It’s Day Three of wondering if I have a parasitic alien life form attached to my spine, and boy, do I feel like shit. It’s not just the pain or the stiffness or the restrictions on movement, it’s the lack of sleep I’m getting because I hurt every time I wake up, and it’s the exhaustion from even the smallest thing because it suddenly takes a ton of effort to do that smallest thing without feeling like someone’s filleting my latissimus dorsi with a very long, sharp, cold knife (because somehow the pain is cold).

I made a doctor’s appointment for the first available time at what I hope will be my new PCP (bonuses include it’s just around the corner from my house and the partner dentist office that also takes my insurance is just across the hall), so from now until Thursday, I’m stuck shuffling around like a goblin and wondering at the amazing painkilling properties of bourbon hot chocolates.

Except I can only drink bourbon hot chocolates at home, preferably at night when I have nowhere else to drive, so for now, most of my day (and overnight) will be spent in grimacing discomfort and if you stand between me and my hot chocolate, so help you god I’ll cut you.

I mentioned before that this happened when I was putting a piece of paper into a recycling bin. A piece of paper. I wasn’t working out. I wasn’t lifting something heavy and impressive. I wasn’t doing anything cool at all. I was putting a piece of regular printer paper into a recycling bin and something near my shoulder blade twinged, and now I’m just that much more aware that I have reached my 30s to become a broken, decaying pile of a person and there’s no way I want to make it to old age.

My grandmother has chronic heart disease and diabetes but has somehow managed to make it to 86. She recently went to the doctor, who told her that her heart is getting weaker. He said her pacemaker is fine and she’s not quite severe enough for open heart surgery (and she might not survive that, I’m afraid?), but that her heart will not get better on its own. This information shocks her for some reason. Actually, I know the reason. The reason is that she heard some pretty standard medical facts and twisted it in her head to “THAT MEAN DOCTOR TOLD ME THAT I AM ACTIVELY DYING, HOW DARE HE.”

It’s not surprising, this is just how she is. And I know that nobody likes to be reminded about their age, especially when that age is one at which a lot of people either die or don’t reach. Because they’ve already died. And of course I can’t claim to understand how it feels to be reminded of your rapidly approaching mortality, although it seems weird to me that my grandmother is surprised at the news, or that she doesn’t seem to realize that she’s lived longer than everyone. Her siblings. My grandfather’s siblings. My grandfather. Most of her friends. This is sad in a pretty obvious way, but hey, Grandma. You did it. You won. You definitely beat me and I’m only 31. I might not have a pacemaker or diabeetus or complain about my walker, but christ, who even wants to live to be 86? Not me. Hand down. I’m in my early 30s and already fucking exhausted all of the time. I can’t imagine what life will be like when I’m approaching 90 (well, I can, but it involves global environmental collapse and probably I might have robot parts for organs and an antennae in my butt).

I listened to this Radiolab episode a few months ago about how regular people view efforts to prolong life vs. how doctors view those same efforts. These efforts are as simple as “would you accept CPR” to as complex as “would you consent to being placed on full life support, even though you display zero brain activity and require machines to breathe.” It was a really fascinating episode (although not an entirely surprising one), and I found myself agreeing with the doctors.

Basically, the doctors say no. No to CPR. No to ventilation. No to feeding tubes. No to full life support, god, absolutely fucking no to full life support. No to almost everything except for palliative care. Which sounds crazy to a lot of people, especially the parts about CPR, ventilation, and feeding tubes. This is because a lot of people don’t understand that while these efforts are technically capable of prolonging life in some cases (and I do mean some, because did you know that the success rate of CPR is something like 8-10% and that’s it?!), they don’t improve quality of life. In many cases, they make life a waking nightmare, that is, if you’re unlucky enough to be awake for any part of it.

I said the episode’s material wasn’t really surprising because I, unlike quite a lot of the people surveyed, apparently, have watched people die. And if you’ve watched people die, whether this experience took place in a home or a hospital, you’re aware of just how agonizing and gruesome it can be. Yes, I guess that some people die like on TV, very serene and dewy and peaceful. But for most people, dying is a painful, humiliating, frightening experience and eventually, they just want to be done with it. They are relieved when someone tells them “it’s okay, we’ll be fine, you can go if you want to.” And it’s fully everyone else’s choice, everyone else is free to go however they want, but you won’t find 86-Year-Old Me’s heart exposed on a surgical crucifix.

I just want to be done with it. When the time comes, I mean. I’ve already signed an advanced directive (in addition to instructions to donate whatever body parts still work assuming they are not robotic and/or butt antennaes and once I’ve been harvested just give the rest of me to a university for kicks), but I’ve seriously considered getting a No Code tattoo just below my sternum sometime this decade. So there’s no confusion. Don’t break my ribs apart to “save” me. Don’t paralyze me in order to hook me up to a machine. Don’t inject me with a steady drip of clear nutrients and call that eating. Don’t make me lie there with listless eyes and a slack jaw, thumb incapable of compulsively stabbing for morphine. Just let me fucking go. Manage my pain and say whatever it is you’ve always wanted to say to me, but don’t do all that gross stuff. I’m not interested. I won’t be mad. I want to go as gentle into that good night as possible, and don’t listen to a raving drunk Welshman tell you any different.

(Lest you find all of this upsettingly morbid, you should know that when it comes to Radiolab, I spend just as much time tearing up over the beauty of the sound of solar winds as Voyager approached the edge of the solar system, or the lonely, ancient death of Ötzi the Iceman, or the impossibly far-reaching impact of Henrietta Lacks’ brilliantly tenacious cells, or the gloriousness of a full classical choir singing the praises of the MANTIS SHRIMP.)