Slow deaths and sudden deaths

My parents both died slow deaths. My father spent the last three months of his life in hospital, of which the last month was in intensive care on ventilator support. He had been rendered immobile, and when the ventilator tube and food pipe went in, there was absolutely no way in which he could communicate to us during the brief times we were allowed to meet him.

My mother’s was a different story, but on a shorter time scale. She spent her last month in hospital, with the last ten days in intensive care and on ventilator, again what I think was fairly painful existence for her, living in a fairly isolated and airconditioned room, not being able to communicate with anyone, with all sorts of tubes and measuring devices stuck all over the body.

In hindsight, I regret my decision to allow them to be put on ventilator. I feel guilty for having extended their lives in a way which was both painful to them and where there was little meaning, for they lived cut off, and unable to communicate (and in both cases, had I thought rationally, I would’ve known that there was little chance the time on ventilator would allow them to recover). The only upside to this was that it gave me time to prepare. That it gave me time to prepare for their impending passing,

People who attended either of my parents’ funerals might have been surprised, a bit shocked even, to see that I was quite composed and in control of things. I wouldn’t be wrong if a number of them thought I was a heartless emotionless wretch. The reason I behaved thus was because it was only an incremental change as far as my mental preparedness was concerned. Till the day prior to both my parents’ deaths, I knew that the chances that they would recover and get back home was minimal. Delta. Epsilon. The death, normally a “discrete event” had only pushed this chance to zero, not a big change in probability.

I was thinking about all this two nights back when my grandfather-in-law passed away, once again after a prolonged illness (he refused to be admitted to hospital or be put on life support so in a way he was spared of time on ventilator), but his condition had deteriorated steadily enough for us to know that he would be gone soon. Several family members reacted quite badly, but several others were quite brave and acted bravely. The slow death was the reason for this, I thought.

There are too many factors that affect death, and no one can choose either the time or mode or pace of dying, but I have been thinking if slow deaths are better than sudden deaths or vice versa. The upside of a sudden death is that there is little suffering on the part of the dyer, but the discrete nature of the change (probability that the person would be no more the next day would jump suddenly from close to zero to one) would imply a huge shock for family members and friends, which they would take considerable time and effort to come out of.

A slow death, on the other hand, is extremely painful for the dyer, while it gives time to the family members to come to terms with the reality. Here, too, of course there is usually one big discrete step involved (like that Monday night when in the matter of less than an hour, my mother went from happily chatting with me to gasping for breath so uncontrollably that they had to immediately wheel her to intensive care and a ventilator; or that Thursday morning when my father suddenly realized he had lost all the power in his legs and couldn’t stand on his own), so it is more like a time-shifting of pain (for relatives/friends) rather than the pain being amortized over a number of days.

Once again, there are no clear answers to this question about which mode of death is better, but ever since I saw my father spend his last three months in hospital I’ve believed that sudden deaths are superior. I’ve found myself reacting to other people’s sudden deaths saying “good for them they went without suffering”. Again, no one really has control about how or when they’ll die. It’s only a question about what to hope for in life.

A Balance Sheet View of Life

The basic idea of this post is that interpersonal relationships (not necessarily romantic) need to be treated as balance sheets and not as P&L statements, i.e. one should always judge based on the overall all-time aggregate rather than the last incremental change in situation.

Just to give you a quick overview of accounting, the annual statement typically has two major components – the P&L statement which reflects what happened between the last release of the statement and the currrent point, and the balance sheet which reflects the position of the company at the point of time of release of the statement.

I think Bryan Caplan had made this point in one of his posts, but I’m not able to find it and hence not able to link it. The point is that you should look at relationships on a wholesome basis, and not just judge it based on the last action. The whole point is that there is volatility (what we refer to in my office as “the dW term”) and so there are obviously going to be time periods during which you record a loss. And if on each of these occasions you were to take your next course of action based on this loss alone, you are likely to be the loser.

I’m not saying that you should ignore the loss-making periods and just move on. You do need to introspect and figure out what you need to do in the next accounting period in order to prevent this kind of a loss from repeating. You will need to “work the loss”, not make a judgment to break the relationship based on it. I think a large part of the problems in this world (yeah, here goes another grand plan) stems from people using one-period losses in order to take judgments on relationships.

Another thing is not to generate the accounting statements on a shorter time period. This is similar to one funda I’d put long ago about how you shouldn’t review your investments at extremely short intervals since that will lead to a domination of the volatility term (dW) and thus cause unnecessary headache. You might notice that corporates rarely release their accounts statements more frequently than once a quarter – this has more to do with volatility than with the difficulty in generating these statements.It is similar in the case of interpersonal relationships. Don’t judge too often – the noise term will end up dominating.

One caveat though – very occasionally the last loss may be so bad that it more than wipes out the balance sheet and takes to zero (or even less) the value of the firm. In that kind of a situation, there is no option but to shut down the firm (or break the relationship) and move on. Once again, however, the clincher in the decision to break up has to be the balance sheet which has gone to zero (or negative) and not just simply the magnitude of the last loss.

Life based on a balance sheet view is a balanced life.