The Lessons of His Dying

Natural death did not come naturally to the Kennedy family. Two siblings brought down in flight; two others slain. But now two more siblings have modeled the death that most Americans say they want and fear they'll miss; both Edward Kennedy and his sister Eunice died within weeks of each other, at home, at peace, surrounded by family, after a race well run. For an eternally public clan that could not rise or fall or sin or stray without every move recorded, even death was a chance to shape the debate one more time.

Kennedy both fought death and welcomed it, consulted the experts, treated his brain tumor aggressively, but also made his plans and found some peace. President Obama hand delivered a letter from him to Pope Benedict XVI and asked that the Pontiff pray for him. Kennedy finished his memoirs. He soaked up honors and awards. He gathered the family and led the prayers two weeks ago when Eunice died. "It's been a chance for us to bond and be together and share a special time together," said his son Patrick of the final days. "That's a big gift. [It] let us have the chance to tell him how much we love him." Kennedy's wife Vicki, his children and step-children were all with him at the end. "He was ready to go," she told Vice President Joe Biden, who called her Wednesday morning. "But we weren't ready to let him go."

Which makes a certain sense. Kennedy lived his adult life in death's parlor, with no reason to imagine he would live long enough for his hair to go grey, much less white. He barely survived his own plane crash in 1964; he campaigned in 1980 in a bullet proof vest. He carried the guilt of a young life lost, after Mary Jo Kopechne died in the accident he walked away from. He was a close personal acquaintance of grief, and so was present during its visits to other people. Biden recalled Kennedy's ministry after his first wife and daughter died in a car wreck and his sons were critically injured. "He was on the phone with me literally every day in the hospital," Biden said. "I'd turn around and there would be some specialist from Massachusetts, a doc I never even asked for, literally sitting in the room with me." Kennedy spent a lot of time at Walter Reed hospital, with wounded soldiers. He gave a dying Senate reporter a watercolor he'd painted for her nursing home wall. He called every family of the 78 Massachusetts residents who died on September 11, to say "I'm sorry, and I'm here if you need me." He opened his Boston home to colleagues who had to come to town for cancer treatment. "An hour after my sister passed away, he was on the phone," said Senator Chris Dodd. "The moment you needed to hear from someone who could share feelings that are hard to express, Ted Kennedy would be [there]."

For most of us, there are no easy conversations about death and dying, the topic we avoid like the shady stranger in the dark alley. Two out of three people die in hospitals or nursing homes, often alone, too often afraid. When researchers interviewed family members of the recently deceased, half of them said their loved one did not get the support he or she needed at the end. Yet it was the idea that doctors should be encouraged to talk to patients and their families about their wishes that set off a firestorm this summer, one of the most disturbed and distorted debates in many years. The effort to talk about how we die was met with a fury of malice and mischief, the invention of government "death panels," the invocation of ghouls at your bedside judging whether you deserve the care you need.

Because Kennedy was the Senate's leading champion of health care reform, even his illness became a debating point. Allies called on lawmakers to honor his legacy, pass real reform; adversaries cited his case as a cautionary tale about too much change. "In countries that have government-run health care," warned Iowa's Republican Senator Charles Grassley, "I've been told that the brain tumor that Sen. Kennedy has — because he's 77 years old — would not be treated the way it's treated in the United States." This would be like saying, he went on, that "when somebody gets to be 85 their life is worth less than when you're 35, and you pull the tubes on them."

Never mind that no one has actually proposed any such plan for the U.S. President Obama has talked about whether it made sense for his dying grandmother to receive a hip replacement. Kennedy himself observed that he never needed to worry about his coverage — "I have enjoyed the best medical care money (and a good insurance policy) can buy," he wrote in Newsweek — and called for the day when all Americans could expect the same. But as a matter of public policy, as opposed to private choice, was the cost and ordeal of Kennedy's treatment worth the extra month of life he won beyond the 14-month average survival time for patients with his diagnosis? And who do we want making that judgment?

That is the hard question: but Kennedy's death also raised the simpler one, about how we plan and what we do to improve the odds of a gentle death. He had his family, his doctors, his priest available to discuss his wishes. He did not need to worry that his treatment was being distorted by doctors afraid of being sued. He fought, but he knew when the fight was over, and those who were with him saw hope, not fear. "The truth is, he had expressed to his family that he did want to go," said Father Patrick Tarrant of Our Lady of Victory Church, who was at Kennedy's bedside. "He did want to go to heaven. There was a certain amount peace —a lot of peace, actually — in the family get-together last night." When his sister Eunice died, Kennedy said that "I know that our parents and brothers and sisters who have gone before are filled with joy to have her by their side again. " Now his family could say the same of him.

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