Each fall, I light a candle for my mother, who died in a quiet hospital bed. She wasn't in a nursing home and she wasn't plugged into machines. She died the way she wanted to die, because she was willing to die too soon rather than too late.
Don't get me wrong. She loved life. But when she was 84 a doctor recommended surgery for two leaky heart valves. She weighed the risks of stroke and dementia, and she said no.
"Are you sure?" I asked. "The surgeon said you could live to be 90."
"I don't want to live to be 90," she said.
Her doctors were upset, but the elderly can be like Humpty Dumpty — seemingly fine until a surgery or mishap sets them on a rapid downward spiral. A quarter of Medicare's entire budget goes to treatment in the last year of life. A third of us get "Hail Mary" surgeries during that final year, and a fifth die in Intensive Care.
My mother fixed a cracked window in her basement, saying she didn't want to leave a mess for her kids. Then she had a heart attack. Another doctor recommended the surgery she had previously rejected.
"I think we're grasping at straws here," I said.
"It's hard to give up hope," she said.
A half-hour later she called me back. "Give my sewing machine to a woman who really sews," she said. "I'm ready to die. I'm at peace with all my children."
A month later on a hospice unit, she took off her silver earrings and said, "I want to get rid of all the garbage." Twenty minutes later, she was dead.
We were not a perfect family and she did not die a perfect death. But she died the death she chose, not the one anyone else had in mind. It was one small step toward a new art of dying for our biomedical age.
With a Perspective, I'm Katy Butler.
Former San Francisco Chronicle reporter Katy Butler is the author of a book exploring better ways of death.