Not Yet Dearly Departed
Leave it to Art Buchwald to bring humor to hospice. Last February, the famed satirist was diagnosed with terminal kidney failure, given three weeks to live, and transferred to a hospice for a quiet goodbye. Then the unexpected happened. His kidneys almost miraculously started working again. The poisons in his blood that were supposed to carry him out in peaceful slumber washed out of his system, leaving instead a funny bone stunned and amused by the absurdity of the situation. It's not every day that someone flunks hospice. Seasoned author that he is, Buchwald turned the irony into a book. I spoke to him by phone from his home last week on the day Too Soon to Say Goodbye hit store shelves. He told me he was not completely well, but chalked it up as one of those things. "You're not out of the woods, but you're happy to be where you are."
Happy was hardly his mood 10 months ago. Then, he was a sad, 80-year-old man with a newly amputated leg and kidneys on the fritz. Buchwald's doctors told him he would need dialysis for the rest of his life. He tried it, but soon had enough. Despite his family's pleas, he entered a hospice facility, at ease with his choice to die naturally. And he was ever grateful for the kind, tender souls who welcomed him there, respected his decision, and helped him with what was to be his final journey.
Most people don't know much about hospice, the place. It doesn't cure; it cares, relieving physical pain and mental anguish. To Buchwald, hospice makes death less scary and dying more respectable. Most often, cancer or cardiovascular disease carries hospice patients to their end, usually in weeks. But like Buchwald, some are put on hold. "Each one of us has a telephone line to God," he says. "If it doesn't ring, you still hang around." But not forever. Buchwald left after five months. In one large study, 6 percent of hospice patients improved enough to be taken off the terminal list and sent home.
Buchwald was shocked when the big sleep didn't come. At first he felt guilty, especially when get-well cards started to roll in. But the hospice caregivers celebrated, and he became their superstar. Before Buchwald earned this title, he had been the poster boy for depression. A decade ago, he went public about his struggles with suicidal depression. He recalls poignantly how he "plunged into a terrible black inky lake." But with the help of physicians and medication, he didn't drown, and he continued to spread his inimitable mantras: "Don't commit suicide, because you might change your mind two weeks later."
Laugh or cry. Facing natural death, he now offers a message many of his contemporaries need to hear. Older men, particularly those in their 80s, have the highest rate of suicide. Risk factors for them notably include health issues. In fact, suicide often comes soon after they've seen a doctor. On that point, Buchwald notes the medical dearth of smiles and laughter. Look at how often doctors and nurses walk into a patient's room all serious, he says. His prescription? They "need to go to Disney World to be trained."
Laughter, of course, is the best medicine, and some studies even show humor is a biological stress reliever. Sadness and mirth just can't coexist in the same mental space at the same time. "If I don't laugh, I will cry" is all too human. As Buchwald sees it, many humorists use it as therapy to block out periods of hurt or anger. In his case, it was his lonely childhood without a mother, knocking around orphanages and foster care.
You would not know there were hurts or anger judging by his hospice time. Friends and family smothered Buchwald with love. VIPs, from Mike Wallace to Arnold Schwarzenegger, beat a path to the hospice door. And they all came bearing food, lots of cheesecake. ("What else do you do when you go to hospice?") He thrived. But something else clicked at hospice. One volunteer told him there were two kinds of patients, the ones who are ready to go home-heaven, that is-and the ones who want to go to the office. Buchwald wanted to go to the office. After he planned his funeral, pallbearers and all, he became a philosopher, pondering the ultimate question. The answer was easy. He was put on Earth to make people laugh. "So I started up writing again and found I could write wonderfully."
And what started out as a deathwatch turned into "months of living, eating, and laughing with my friends." Perhaps as important, Buchwald is now teaching all of us how to live—and to die. Yet he's quick to add, "I have had such a good time at the hospice. I am going to miss it."
This story appears in the November 20, 2006 print edition of U.S. News & World Report.