John Updike published Rabbit Remembered in 2000 and died in 2009 aged 76. Death was always one of his themes, but aging, the possibility of dementia, and his own death must have been on his mind as he wrote the book. Twice in the book he refers to the pointlessness of people continuing to live when almost all their faculties are gone; each time, like the great novelist he is, he at the same time presents an opposite view.
Annabelle, the “lovechild” of Rabbit and a private nurse who cares for patients with Alzheimer’s, observes: “Health care is an expanding field, as the world fills up with people that would have been dead a hundred years ago. Everybody winds up needing care, pretty much.”
Her half-brother Nelson–son of Rabbit, a former drug addict, and now a care workers–responds: “Yeah, you wonder if it’s worth all the effort. I mean, you’re keeping these Alzheimer’s wrecks going when they don’t even know enough to thank you, and I knock myself out to keep a bunch of depressive loonies from killing themselves, when if they did it would save the government a fair amount of money.”
Annabelle responds: “Even at the very end, there’s something in there, a soul or whatever, you have to love.”
Not many pages later in this short book, a cynical banker says: “You wonder how much dead weight society can carry….At some point in the next millennium, governments will have to establish a cut-off point. Eskimos did it, when they were a viable population. Native American tribes did it. In Sicily, they used to make a party of it— everybody piled on with pillows, so when the old person smothered there was no single person who had, so to speak, ‘done it.’ ”
Annabelle again speaks up for her patients: “I don’t know, there’s always something worthwhile there, even when they can’t remember from one minute to the next. They’re easy to make contact with. Maybe the shame they can’t express, about being useless, opens them up.”
A friend, a writer and comedian, has several times observed to me that society won’t be able to afford all these elderly people in care homes. Assisted suicide will fix the problem, he thinks.
I reflect on all of this as I cycle off on Christmas morning to see my mother, who has no short term memory and has been in a care home for three and a half years.