Sunday, July 17, 2011

Irrational Death

My mind has been wracked by this story of a man falling out of the stands at a Texas Rangers game while trying to catch a game ball tossed into the crowd by star outfielder Josh Hamilton. He was a 39 year old firefighter and a husband and a father. He had driven his 6 year old son Cooper three hours to the game to watch their beloved Rangers. By all accounts he was a great fireman; fearless and a leader of men. He was a husband and a father. He took his son Cooper everywhere with him, to the fire station, community events, to baseball games at Rangers Ballpark.

He fell on his head reaching for a baseball. In the end, that's what it comes down to. The injury was probably an epidural hematoma that expanded rapidly. By the time he got to the emergency room, he was probably already on the verge of brainstem herniation. He didn't have much of a chance. Again, he died reaching for a goddam baseball. Sports columnists and writers will try to spin this as a "tragedy at the ballpark". They will dress it up in the narrative of fathers and sons and how baseball is a metaphor for life and fatherhood and growing up and all that Field of Dreams nonsense. But it's all bullshit. This wasn't a tragedy, not in the Greek sense of tragedy describing a character's fall from grace due to an unrecognized, fatal moral flaw. He didn't fall as a result of some fatal moral flaw. It was momentary lapse of judgment. A split second of reflex reaction, the excited boy in the heart of a man reaching out for a real live ball at a game. To give to his son. He died stupidly, and I don't mean that as an attack on Shannon Stone. I'm not saying Shannon Stone was a stupid man; just that the circumstances of his death were absurd, in the existential, Albert Camus-sort of way. There are plenty of stupid deaths that happen every day. Rarely does such a death reflect on the intrinsic worth of the individual who succumbs to it.

The difficult part is how this death doesn't easily lend itself to any rational narrative. Humans have a natural inclination to tell stories about the things we don't understand. We tell ourselves stories to make sense of a seemingly random, brutal existence of winners and losers and arbitrary suffering. A death, especially a premature one, has to be explained in a way that makes it meaningful. Otherwise the pain of meaninglessness is intolerable. When the ones we love slip away into the eternal darkness of the great unknown, we grasp feebly for a narrative that can show the natural progression of a Life and how the end came "in good time". We strive to demonstrate that it was "meant to be."

In the ICU I see such narratives play out every day. These little old ladies who fall and strike their heads and spiral into oblivion. The bedside is adorned with pictures of earlier, healthier times. Surrounded by grandchildren and everyone smiling, a cake in the foreground, inter-generational gatherings, the completeness of a life captured on film. Those primitive drawings from children. Get Well, grandma. Everyone can gather and celebrate a life well lived.

My grandfather had one of those textbook "perfect deaths". He was in his mid-eighties and every morning he swam at the YMCA before work. Yes, he still worked with my Dad. The morning he died, he met my Dad for coffee and then went to the Y for his morning exercise. According to Y attendants he was in his usual good spirits, smiling and wishing everyone a great day. He swam his laps and then, in the shower, he suddenly collapsed and died instantly from a massive stroke. He had lived a full life. He had watched his children grown up. He had been in a fifty year marriage. And then he died just after doing something he loved. You couldn't have scripted it any better. There was no bewilderment at his funeral. You didn't look around and see blank, baffled faces mottled with grief and confusion. Death had simply come. No one could quibble about the timing. It was a reasonable death.

There are other good deaths. The Army private who dives on a grenade to save his buddies. The father who dies protecting his family during a robbery. The secret service agent who takes a bullet for the President. I read recently about a Thomas VanderWoude in Virginia who died in 2008. His youngest son, Josie, had fallen through a septic tank cover into a deep pit. Josie had Down's Syndrome and he was an adult and lived with his parents, semi-independently. Mr VanderWoude immediately jumped into the septic pit, immersed himself in eight feet of raw sewage and propped his son's head above the surface until he could be rescued. By the time Josie was safely extricated, Mr. VanderWoude had already died from the asphyxiating fumes. This was his seventh and youngest child, a boy with Down's Syndrome and he didn't hesitate to put his own life at risk. There was no moral calculus in the decision, no weighing of the costs and benefits---just instinct and love. This is what we mean by a heroic death.

