A Compassionate Discussion of Caring for the Dying.
Recently my wife and I updated our wills, our revocable trusts, and including our living wills. The latter are about the burden of decisions to be made on my behalf - I selfishly hope my wife will outlive me - either by my wife or my sons.
I am thinking about the end of my life a great deal lately - I'm at that age where waking up is something of a pleasant surprise - and I'm thinking about the huge psychological (and sometimes physical and fiscal) difficulty that attending to my death will be for my survivors.
The most powerful emotional pain for me in attending those whose deaths in which I was a participant, either in a primary or secondary capacity as an attendant, was how to talk to the dying about what is happening.
This beautifully written article by a palliative care physician was published in the New York Times, and I found it moving.
As a Doctor, I Know Being Ready to Die Is an Illusion
Dr. Sunita Puri, NY Times Opinion, March 29, 2023
Some excerpts:
Each time I saw him, the hollows of his cheeks deepened. I wanted to tell him that he was dying, that I wanted to understand how he envisioned spending his remaining life. But he mostly spoke about his plans: a camping vacation in six months, a friend’s wedding after that.
I awaited some sort of arbitrary signal that it was safe to talk about dying. Maybe he’d tell me that he didn’t want more chemotherapy or that his affairs were in order. Like many physicians, I feared that by talking about death before he appeared ready, I might take away his hope, make him give up or send him into an unstoppable tailspin of anxiety and depression.
Whether he hadn’t accepted his fate or simply wished to avoid the subject, he didn’t appear to be ready to talk about his death. How could I reconcile what appeared to be our radically different interpretations of his condition? By waiting for him to act in ways that I understood as acceptance, I thought that I was being compassionate and sensitive...
...Nine years ago, I think my patient sensed both my urge to tell him something and my hesitance. “Are you OK?” he asked me one day.
“I’ve been meaning to talk to you about something,” I stammered, looking past him at the eye chart on the wall. “I’m worried about you, because every time I see you, you’re losing weight and seem less like yourself.”
“It’s because I’m dying.” He was matter-of-fact, as though he’d just said it was raining outside.
I was stunned, then relieved. Yet I still struggled to tell him what I wanted to say. “I am so sorry,” I whispered.
“It’s not your fault. My father died in my arms. So did my wife,” he said. “It’s just my turn now.”
“I feel bad that I didn’t talk to you about this sooner,” I said. “I thought I’d upset you or maybe you weren’t ready yet.”
He laughed. “Ready?” he said. “I’ve wrapped my head around being dead, certainly. Not sure if I’ll ever really be ready. It’s not like packing a bag and standing outside waiting for a taxi.”
He died in his sleep a month later, missing his vacation and his friend’s wedding. Even if he told me he was ready, nothing could have lessened the blunt force of losing him.
Physicians feel it too.
It's not easy.
Dr. Puri is the author of this book: That Good Night. It's an eloquent title. I think I'll read it.
= new reply since forum marked as read
where there's a lot more days behind me than in front I think about dying or the end and just want to be remembered as someone that cared for others.
there's nights I lie in bed and before falling asleep I think of all the stupid stuff I did along the road and hope I caused no lasting harm.
I think it's fairly common for us all to think about it. It's not knowing when that scares the beejeeezzzuss out of us.
