The Diagnosis, the Tractor, and the Chair
A lifelong farmer recognized three signs that his life was winding down, and chose a different kind of care for each stage.

When I was a small child awakened by thunder in the night, my brothers and sisters and I would run to our parents' bed and pile in. As soon as the lightning lit the room, my dad would begin to count, "one steamboat... two steamboat... three steamboat..." until the thunder rumbled in. The fewer the steamboats, the closer the storm was to us. And when it was right overhead, wild with wind and rain, there were no spaces left between the flashes and crashes, until the storm moved on again.
Timing the spaces between the lightning and thunder is like timing the seconds between contractions before birth. Nature has her ways of letting us know what's coming. Signs of lifetimes nearing completion may be subtle or plain, but most of the time, there are signs. And like the magic light in the sky that lets us know when the day is turning into night... these signs come to guide.
After farming for food for forty years, Matt knew that the magic light could tint the sky as far as the eye could see, or come as a tiny flush of jewel tone color on the leaves, grasses, and trees beneath cloudy skies at sunset time. And, he had seen that the signs of our lifetimes winding down were just about as variable.
Matt's signs came in the forms of a diagnosis... a tractor... and a chair.
The diagnosis directed all of his attention toward recovery.
When his old tractor became too high for him to climb, he redirected half of his attention toward staying alive, and the other half toward getting ready to die.
He knew the preparations would come in handy sometime, even if he survived.
And when he could no longer rise from his chair, he directed all of his attention toward making the most of the time he had left, rather than trying to extend it.
Matt knew these same signs would have drawn others to different conclusions; but these were his signs, and he recognized them when they came.
The first sign directed him to standard (aggressive/curative) treatment;
the second, to palliative, which he called "Comfort Care;"
and the third, told him it was time for Hospice.
Standard treatment satisfied his initial need to rally for recovery.
Palliative treatment managed his symptoms when recovery seemed less certain.
Hospice gave him the care he needed to ease him through the time he had left.
Matt turned out to be one of those whose condition improved in response to "Comfort Care." There he sat at the farmer's market, on a pile of wooden crates, rocking his latest grand baby, while welcoming every passerby and pet with a cheerful word, handy tip, or smile, while his family managed the stand.
Matt had been the buoyant, beacon spirit of that market for forty years. He used to look towards his vast array of vegetables, fruits, flowers, dairy, bakery, jams, homemade catsup, sauerkraut, and more... and say, in a voice full of bounteous appreciation and enjoyment: "This isn't just food. This is my life."