But it doesn't always have to be an act of heroism. Sometimes death is reasonable if it just alights upon us gently. Even the cancer death can be a good one. Usually one dies from cancer slowly. Slowly one wastes away, after all the surgery and chemotherapy and experimental treatments. The end presents itself. But at least it's an honest end. There are no surprises. One cannot deny that Death beckons. One look in the mirror will shatter all those illusions--- the sunken cheekbones; the amber-tinted, dulled eyes; the protruding skeleton; the wasting away of vitality and slow erasure of prior Being. One cannot hide. But there is solace in finality. One cannot procrastinate any longer. The end is near, inevitable, but there is still time to make amends, to heal old wounds, to express love, to say things you were saving for an indeterminate denouement, to make peace with God, soul, life. You have time to touch up the narrative of your life. Although the end is premature, you are given the gift of writing the final chapter. You have time to make sense of it all, to reconcile yourself to extinction.

But there is another kind of death that we don't like to discuss. There are deaths that don't announce themselves. Deaths that ambush us suddenly and without warning. The 18 year old valedictorian who dies in a graduation night car accident. Len Bias. The five year old who is abducted and murdered. The 44 year old father of five who dies of a massive MI during his seventh marathon. The 32 year old who is struck by lightning while golfing on his honeymoon in Bermuda. The 13 year old Afghani girl killed by a Predator drone strike. The 18 year old high school senior with a full ride football scholarship who dies on spring break in Panama City after drunkenly falling backwards off a third floor hotel balcony. The four year old who runs out into traffic after a ball and is struck dead right outside his house. I remember this patient from medical school while I was on a trauma rotation. They announced him as a motor vehicle crash (MVC) and when they wheeled him in, he was already intubated. He wasn't moving anything and they hadn't given him any sedation. The story was, he was sitting at a stop sign in a Topaz or whatever, awaiting his turn to go. He was an IT specialist, or something along those lines, for a local industrial behemoth and he was on his way home from the grocery store. He was a bigger man, but he seemed soft and doughy, like a high school math teacher. The worst part was that he was completely conscious when he rolled into the trauma bay. I remember looking into his terrified eyes. I was a green and arrogant student then, completely out of my league. I guess I had never seen true Fear before. This was the real deal. Anyway, he was sitting at that stop sign, just another day in an anonymous life, when a pickup truck, piloted by a drunken repeat offender, plowed into him from behind. The impact whipped his neck forward with a violence that snapped his cervical spine at C2 and C3. The CT scan was obscene. There was nothing to be done. I recall being forced to attend the meeting with the man's wife in the consultation room. This was for our edification, as medical students. His wife was there by herself, surrounded by about 8 people (Trauma surgeon, Neurosurgeon, residents, students, etc). I remember the look on her face as the Neurosurgeon methodically explained that her husband was condemned to a life of quadraplegia, as a best case scenario. She had this look on her face like someone who sneaks into a Harvard mathematics class where the professor is lecturing on how 2+2=5, while everyone nods their head and takes notes. The anger and incredulousness on her face betrayed all decency. They had a three year old girl at home. He died within the week.

Let me now venture into a prohibited zone for just a moment. You know, while we're on the subject of unjust deaths that are redeemed by narrative. The mother of all examples is, of course, the story of Jesus of Nazareth. Let's review: God watched us for two centuries. He tried Law and Covenants and Promises. Over the eons, we continued to disappoint Him and betray Him. God was pained beyond understanding. But His love for us was infinite. So He sends down his Son, Incarnate in Man, as a final offering. This Son is to live and suffer and ultimately die for all mankind's sins. He dies violently on the Cross and rises again on the third day. Man, if he chooses, is redeemed through Grace and Faith.

