I made more calls. I learned that in an ideal world, doctors told their patients about the pros, cons, and alternatives to any proposed medical treatment. I learned that the pacemaker could have been avoided altogether if my father’s hernia surgery had been performed another way, using a local anesthetic less risky to the heart. I learned we could have signed a waiver accepting the risks. I learned that the surgeon could have hooked my father’s heart up to a temporary external pacemaker—a procedure that a leading cardiac surgeon told me was perfectly safe—and removed it after the hernias were sewn up and my father safely out of the recovery room.
I would raise these options years later with my father’s cardiologist and surgeon. They were nonplussed. Said the surgeon, “Your father was still pretty together back then. It’s hard to envision a scenario where you’d say, ‘I’ve got to get that hernia fixed but don’t worry about his heart!’” Said the cardiologist, “When one has a pretty solid indication for a permanent pacemaker, you don’t usually do that [use a temporary device]. That’s a risky situation versus a fairly minor procedure and a permanent solution.” In any case, Dr. Rogan said, “Everyone takes for granted that it’s the family care physician who really acts as a quarterback.” And where was my parents internist, Dr. Fales? Why did Medicare reward the surgeon and the cardiologist far better for doing the procedure than it would have Dr. Fales for making a reasoned argument against it? “I spend 45 minutes thinking through the problem, and I get 75 to 100 bucks,” Dr. Fales said when next we spoke. “Someone spends 45 minutes putting in a pacemaker and is paid six times as much.”
— Katy Butler, from The Problem of Prolonging Life
Organized shuffleboard has always filled me with dread. Everything about it suggest infirm senescence and death: it’s like it’s a game played on the skin of a void and the rasp of the sliding puck is the sound of that skin getting abraded away bit by bit.
— David Foster Wallace, from A Supposedly Fun Thing I’ll Never Do Again
We do not know yet, a not yet that can be dilated corrosively; frustrating the end of metaphysics, interminably deferring truth. Yawns become scarcely controllable. Does it matter what we know or will never know? Let us not forget that philosophy is also primate psychology; that our loftiest speculations are merely picking through a minuscule region of the variegated slime encrusting a speck of dust. An obsessional concern for such insignificances is a tasteless parochialism. What matters is the Unknown: the escapographic matrix echoed spectrally by the negative prefix, sprawled in immense indifference to all our “yets”. Beyond the anthropoid gesticulations of knowing, suspension is not differentiable from death, and death (“one’s death” as we so ludicrously say) does not belong to an order that can be delayed. Has our Socratism reached such a pinnacle of profanity that we really imagine she would wait for us?
from FANGED NOUMENA: COLLECTED WRITINGS 1987-2007 by Nick Land