About six months ago, I was in the waiting room of our vet and the woman next to me, who was sitting next to a wheezing old glassy-eyed Lab, turned to me and burst into tears. She had come to tell the vet she wanted to put Zeus down, he was blind, deaf, could hardly walk and was now incontinent.

He was 15, she said, she had kept him alive too long, but she could see how painful it was for him to walk, how undignified his life had become.

“I want to end his suffering,” she told me, “it is my final gift to him. I wish I could have done it for my mother.” Later, when she came out crying, she told me it was quick and painless. “One shot, then another, and he was gone. I was so relieved for him, he did so much for us, it was the least we could do for him.”

If you spend much time in a veterinary office, and you get to know people,  then sooner or later, someone  – a tech, vet, receptionist, pet owner – will say, “I am so grateful we can do for dogs and cats what we can’t do for our mothers and fathers, help them to die in peace and comfort.”

Most often I hear this said about mothers. This is, I think, because mothers tend to live longer than fathers and make up the majority of patients in elderly hospital wards, nursing homes and assisted care facilities.

We are a curious species when it comes to death.

Several years ago, working in hospice, I heard a daughter threaten her cancer-stricken and emaciated mother with the threat of a painful and intrusive feeding tube if she didn’t force herself to eat. She was down to 75 pounds and could not eat and she told me every time we were alone how much she simply wanted to be left to die in peace.

Nobody would permit it, she lived for many months.

We are the only living things in the world who know what death is, or that we are going to die, and yet we hide from it all of our natural lives, and when the times comes to face it directly, we don’t, we abandon our mothers to die in ways that are often cruel, painful and without dignity or peace.

I’ve been working around death for more than a decade now, in hospice, nursing homes and assisted care facilities. A friend sent me this message today, and I was struck by the truth of it.

“I was just talking to my neighbor about our elderly mothers and how important it is to respect their wishes,” she said. “Once they are confined in the medical system, its a different pathway to death…”

If you care about the elderly at all, then you will soon come to care about the way they die, and the helplessness and suffering they endure at the end of their lives. It is true that we often give dogs better deaths than our mothers. We happily spare them pain and endless suffering.

Before World War II, most mothers died at home with their families. Today, we have shoved the dying out of sight, confining them to medical institutions, funneling them into rehab centers and hospitals, where they die out of sight. Today, 87 per cent of Americans die in hospitals.

If you work with the elderly, you see the truth of my friends statement, once they enter the vast and often invisible world of medical facilities and institutions, they lose control of their lives and it is most often too late for them to make meaningful decisions about how they wish to leave the world. The system is a sort of mindless eco-system, pushing everyone through.

For years, I have seen this world of bandages, pills, doctor’s visits, nursing home visits, ambulances,  IV’s, bandages, surgeries and procedures, the shuttling from one facility to the other, living at the mercy of administrators and bureaucrats, regulations and insurance companies, pharmaceutical monoliths and fearful and corruptible politicians.

Our medical culture is wonderful at keeping people alive, but indifferent to how they are living. Or how they might wish to die. Hardly any doctors ever wish to have this conversation.  They are data and systems people, they prescribe and treat.

There are countless caretakers of mothers in our country now, most of them women, and they know just what I am talking about, even if the politicians pretend to be deaf, dumb and blind. I hear from them often.

I’ve seen countless families, full of love and good intention, worn out financially, emotionally, spiritually at their powerless and inability to help their mothers, finally surrendering to the vast system that absorbs them.

I should say that within this world I have seen countless and dedicated nurses, aides, caretakers and helpers, full of love and devotion. I know some ferocious family advocates who have made a difference, and some compassionate doctors who try hard.

But it is perhaps our widely shared secret, those of us who know one another,  these stories of suffering and pain, people kept alive without discussion, consideration or consultation, a medical system that is a vast underworld, hidden from sight and consciousness, keeping people alive beyond all reason or meaning. Does anyone really wish to hear these stories?

I have lost count of how many people in these institutions have told me they are prepared to leave the world, but there is no one to listen to them, no way to help them. Perhaps there is just too much money to be made from the illnesses and medications of the elderly.

I am a volunteer, not a politician or health care worker, and I cannot imagine ever having a say in how this system works.

But it is good to talk about the mothers, to speak for them every now and then, and about how people, die, because most of us love our mothers, even when we can’t agree on much else, and we wish they could die as peacefully and comfortable as most dogs.