Now that's a good death, no? To die as the sacrifical lamb for all mankind, the vessel through which all can be saved from eternal damnation. It's a beautiful story. A father sacrificing his only son for a greater cause. A supernatural diety trying to connect with his creation in terms that they can identify with. But then I start wondering. Why did old Jesus have to die such a violent, unjust, horrifying death? The Passion of the Cross is certainly dramatic. There's no doubt about that. Just ask Mel Gibson. But does the mode of His death somehow overshadow the ultimate message? Would it have mattered if old JC had died of typhus or malaria or leukemia in some clay hut in Palestine? If He had succumbed to famine or flood or pestilence? What if He had simply tripped over a rock after 40 days in the desert with Satan and fallen down a cliff? What if He had sustained a massive heart attack ten minutes after delivering the Sermon on the Mount? What if He had drowned while bathing one morning in the river Jordan? Would it have mattered? Would the stupidity of His death detracted from a lifetime of everyday suffering? Did it have to be so dramatic? Would the story have been any less compelling without the Passion? (I know, there's probably something to be said for Original Sin and how Man's Fall from Grace during the Edenic phase mandated that humans were wholely responsible for the Savior's death. But still. It bothers me. Sort of an abrogation of responsibility, in my mind. And I hate the Original Sin argument anyway, especially when it's used to justify the death/suffering of innocent children. Tangent ends.)

We humans need a coherent narrative, not just for those whom we choose to worship, but for the flesh and blood we share our lives with. Death disconnected from narrative is intolerable. It's too much of an obstacle, even for a great Faith.

I don't know the answers to these questions. I'm no theologian. I'm a traveller through the inexplicability of life like anyone else. But I think we should all pray,or something along those lines, for Cooper Stone. He is a child now without a father. But he has a long ways to go (hopefully) before his time on earth expires. He has time. He will grow into a man someday. He will exercise a free will. And he will tell himself stories about a father he barely remembers. He has time to construct a meaningful narrative for a father who missed the bulk of his life. And there is Hope in that. There is Hope in the possibility that somehow, someway, Cooper Stone can eventually explain his great loss to himself through a fictive amalgam of memory and imagination. Perhaps his mind is seared with images of going to the fire station with his daddy, playing catch in the hot Texas afternoon, the way his daddy smelled when he came home from work, the prickliness of his unshaven, up all night face. This is all we have. The dead are lost to us otherwise. They die in a multitude of ways. They are extinguished like flickering candles in a November wind. The way they die is immaterial. It won't always make sense. The story just begins. They leave fragments and remnants and shattered pieces of a life. It's just lying there, fluttering in memory and anecdote, evanescent snippets of reality. And it is up to us, the living, to put those fragments back together again when we finally choose to speak of the dead we have lost and loved. I think this is the essence of a True Faith--- to believe these assuaging stories with all our hearts, in spite of all the evidence to suggest otherwise, in spite of the irrationality....

Sorry for the heaviness.

20 comments:

lorri666 said...

What an interesting post... We had a family here in L.A. who died a few months ago when they got rear-ended into an oncoming train. Even now it just upsets me to think of their final moments of fear.

Deaths like this, for me, do not bring Jesus to mind, but instead the story of Job. If you can witness (or suffer) these horrors, but still retain your optimism, refuse to become cynical and give in to hate and anger, refuse to renounce your faith, then (following the Job story) you score one for the Creator in the big battle against evil. I don't mean to be too flippant when I say that, either. To me it's the only thing that makes sense when looking for cosmic interpretations of events on earth. Or it could be that it's all completely meaningless and random - but that would be a matter of faith or lack thereof on the part of the person perceiving the universe...

Anonymous said...

His widow requested that video of his death not be shown by the media. Although I do realize this does not apply to you, I hope that you will abide by her wishes.
Thank you

Anonymous said...

