The Actuarial Table

Regular readers will have noticed my lack of content these last few months. I intentionally put everything in my life on hold back in August in order to tend to some more important business. My friend Marie was diagnosed with glioblastoma. I moved in with her, cared for her, and took her to her treatments each day. She just passed and I’m beginning to resume my normal routine.

This blog is about architecture, urbanism, and the intersections of culture, politics, and economics. I’m not interested in writing about disease and dying. But I learned a fair amount about how the built environment affects us as we age and experience the end of life. Where and how we all live is important when our bodies begin to fail. I got an up close tour of these overlapping dynamics with Marie.

In the months just before her diagnosis she embarked on a full gut renovation of her home. As I helped her pack all her possessions we had several long conversations about her plans. I was very much against the concept. There was absolutely nothing wrong with her house and it just didn’t need a renovation of any kind. At the age of seventy six she had a mortgage free home with Prop 13 property tax protection for life.

Yet she took out a reverse mortgage to fund the work, effectively pre-selling her home in exchange for some easy up front cash. It was financial madness and completely unnecessary. But she dismissed my concerns. She was going to enjoy her retirement in style with money she didn’t actually have.

As the renovation began she moved in with an old friend who had recently lost her husband. The house was large and the friend could use some company as she rattled around a newly quiet home for the first time in fifty odd years. And Marie was a wonderful cook. It was a good fit. Then…

Halfway into the renovation she was rushed to the hospital. At first her illness presented as a stroke. Then seizures. After a week of tests her medical team offered their prognosis – four extremely aggressive brain tumors. Statistically she had eleven months to live. Her friend was still emotionally raw from the death of her husband and wasn’t up to caring for a terminally ill housemate. Marie was politely asked to leave. I know it was a painful moment for everyone.

I offered to take her in at my city apartment and I knew we could have made it work. But her daughter and son-in-law have a large comfortable home in a wealthy suburb and the family decided it was the better option. The family was out of town at the time so I helped Marie get settled into the guest room and stayed with her for a couple of weeks until they returned and she got acclimated. She hated it there. She could no longer drive due to the ongoing seizures and it was impossible to walk beyond the landscaped garden on twisty semi-rural roads with no sidewalks. There wasn’t anything to walk to in any case. The family was busy and she felt trapped in the house with nothing to do but watch soap operas and game shows. As luxurious as the accommodations were she didn’t want to be there.

There was also the logistical trouble with her daily treatments. Getting from the suburbs to the hospital in the city every day was a long haul. The side effects of radiation and chemotherapy don’t mix well with being stuck in traffic for an hour each way. And her busy family didn’t have the time or energy to be chauffeuring her around on top of all their other daily obligations. Her daughter never said it directly, but it was clear that having Marie at the house was straining everyone’s patience. Marie was stressed and she could be difficult when things weren’t precisely the way she thought they should be.

The decision was made to rent a house in the city close to the hospital. Her daughter was in a position to write a $12,000 check to secure monthly accommodations. I could go down a rabbit hole on the topic of affordable housing in San Francisco, but that horse has already been beaten. At the end of the day cash wins the battle for available housing. But Marie still couldn’t be left alone. She was adamant that she wouldn’t tolerate hired caregivers. She just didn’t want strangers looking after her. That’s when I moved in.

My goal was to make life as pleasant and normal as possible under the circumstances. I cooked and we entertained visitors everyday. We took walks around the neighborhood when she felt up to it. We personalized the rental with things that were meaningful to her. But she still was always completely preoccupied with returning to her own home – a home that was in the middle of a serious renovation and in no way livable.

Each morning after radiation and chemo she’d ask me to take her to the house to see what progress had been made. There was a tension between getting the work done as soon as possible, and making the house absolutely perfect. But the treatments weakened her over time and expediency began to win.

There never was a cure for her illness, but we had less time with her than expected. She lasted four months after diagnosis. In the end it wasn’t the brain tumors that killed her, but a massive infection.

I was with her when she passed. Her death came swiftly and she had her family around her. It was a mercy in some respects given the alternative of a slow miserable death if the disease had progressed to its inevitable late stages.

The house is finished now. It’s being sold and the proceeds will be going to the finance company. Marie transformed what could have been a million dollar gift to her grandchildren into a show home for creditors.

Marie was born and raised in San Francisco. On one of her better days before she passed she gave a group of friends an impromptu tour of her childhood neighborhood in Noe Valley. She pointed out the home where she lived and the park where she and her friends played back in the 1950s. Her mother was a bookkeeper for various local shops and managed to raise three children and purchase her own home on a single salary. (Marie’s parents were devout Catholics so divorce was unthinkable, but they lived separately with no financial support from her father.) It was possible at that time to buy a home on a middling pink collar income. As Marie explained, the city was in decline back then and respectable people were moving out to the suburbs. Property was cheap. Today the homes on her old block sell for $1,700,000 on average. The homes haven’t changed. But everything around them did. One of the recurring themes here at Granola Shotgun is that everything unfolds in long slow cycles. There’s always a beginning, a middle, and an end.

This piece first appeared on Granola Shotgun.