Talking About Death II

The topic of death makes people uncomfortable and I know that many people avoid addressing the issue and will not read this article because it threatens them. Yet death is ubiquitous and inevitable. We will die, as will people we love and hate, and we have limited control over the timing.

The inevitability of death is not negative. That life is finite gives urgency to our time on this planet. If we had infinite time, we could put off many of the interpersonal, intellectual and experiential opportunities that life offers. Often, we are too interested in careers, in impressing others and accumulating things to avail ourselves of experiences that enrich our lives.

Jerry, a friend, has volunteered at a hospice for seven years. In his experience, dying people never regret not making enough money. Those who have good family bonds are generally peaceful when facing death. They feel comforted by the legacies they are leaving—warm, loving relationships and good memories. Jerry also reported that religious beliefs helped people accept their final fate.

Until Elisabeth Kübler-Ross published her book, On Death and Dying in 1969, death was rarely even discussed with terminal patients. While training on a neurology ward, I argued with physicians who believed patients would give up their will to fight and become depressed if told that they had incurable cancer. To me they had a right to know. The physicians’ reluctance to discuss death was influenced by their own anxiety and lack of training on how to deal with finality. Because of this, I was given the job of discussing dying with Maurice, a 68-year-old married man with two grown sons. The neurological resident simply said this was a psychologist’s job.

After getting all the relevant and available information about his condition—he had a non-treatable astrocytoma—a brain tumor. I openly related this with him and his wife. As pointed out by Kübler-Ross, I was rattled when Maurice was predictably in denial and thanked me for telling him everything was fine. After giving him time and remaining available, we were eventually able to discuss death. He did go through many, not all, of the phases—denial, anger, depression—before

accepting his fate. The acceptance stage is awesomely calm. It has always seemed to me that the things we sweat are put in perspective by the acceptance of death.

Maurice told me something that stuck to my ribs. He said he didn’t want anyone to be despondent. He had a good life, wonderful family and wonderful friends. He also related that he felt lucky that his sons were self-sufficient and that he had grandchildren. There is a lesson in Jerry’s observation and Maurice’s comment.

The acknowledgment of our limited time should make us reflect on values. Important values and experiences should be placed on our bucket lists. While I lived in London, a friend said, “I want to be remembered as a decent person.” Simple and poignant. Yet how many of us, including me, would pass that test?

Many people have a false religion that would not comfort them at the end. Their god is the dollar and the moral code is, “That which makes money is good, that which loses it is bad.” Certainly making money is a hell of a lot better than losing it, and money allows us to do things that we couldn’t do without it. Obviously, not having money often is debilitating. Yet, as Jerry pointed out, no one seemed comforted by it at the end.

Upon reflection, I have a personal value system I’m comfortable with. Whether it will lend support at the end remains to be seen. They can take away my house but not my experiences. Some experiences are more valuable than others and there are huge differences in our priorities. It is never too early to begin clarifying our priorities. We should ask ourselves what positive things we want to be remembered for and let those guide us.