by First, virtually no one thought he would be elected president. Or that it would forge a historic treaty in the Middle East. Or that he would win the Nobel Peace Prize. Or that he would beat cancer.
But Jimmy Carter has been confounding expectations throughout a life that has spanned nearly a century. And so it is again, now near the end.
Mr. Carter entered hospice care a year ago Sunday, choosing to forego further life-prolonging treatments with the intention of returning to his simple home in Plains, Georgia, to spend his final days in comfort and peace. It turns out there have been more final days than he or anyone around him expected.
The former president’s long goodbye has defied the odds and absorbed many around the world who have spent the past 12 months honoring his memory, even as he has refused to follow anyone else’s timeline. Palliative care is intended to ease the end for both the patient and his family, prescribed for those who have less than six months to live. Approximately half of those who enter palliative care do not last more than 17 days. Only 6 percent are still alive a year later. Carter, the only president to live to be 99, seems destined to continue pushing the envelope.
“He’s been breaking records for decades: oldest president, longest-married president,” said Jill Stuckey, an old friend from Plains who visits regularly. “He has always been on President Carter’s terms. This is how he lives and this is how he is going to die.”
His resistance in the end can serve as a reply 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 Carter. “He was not, neither as a person nor as president. Truly, this little man, called ‘Peewee’ when he was a child, is a person of extraordinary toughness and courage.”
Alter recalled that when Carter revealed in 2015 that he had cancer, the former president said he was at peace with whatever God chose for him before finally overcoming the disease. But even if he accepts his fate, Alter said, “he’s also always been very ambitious, and that ambition extends to a desire to stay and see what happens in the world.”
Carter spends his days in the Plains single-story rambler he has owned for more than six decades, watched over by caretakers and visited by family members who take turns making the pilgrimage. He was last seen in public in November, when he demonstrated to attend the funeral of his wife of 77 years, Rosalynn Carter, who died at age 96.
He looked so frail in a wheelchair, with his legs covered by a blanket and his mouth open, that it surprised friends at church and fans watching on television. But he was determined to be there no matter what, according to family members, who believe he has stuck it out this long in part to ensure Mrs. Carter was never left alone.
“He was really honored and happy to have come to the end with my grandmother, and that was a real treasure to him,” said Jason Carter, grandson and president of the Carter Center’s board of directors. “And I think, for some reason, the way he approaches this is from a place of enormous faith. And then he just believes that, for some reason, God is not done with him yet.”
Mr. Carter said one of the notable things about these past few months is that his grandfather is not much different today than he was at the beginning of hospice care. He doesn’t eat or drink much (he ordered coffee after Mrs. Carter’s service, a rarity these days) and he isn’t moving or particularly talkative. But it’s still clear enough to make your thoughts known and absorb and appreciate the information.
When Jason Carter told him that tributes and well wishes for his 99th birthday came from more than 100 countries last fall, the former president was deeply moved. “He cried,” Jason Carter said. “It was really moving for him.”
Ms. Stuckey, superintendent of Jimmy Carter National Historical Park, said she still expressed her wishes. “I walked in the other day and he smiled, we were talking to him about a future meal and he told us exactly what he wanted for dinner the next night,” she said.
He was not surprised that many friends were impressed by his appearance at Mrs. Carter’s service. “I think a lot of people were surprised that he went and was able to go, and people hadn’t seen him in a long time,” she said. “When you don’t see someone for a while, it’s usually a surprise to see them. He may look weak, but he still has that spark in his eyes and he is still willing to help as many people as possible.”
Carter, a peanut farmer with a toothy smile who rose from obscurity to become the 39th president of the United States, left his mark after leaving office after decades of philanthropy fighting disease, negotiating conflicts, overseeing elections and building homes for the disadvantaged. Even as he faded, he periodically asked for the latest figures on Guinea worm, a disease that affected 3.5 million people a year in 21 countries in Africa and Asia when he began fighting it in 1986, but which has been almost eradicated. with only 13 cases worldwide last year.
“Carter’s entire life has been defined by his relentlessness,” said Kai Bird, author of “The Outlier,” another Carter biography. “That’s why I’m not really surprised that he persevered in palliative care. He is a silent force of nature, a man relentless in life but also in approaching the end of it.”
While Carter does not have an underlying life-threatening illness such as cancer or heart disease, last February he decided to reject life-prolonging medical treatments in favor of palliative care, the first president known to use them. His decision has expanded awareness about the availability and benefits of palliative care, which focuses on relieving pain and discomfort in the last stage of life.
“The way he and his family have approached this is turning this into 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 another way. “It opens up new dimensions of the conversation.”
The one-year anniversary of his entry into hospice is not marked as a holiday, but by chance for Carter it will fall the day before Presidents’ Day, so Ms. Stuckey’s park will host a discussion about his life .
For his family, however, there are mysteries that no panel or biography will solve. “One of the things that has struck me is that there are things about life and spirit that simply cannot be understood,” Jason Carter said. “I don’t know what it’s like for him right 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’s been liberating for me to know that I just don’t know. And that’s okay.”
