon time as no more than an idea,
and I consider eternity as another possibility,

and I think of each life as a flower, as common
as a field daisy, and as singular,

and each name a comfortable music in the mouth,
tending, as all music does, toward silence,

and each body a lion of courage, and something
precious to the earth.

When it's over, I want to say: all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it's over, I don't want to wonder
if I have made of my life something particular, and real.

I don't want to find myself sighing and frightened,
or full of argument.

I don't want to end up simply having visited this world.

--Mary Oliver