Be Careful What You Wish For

When my sister-in-law called to tell me my big brother had died, I was--well, surprised isn't a strong enough word. Thunderstruck, maybe. He was 68, but as far as I knew, he had no health problems other than arthritis, which was sometimes pretty bad but manageable. She didn't offer a cause of death and I felt like I couldn't ask. She'd just lost her husband of nearly five decades, and she had a lot more calls she wanted to make herself.

A few weeks after he died, I learned the sad and ugly details. Through careful planning and some good luck, my brother had been able to retire quite young, about fifteen years earlier than most. He and his wife had the financial security and the time to renovate their home, to travel, to exercise regularly, to seek live entertainment, and they did.

My brother, an engineer with a PhD and extensive management experience, volunteered at the California Railroad Museum, the Computer History Museum, and the Society of Industrial Archaeology. He treated them like jobs until they either phased him out or he burned out, losing his original enthusiasm. Sometimes he grew bitter at the direction in which the enterprise was going and thought he'd have run it better. Maybe he was right, maybe not.

He had little sense of purpose and knew he was depressed but refused to tell his doctor. No mental health professional need apply, either. He self-medicated with alcohol, usually an unassuming California wine from a winery he'd visited. On the infrequent occasions my sister or I spent time with him, it was usually brief and over a restaurant meal, where all of us enjoyed our wine. He'd get a little tipsy, but so did I, and since neither of us was driving, where's the harm in a little family celebration? It was so good to see him.

His arthritis worsened and he couldn't take the prescription-level pain medication and drink, too. He opted for the physical pain and being able to drink for the depression. His alcohol purchases were now by the case and with increasing frequency. He developed peripheral neuropathy, possibly due to alcohol abuse, which had two negative consequences, a loss of balance making even the mildest exercise unsafe, and memory loss issues. He was aware of both and the latter infuriated and further depressed him.

That meant heavier drinking. Still, he was able to stop drinking through an in-hospital rehabilitation program in order to be healthy enough for surgery to remove a kidney tumor. The operation was a success. Post-op treatment was a course of drugs that did not mix with alcohol, so he was sober for about three months. As soon as the doctor said he could safely stop the medication, he returned to drinking.

There was another crisis, a fall at home, another hospitalization and rehab, this time revealing a seriously inflamed liver. He entered an outpatient dependency recovery program, but on the trip home from his third session, he bought a case of wine. He did not return.

I can only imagine the pleas, the arguments, the utter frustration of his wife, his adult daughter and her husband, all to no avail. What they said and how he reacted are none of my business, but it had to be maddening that this smart guy would choose alcohol, which made him less unhappy, over treatment for depression and people he loved and who loved him.

My guess is that like a lot of men of my generation, needing help was a sign of weakness, of not being man enough. It's the thinking behind many men's refusal to see the doctor for obvious symptoms, and it's worse for mental health issues. Manly men suck it up, tough it out, play through the pain.

It worsened the loss for me to understand he'd deliberately chosen to hide all this from me and my sister, pretending during phone calls that he was happy, busy, and everything was fine. Only his immediate and local family knew how deeply he'd entered the downward spiral.

In a fairly short period of time, his wife explained, he was sleeping way too much and drinking while awake, often watching TV without changing the channel, or just staring off into space. When his wife noticed jaundice and edema, she called 911. The hospital treated his acute alcoholic hepatitis in multiple ways, with no improvement. He went from there to the hospice, where he died.

So is there a lesson here, besides "Don't drink too much"? Yup. Whether we admit it to ourselves or don't, all of us need to feel valuable or needed. For some people, a loving relationship or a circle of friends is sufficient. Others invest themselves in a hobby or interest which keeps them busy, happy, and often benefits someone else. But for my brother and those like him, it's the challenges we face at work, no matter what we do for a living, that give us purpose, and to a degree the paycheck that proves we are valuable, even if we don't need the money.

When my brother retired early, to the envy of family and colleagues, he effectively cut himself off from the feeling of accomplishment that comes with working for a living, the camaraderie and sometimes admiration of colleagues who came together to meet the goal, the knowledge that he was an integral part of a process. His sense of self-worth took a hard hit, and whatever level of depression he might have suffered as an adult increased to a level which was no longer manageable without help.

Like too many men (and not a few women) his age, he refused to seek treatment until his problems were so serious health professionals recognized he was well along the path that led to his death. Like every addict, he wanted what made the depression better more than he wanted anything else, including the love and respect of his family, his health, or a future in which his young grandchildren would even remember their grandpa.

There's the lesson. You may not like working, but be careful what you wish for.