Jimmy Carter’s Long Goodbye

Practically no one ever thought that he would even be elected president. Or that they will make a significant agreement in the Middle East. Or that he will win the Nobel Peace Prize. Or that he will beat cancer.

But Jimmy Carter confounded expectations throughout his life of nearly a century. And so now it’s over again.

Mr. Carter entered the hospital a year ago Sunday, deciding to forego further life-prolonging treatment with the intention of returning to his simple home in Plains, Ga., to spend his final days in comfort and peace. As it turned out, there was more to the last few days than he or anyone around him expected.

The former president’s long farewell defied the odds and absorbed many around the world who spent the last 12 months honoring his memory, even as he refused to follow anyone’s schedule. Hospice care aims to make the end easier for both the patient and the family, it is prescribed for those who have less than six months to live. About half of those entering hospice care do not last more than 17 days. Only 6 percent are still alive a year later. Mr. Carter, the only president ever to live to 99, seems destined to continue pushing boundaries.

“He’s been a record holder for decades — the oldest president, the longest-married president,” said Jill Stuckey, a longtime friend from Plains who visits him regularly. “It was always on President Carter’s terms. This is how he lives and this is how he will die.”

His endurance may ultimately serve as a retort to those who never recognized his tenacity. “Carter once told me that he thought the biggest misconception about him was that he was weak,” said Jonathan Alter, author of “His Very Best,” a biography of Mr. Carter. “He was not, neither as a person nor as a president. Frankly, this thin man — who was called ‘Peewee’ as a boy — is a person of extraordinary toughness and courage.”

Mr. Alter recalled that when Mr. Carter revealed he had cancer in 2015, the former president said he was at peace with what God had chosen for him before he eventually beat the disease. But even if he accepted his fate, Mr. Alter said, “he was also always very ambitious — and that ambition extended to wanting to stay and see what was going on in the world.”

Mr. Carter spends his days in the one-story rambler in Plains that he has owned for more than six decades, overseen by caretakers and visited by relatives who take turns making the pilgrimage. He was last seen in public in November, when he gathered to attend the funeral of his wife of 77 years, Rosalyn Carter, who died at 96.

He looked so frail in a wheelchair, with his legs covered by a blanket and his mouth agape, that it shocked friends in the church and fans watching on television. But he was determined to be there no matter what, according to family members, who believe he held on for so long in part to ensure Mrs. Carter was never left alone.

“He was really honored and glad to get to the end with my grandmother, and it was a real treasure for him,” said Jason Carter, grandson and chairman of the board of the Carter Center. “And I think for whatever reason, the way he approaches this is from a place of tremendous faith. And so he just believes that for whatever reason God is not done with him yet.”

Mr Carter said one of the remarkable things about these past few months is that his grandfather is no different today than he was at the start of hospice. He doesn’t eat or drink much—he asked for coffee after Mrs. Carter’s service, a rarity these days—and he isn’t mobile or particularly talkative. But he is still clear enough to express his thoughts and absorb and appreciate information.

When Jason Carter told him last fall that he had received tributes and well wishes from more than 100 countries for his 99th birthday, the former president was deeply moved. “It brought him to tears,” Jason Carter said. “It was something that really affected him.”

Mrs. Stuckey, superintendent of the Jimmy Carter National Historical Park, said he did make his wishes known. “I walked in the other day and he smiled and we talked to him about the future meal and he told us exactly what he wanted for dinner the next night,” she said.

She was not surprised that many friends were surprised by his appearance at Mrs. Carter’s service. “I think a lot of people were shocked that he went and was able to go and people didn’t see him for a while,” she said. “When you don’t see someone for a while, it’s usually a bit of a surprise to see them. He may look weak, but he still has that spark in his eyes and still wants to help as many people as possible.”

Mr. Carter, the toothy-grinning peanut farmer who rose from obscurity to become the 39th president of the United States, left his mark after leaving office through decades of philanthropic activity fighting disease, negotiating conflicts, monitoring elections and building homes for the vulnerable. Even as he faded, he regularly sought the latest data on Guinea worm, a disease that struck 3.5 million a year in 21 countries in Africa and Asia when he began fighting it in 1986 but has been nearly eradicated. with only 13 cases worldwide last year.

“Carter’s entire life is defined by his relentlessness,” said Kai Bird, author of “The Outlier,” another biography of Mr. Carter. “And that’s why I’m not really surprised that he persevered in hospice care. He is a quiet force of nature — a relentless man in life, but also in approaching the end of life.”

Although Mr. Carter does not have an underlying terminal condition such as cancer or heart disease, and he chose last February to decline further life-prolonging treatment in favor of hospice, the first president known to use it. His decision expanded awareness of the availability and benefits of hospice care, which aims to alleviate pain and discomfort in the final stages of life.

“The way he and his family approached this makes this a national conversation,” said Ben Marcantonio, interim executive director of the National Hospice and Palliative Care Organization. “We talked about it one way at the beginning of his care, but now we talk about it in a different way. It opens up new dimensions of conversation.”

The anniversary of entering hospice care is not celebrated as a holiday, but it happens to be the day before President’s Day for Mr. Carter, so there will be a discussion about his life in Mrs. Stuckey Park.

For his family, however, there are mysteries that no panel or biography will solve. “One of the things that brought it home to me is that there are things about life and the spirit that you just can’t understand,” Jason Carter said. “I don’t know how he is now. I don’t know what it’s like to face this moment the way he’s been facing it for the last year. But it was liberating for me to know that I just don’t know. And that’s okay.”

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