Overliving

The patient's apartment is full of books. A whole shelf is devoted to Virginia Woolf. I ask which novel she likes the best and am surprised when she says The Waves, a lyrical book of sensation and consciousness, with hardly a narrative at all. This, I think, is the way to live at ninety-five. She tells me she wants to die. She can see how things are likely to go. She will fall one morning, and paramedics will be summoned to pick her up. Caregivers will be invited into her home. The pain in her knees and back will worsen. Disability is coming, it cannot be avoided, she says, and it would be better if her life were now simply to cease. I struggle to find a name for this state of thinking. A senior geriatrician in my department tells me that she sees elderly patients like mine all the time. What word does she use for these men and women, I ask?