Don't wanta sound crude, but its Evil-Lution...
In a billion years we'll be a species that doesn't fall out of the bleachers for a $6 baseball.
And what really P's me off is how the players today just toss balls into the stands routinely, as in the case of the unfortunate Ranger's fan. (Old Fart Voice) In MY day, you only had a chance at homerun or foul balls that made it into the seats.
I still remember a Dodger game from 1975 when Bill Buckner caught the 3rd out in left field, ,looked me RIGHT IN THE EYES and then tossed the ball to the ballboy, like everyone did back in 1975, the Dodgers didn't make billions of dollars givin baseballs away...
And I consider myself partially responsible for the NY Mets 1986 Championship, cause for YEARS I followed Buckner's career, wishing him nothing but curses and despair for trampling on the feelings of a naive 12 yr old...

and why wasn't this fan wearing a Helmet?!?!?!?!?!?!?
Seriously, if this guy hadn't got himself killed at the ballpark, he'd have done it doin something else....


Frank

Skeptical Scalpel said...

A very thoughtful post, but I agree that the video is unnecessary. Typically, the TV news ran it twice in slow motion. I regret watching it.

Buckeye Surgeon said...

Yeah I agree. Video removed 7/18.

Anonymous said...

I agree, this story affected me for the same reasons you stated, the utterly pointlessness of his death. I can accept the randomness of the father's death. That happens everyday. And although he died too young, he did experience 39, hopefully good, years of life. What I struggle with is the implications of his death for his 6 year old boy. No reference to any religious text can makes any sense of that. Anyone who has children uderstands that there is nothing more pure and innocent than a child. To take away his father is unjustfiable.

So what's the meaning? I don't know, but I'm certain that it cannot be explained by a book written by man. Personally, I try to come home from work everyday, hug my 2 children and let them know that they are loved and cherished. I try to make a conscious effort to put aside all the petty arguments with the wife and financial stress of life (which is not easily done), and just enjoy the company of your family. Because simply, I don't think there is any more meaning to life than this.

Bianca Castafiore? said...

I just erased a long and extraordinary comment, during which I took a 3-hour nap. Good sense finally won out, hence the absence of all that... text.

There is one thing, though, that remains unanswered -- unasked, even -- in this lighthearted theological miasma of yours:

What do you have against math teachers?

Bisou,
A bientôt --

Bianca

Gil said...

Liked the post......

Death comes for us all, and the only preparation that you can have is to live each day to the fullest without regret. To tell those that you love how you feel, and to harbour no ill will to those that may be loved less so.

Now that I do more palliative care than deliveries, I have learned that the life well lived is done so on a daily basis. It is through this daily living, being present in the moment, open and honest with those we love and cherish that we can walk into that ambush and not leave others feeling so lost by our absence.

Just my thoughts on this issue.

Attorney Andy said...

Your thoughts on this story likely come from the fact that you are a father. When you have little kids, it's hard to hear what happened and not immediately feel sad for the little boy, who watched his dad fall.

The lawyer in me can't help but think about the terrible design in the stadium. Why was there a huge gap behind that scoreboard adjacent to the seats? And if it was there, why are the railings barely up to the guy's waist? Even the smallest consideration of patron safety would have caused these things to be corrected. I hope the guy's estate sues the team; not for the money, but to make sure that the design problems in the ballpark are fixed.

Great post, by the way

Anonymous said...

What about that Clemson player Woody Hayes beat to death in the 78 Gator Bowl???
Dudes just minding his own business, returning an interception, when this crazy old man beats him with a cane..
sad, really...

Frank

Mimi said...

Yes, yes, you raise a lot of questions that can never be answered. We all know of "inexplicable" deaths; for me, young suicides, especially. My twin sister's son took his own life at 31. I've never been able to understood, let alone accept that. I want it to have been an accident, even a grotesque accident, rather than his decision.

Anonymous said...

Magnificent post...

Anonymous said...

I like to think that while reaching out for that foul ball, Mr Stone anticipated only his young son's delight when it was caught.

Also I agree (with the attorney)that professional ball clubs have a responsibility to build safe facilities with their billions.
DD

Anonymous said...

