by Katy Butler
Katy Butler’s book is part a personal memoir of watching her parents die and part an investigation into how the medical advances of the second half of the twentieth century have worked to increase and prolong the suffering of the elderly as they near death. She describes this as: ‘the erasure of the once bright line between saving a life and prolonging a dying.
In 2001, her father, then 79, suffered a catastrophic stroke. He survived, or was kept alive, for a further six and a half years. The burden on her mother, a weekly routine of a hundred hours of care, became intolerable; the stroke had devastated two lives. During this period a pacemaker was fitted which ‘kept his heart going while doing nothing to prevent his slide into dementia, incontinence, near muteness, misery and helplessness.’
Katy Butler’s research led her to a new medical approach in Italy: ‘Slow Medicine.’ This advocates a calm and broader assessment of the needs of the patient and his family as death approaches. It seeks to avoid a series of medical ‘fixes:’ ‘To do more,’ one of its advocates writes, ‘is not necessarily to do better.’ Her mother chose to follow this path and at 84, refused open heart surgery:
‘She died of old age, sickness and death. She died of being eighty-four. She was continent and lucid to her end. She took her body back from her doctors. She died the death she chose, not the death they had in mind.’
These are issues which are both challenging and humbling as most of us approach death inadequately prepared and with little courage. Katy Butler tells her own story with unsparing honesty and in the final chapters shares ‘What I wish I had known’ and her guidance for tackling our collective denial: ‘Notes for a New Art of Dying.’
Buy the book on Amazon: Knocking on Heaven’s Door: The Path to a Better Way of Death