This was a difficult summer. It was the first summer of my new persona as a writer. Outwardly it appears to have been luxuriously loaded with visits and weekend trips. Inwardly it was littered with insecurities, frustrations, and the angst of authorship.
Having explored the world during my Gap Year and having dipped my toe into the world of health care reform during my post Gap Year, I found that I remain passionate about the ineffective excesses of the American Medical Industrial Complex (see previous blog posts here and here and here).
One factoid that became known to me recently is that more than 75,000 Americans over the age of 85 die in the ICU annually. Some of them were there by desire and design, perhaps because they thought that they would be part of the first generation to beat the certainty of death. Most were there because they had not prepared for the inevitable.
Is 75,000 a lot or a little?
Debbie thinks that 75,000 is a comparatively small number. In the absolute sense it is, as 2.6 million Americans die per year. In a relative sense it is not. My interpretation is that it represents 75,000 people who have exceeded the average life expectancy and who are physically plugged into a medicalized death with tubes in every orifice.
They are separated from their family, homes, and peace because they misunderstood the false promise of American medicine. They were tortured because the “promise” of their treatment proved to have the side effect of a false hope for a “cure.”
These ICU deaths represent 14 percent of the 540,000 85-year-olds who die in hospitals annually. Most of those patients would have preferred to die at home, in comparative peace, but they were not prepared to make the difficult choices to make that happen.
When my father died last April, I was self-released to write the bulk of my book about preparing for death. He died “quietly” with his oldest daughter at his side. His other children had visited and made their goodbyes. We buried his ashes without recrimination.
Over this past winter and spring I pounded out my book in the Brooklyn Law School library. I hired a book coach. I started to rewrite (mostly rearrange) the book with her vision in mind. Then summer happened.
Summer meant constantly struggling to refocus
Long-scheduled family reunions, family visits, and guest visits were interspersed with more spontaneous weekend trips and guest arrivals. The book progressed (or not) in fits and starts. While each reunion, visit or excursion stands alone as a delightful experience, they made a patchwork of the summer.
I was continually struggling to refocus on the book project. In my former life, I was not given to procrastination. A big writing project, however, lends itself to procrastination like no other enterprise. In doing so, the delay in writing amplifies the stress of arriving at an outcome.
I am now in the process of writing a book proposal, a 60 to 80-page document that will crystalize the book contents and render it “irresistible” to an agent and a publisher. It is another step in my commitment to an end and it represents a stressor in the creativity process that I have not faced before. I must justify my particular book in a nonfiction world crowded with end-of-life books and I must do so in a way that is uniquely compelling to an agent. And, I am just a beginner writer without a platform and only a passion to guide people away from a medicalized death.
Worse than having to crystalize the work, I have to come up with a plan to promote it and market it. One aspect of this means creating the online persona that I have assiduously avoided. Prepare reader, I will be blogging book excerpts in the next few months.
Prepare reader, I will be blogging book excerpts in the next few months.
Of course, “my book” has been written before. What book hasn’t? Few of the competitive titles sold well. My thesis that most patients can better prepare for the inevitable is difficult to communicate. But there remains the rationalization that if I do it properly, I can make my mark. There is also the reality that the vast majority of book proposals go nowhere. In that case I will proudly self publish it with Debbie’s company, Voxie Media.
As my summer schedule comes to an end, I see the potential for progress, a window of opportunity before my contract with the book coach expires, but the existential angst of the first time author persists.
And when I finish… what will I do next?
When I have finished this book (assuming I am not on a national book tour, The Today Show and Obama’s ad hoc Committee for Natural Death – JK) what will I do with myself? What will be my next project? Most of me wants to finish the book. A small part of me subverts the process for fear of the future.
There is a lesson in there, somewhere, for Gap Year wannabes. If you are an introvert who values the completion of tasks and who hopes to become a first-time author, prepare for discomfort.