The Technology of Living and Dying

Dr. John Roberts discusses aging and decline in John Updike’s writing in our Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley

Last week’s Faculty Fellows Seminar in “Health, Well-Being, Healing” focused on questions of dying and, specifically, how new life-prolonging technologies compel one to rethink what it means to die. Dr. John Robertson of the School of Law presented his current research on Left Ventricular Assistance Devices (LVADs) and the later poetry and prose of John Updike. Dr. Robertson is especially interested in Updike’s short story “The Full Glass”—written shortly before Updike’s own death in 2009—about aging and decline. Updike’s protagonist reflects on a small detail of his daily life, filling his bedtime glass of water, to think about the end of life without directly confronting the experience of dying. Dr. Robertson’s work-in-progress on this material is entitled “Writers at the End—John Updike’s ‘The Full Glass,’” which he hopes to publish in the journal Literature and Medicine. Although “The Full Glass” does not address machines or surgical implants (such as LVADs), Updike’s writing reflects on the quality of life from the perspective of an elderly man.

The LVAD is a surgically-implanted mechanical pump, which helps the heart’s ventricles to move. It requires electric power to operate, meaning that recipients must either remain close to a power source or carry battery power with them at all times. The LVAD has two uses. It can either serve as a bridge to transplant (a short-term solution while patients wait for an organ transplant) or as a destination therapy, a permanent installation for heart patients. LVADs’ use as a destination therapy is a recent innovation, made only within the last five years. Though LVADs save lives, they are intrusive, inspire anxiety about the effectiveness of the device, and come with an increased burden to caregivers, a traditionally feminized profession. Seminar participants questioned whether LVADs are worth their human (not to mention financial) cost to quality of life.

LVADs can place humans in a new state of being. Through LVADS, patients may remain alive, but they are dependent upon a burdensome machine to live. Fellows discussed a number of philosophical approaches which might be used to name and understand this new state, including zombies, liminality, and purgatory. As anthropologist Victor Turner would suggest, ritually-authorized transition from one lifestyle stage to another could ease the difficulties experienced by LVAD recipients. LVADs require an intertwining between person and machine, causing reconceptualization of what it means to be a cyborg or whether interactions with machines make us more or less human, questions addressed by new media studies.

Updike’s work in his book Endpoint and Other Poems feature experiences of aging and decline paired with reflections on writing and production. His poems express the distinction between the fruitful creative impulses of the mind and the failure of the body to cooperate as it had previously. In his poem “Oblong Ghosts” Updike writes:

It seems that death has found
the portals it will enter by: my lungs,
pathetic oblong ghosts, one paler than
the other on the doctor’s viewing screen.

In “The Author Observes His Birthday, 2005,” in a manner reminiscent of Anne Bradstreet’s work “The Author to Her Book,” Updike uses bodily imagery to describe his books, lining up their spines on his shelf:

And then to have my spines
line up upon the shelf, one more each year,
however out of kilter ran my life!

Fellows discussed a wide-ranging set of issues, including end-of-life experiences, caregivers and patients, quality of life, the interaction between humans and machines, and autoethnography. Fellows suggested that Prof. Robertson could use techniques drawn from autoethnography to contemplate aesthetic distance and connect his reflections on LVADs, bioethics, and John Updike.

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