I do not want to be kept alive or kept on mechanical support if I have a permanent and severe condition where I am not able to take care of myself, and I am not expected to recover.

Whoa. This is ME I’m talking about. Not my elderly friend, not my mother, not my daughter who died. It’s also about some of you who have no devoted partner or family member who you feel absolutely certain will step in and make all the exact right choices if you lose your ability to make your own health care decisions. Who will take care of us, and how?

I’m watching a lone duck swimming in my pond where the ice is closing in on her, and imagining that one day I, myself, may be cornered into an ever-shrinking world with limited options. A world where I am no longer in control. Facing pain. Dementia. Death. My gut suddenly feels like I’ve swallowed an iceberg.

Years ago my daughter, in the throes of cancer, appointed me to be her health care proxy. Not understanding what that meant, I was thrilled to be chosen over other family members, and I carried that document with me like it was a certificate of merit. But I was clueless. We never talked about quality of life, pain, comfort, dying. What she might want or not want. I flubbed the job. When her health eventually crashed, and the doctors wanted to shove scaffolding through her ribs to bolster her collapsing lungs and—well, who could have predicted the myriad of sudden frantic decisions and all the things that could go wrong in a short time? I’m screwed if there’s such a thing as bad proxy karma that catches up with you when your own turn comes.

Having witnessed enough human deaths, and played god for too many pets’ endings, I do not take this health care proxy thing lightly. As the New Year tumbled in, I lost sleep worrying about how another person could possibly make life-or-death decisions for me, ever. When a friend finally looked me straight in the face and said, “That’s going to require a very long conversation,” I practically wept with relief.

If you were close to death with no hope of recovering, and you could not make decisions or communicate your wishes, what would you hope for from those who are caring for you?