The Salt Marsh in Early Autumn

Monday, November 28, 2011

Nothing About Us Without Us Part II: Worry and Help


This Thanksgiving, as my kids left, I called out to each of them, “Take care!” “Drive safe!” Probably, I threw in a few of my other favorites like “Be happy!” Or “Be good!”

None of the people I love, especially my children, leave the house without being carpet-bombed by my bon mots. What do these incantations really represent? They’re the language of worry. I speak worry fluently; in fact I'm a native speaker. This kind of speaking is hardly peculiar to me–most of us do it. It's a way of expressing care and concern, since it’s certainly not actual practical advice.

These sayings could be labeled as what they really are: blessings. In other words, the language of worry is a dialect of the language of love. When someone I care about steers their car onto the highly hazardous reaches of Highway 1, I send them off with a blessing no different from the rituals I've heard from many people around the world that involve incense or pouring libations. The language of worry is spoken widely, in many tongues.

Okay, having admitted to being a consistent inflictor of these anxiety statements, I should also confess to being prickly when I'm on the receiving end. Some of the admonishments tossed my way feel insulting, as if I'm an idiot who needs to be told how to look out my window to see the view, or not spill hot coffee on myself, or let my dog sniff my cat. All of these are real examples. Even so, it seems hypocritical for me to casually toss off outlandish advice but be unwilling to receive it from others. We need to figure out how to receive as well as give.

But it's not that simple.

For many of us, harmless loving blessings can become cover for something that crosses the boundary from care and concern to a region of human interaction that's much darker. In extreme but very real cases, worrying or helping becomes dangerous, as were going to see.

You might recall my mentioning meeting folks from Not Dead Yet. These lawyers, educators, and others work hard against euthanasia laws. As I understand what they've said and written, they know from first-hand experience what happens when “helpers” get carried away assisting people who are unable to run away or strenuously object (or object at all) to what's happening to them. Some of the stories I heard from this bunch were deeply frightening, because anyone can end up vulnerable. I've learned firsthand that helping can be a slippery slope.

The topic of euthanasia and its sister subject suicide are alarming to most of us. When my wife was diagnosed with ALS, the idiot neurologist who told her of her diagnosis immediately raised the issue of Mary or someone killing her, and Mary never got over that terrible juxtaposition. Over the years she gradually devolved the protection of her life onto me. In a marriage, nothing is more intimate than the sharing of life - and death - choices.

In writing about my wife's suffering and death, I feel concern that these extreme subjects could be alienating to a casual blog reader. Thankfully, few people get ALS. But we all die, and I suspect few escape some encounter with harsh choices and bungled assistance.

Let's get practical. What's a person to do, who means well and wants to help? Having worked in the “helping professions” all my life, having helped my wife with her illness and living with mine, here's what I think I've learned:

1. Don't abandon your impulse to help. I believe it's part of what makes us human.

2. If you're at the receiving end of being helped, learn to say yes. Be gracious. Take those damn deep breaths everyone is always telling you about before you fend people off.

3. The 1st through 5th rules of helping in my list of 6 are: ask. I think the key mistake made by the good-hearted is to barge in. This is the slippery slope of the language of worry–we go easily from a harmless blessing to intrusive imposition.

4. A corollary of my caution about asking is, is never go first. Wait. See what happens. Back off.

The really good helpers, people I've met in settings ranging from hospice to gas stations, mostly listen. They are receivers more than they are transmitters: they hear, absorb, and only then–they respond, modestly.

There is an innate power gradient involved in helping. Once you’re labeled as sick or old or just plain helpless, others assess their own power as greater, and this gives them permission, they feel, to impose themselves in ways that they would find intolerable were the situation reversed. As both someone who likes to help and someone who is learning to be helped, I know that issues of power and domination are at the core of this most human transaction. I remember a conversation with one of the Not Dead Yet activists, a lovely woman born with spina bifida, who starkly described the unmistakably murderous impulses of some of the helpers circling around her life. Even though most of us acquire greater vulnerability later in life than someone with a birth defect, there are otherwise no real differences between us.

The slogan, “Nothing about us without us,” is not a statement of political correctness or exclusivity. It's an announcement of survival by means of a deep commitment to autonomy, in the face of the infliction of great harm. It’s a dialect of the language of love as much as the language of worry is. And we ignore these warnings at our deepest peril.