12:26 p.m. on July 2, 2009 (EDT)
As one of the consequences of being an Old GreyBearded One, I have seen the passing of many friends, relatives, climbing and hiking companions. Currently, we are dealing with the imminent passing of Barb's favorite uncle, who fell a few days ago and suffered a concussion that was not diagnosed properly for several days (a concussion involves bruising and bleeding of the brain, which is often signaled by headaches due to the pressure building due to the fluid buildup, but in this case was masked by the atrophy of the brain with age - he is 95 yo). He has 2 daughters, one of whom is in a full-time care facility. This is one of those "no choice, you end in the hospital" cases.
Just a couple weeks ago, a climbing partner died in a car accident on his way to a weekend of climbing (Brutus, who I posted a note about in the Climbing forum). Not in the wilderness, and not doing what he loved so much, but it was apparently instantaneous. 10 years ago, John (aka Zippo), a climbing partner and an active participant on the original rec.climbing.useful website that spawned Trailspace died from hypothermia while climbing Shasta - doing what he loved, but not at a time and place of his choice. That one involved a major search effort (Brutus was one of the group that eventually found John 6 weeks later).
Over the last 15 years, Barb and I have lost parents, all in hospital and hospice situations. I have lost mentors (both professional mentors and climbing/outdoor mentors) and friends, some while climbing or doing something else they loved, most, though, spending their last days in a hospital or hospice situation.
Sometimes you get a choice, or make a choice. But mostly it happens when it happens with no choice on your part. No matter what, it is always hard on others, whether they be loved ones who are close (spouse, child, siblings, or, perhaps worst of all emotionally, a parent whose child dies before them), or the police, paramedics, firemen, search and rescue, who have to find the remains, perhaps extracting them from a burned-out building, twisted wreck, or finding only the skull somewhere in the wilderness (like the "Jane Doe" who was finally identified 2 years after her skull was found in the mountains not far from here).
Some of the people, like Guy Waterman, choose to go off somewhere do so because they feel they cannot suffer any longer, whether it is a physical problem (perhaps very painful) or an emotional one (others in Waterman's family have ended their lives as well, based on a couple books I have read). But even when this path is taken because the person feels abandoned and alone, with no one caring, it always turns out that there are others who did care. And those who have to search for and recover the body suffer as well, even when they have been trained and professionally for just this task.
Remember, choosing a hospital or a tent does not just affect you. It affects many others as well. I do not want to suffer a long and painful passing, of course, or spend months as a vegetable - I do not think anyone does. That's why I have a DNR in my wallet and on file with my doctor. I would rather practice LNT in passing as I do in living. A hospital produces one of the least messes to clean up, but so does disappearing into a crevasse (except that involves great risk to searchers).
In the end, though, there probably will not be a choice. What will happen will happen, and will probably be unexpected.