Attorney Andy:

Good example of why y'all are lower than John Wayne Gacy, heck at least he killed his victims relativly quick...
and you probably oughta sue George W. Bush too, I'm sure he had something to do with it.
Some 40 million + fans have attended games at the Rangers stadium since it opened without managing to kill themselves, a few of em even got foul balls.
and the other 29 MLB stadiums? NO deaths, unless you count that fat umpire who keeled over back in the 90's, and now they've got AED's every 20 feet, which is why a hotdog and a beer cost $30..

Frank

Anonymous said...

Thanks for your thoughtful post on the evanescence of life. I always enjoy reading your blog.

Anonymous said...

I just landed here on your blog after a restless night of unexpected resurrected grief, past losses coming back to haunt, recent loss, inevitable future loss pressing closer. It is an old familiar grief but it takes me by surprises - first the sharpness of the pain, then the weight, just the weight of being human and a human witness at the bedside of so many dying patients.

I was a Hospice nurse for many years and those experiences will never leave me. They were powerful and life-changing and I am grateful for the privilege of having been there.

Thank you for the healing words about the human condition. Thank you for the work you do each day that contributes to the ordinary miracles that will never get acknowledged because you were just there doing your job and doing your best to do it right.

That these words I found this morning came from a physician offers more healing than you can know.

Anonymous said...

gosh damn instead

Pattywagon said...

It seems to me the irrational deaths are the ones that haunt healthcare professionals. Just recently I cared for a young 13 yo girl, poverty stricken, who suffered from a tooth abscess that turned into a necrotizing facsiitis. She came in with her airway occluded and needed to be emergently trached in the er. She had many surgeries but later died. I heard that the abscess enter into the blood brain barrier and the infection killed her. I guess it just haunts me because she was a active young girl, and had such a easy problematic cavity if only she had access to medical care.
I remember a doctor venting in the nurses station saying things such as "What is it $150 for a filling these days?, why couldn't the parents just fork out the money to see a dentist?" This angered me beyond belief. How could a physicians or nurses be so disconnected and unable to to see that 150.00 might mean no groceries for a week, no gas to get to work. This among many other cases is why I believe universal healthcare might be the answerer. I also feel that since health care cost are so high and unaffordable to the average American. A person is not making the choice not to pay for a dentist appointment as oppose to a fancy cell phone, rather a house payment compared to a root canal. People don't make the choice to go out to dinner rather than get a check up. Most poverty stricken folks are making hard choices weather to purchase needed medications or buying groceries. It angers me that people who don't see these people struggle think it is exaggerated. Healthcare is not affordable to the average person with out insurance. In fact I believe even the insured folks are struggling to pay higher premiums and less coverage. Its crazy. I don't know what the answer is.... universal health care...medicare for all... single payer...its all so mind blowing. When people start believing access to health care should be a right and not a luxury it might change, because when it comes down to it the only difference between that 13 yo girl that died and my 13 yo daughter is that my daughter had health insurance that paid for her care and what the insurance did not pay for ($368.78 of the 968.78) I had available in a flex spending account. Perhaps I could be the one laying to rest a child if I worked as a nurse assistant at local nursing home only hired as a registry personnel not able to qualify for health insurance benefits, forced to work 2 other jobs cleaning homes like this mother did just trying to make ends meet.It all just makes me sad... I just needed to get this out and vent. May be off topic a little but I was surfing the web and came across your blog irrational death.

Anonymous said...

Allowing medical students to be a part of that conversation is something so sacred and important.
ONE DAY they will have to exlpain a death to a scared family- no one is a medical school class can ever teach someone who to tell a family that there loved one just passed away.

You were lucky and priviliged that you got "pulled" into that situation.

Gregory Dawson said...

I second the call for universal healthcare. Many people die everyday for lack of routine care they could not afford. Those that wish to push away any responsibility for their fellow man try to blame those deaths on poor life choices. We all make poor life choices, only some are called to pay for them with their lives.

The random, freak nature of the death of this young father only underscores how much of our lives are determined by luck or a lack there of. I am not a religious person but the phrase "there but for the grace of God go I" means everything to me. We have a duty to reach out to one another and help however things came to be as they are.