In my work in the hospital, dying is such a common theme. Something about being in the hospital, whether one has a terminal illness or not, brings about questions of one’s mortality and readiness to die. It really is amazing that something that people think about so often, or resist with such stubbornness is such an avoided subject by many medical professionals. I have been in so many conversations with medical teams, families, and patients talking about end of life, comfort care, and palliative care where the words “death” and “dying” are never mentioned. Why the awkwardness, why the fear? I think there is definitely something going with the doctors and nurses that I will address in other posts, but I would start with what I have been offering patients and family members these days.
I think there are three areas people become ready to go about their dying: their mind, their heart, and their body. Often times, especially when someone is younger and dying of cancer, their body might be saying, “It’s time,” but in their heart and mind, thinking and emotionally, they are far from ready. They have things to do, kids and grand kids to spend more time with, fears of the unknown that they hold on to. This so often makes for a lot of suffering. They pursue extreme treatment, their family members get alongside their efforts for more time, and doctors very readily do everything can to keep someone alive. But their body is saying it’s time.
The other, and perhaps less common situation, is when someone’s body is strong and in their heart and mind they really want to die. I see this with women and men in their 90’s who have no one left. Their parents died half a century ago, their spouses have died, some of their children have died, and all their friends have died. They ask me to pray that they would die soon. And yet they keep on living. I think this is getting to be more and more common with so many life-extending practices that we have now. This is a different kind of suffering, and I see doctors and nurses responding often with, “This patient is depressed.” I often remind patients (and staff) that wanting to die is not necessarily being “depressed.” It is not always “giving up.” Assuming this desire as such, minimizes the experience.
So ideally, our heart, mind, and body would be in sync when it comes to our dying time. How do we as those who may or may not be dying get to this place? Stephen Jenkinson writes that someone must be very out of touch with their life if they have to be told that they are dying. If we are paying attention and unafraid, we will know. The body has a wisdom of its own and knows when it has had enough. We would also do well to begin contemplating our dying and preparing for it as soon as possible. Why not now? I will tell patients it’s never too early to begin thinking about how we want our dying time to be. If only we can include our loved ones in this conversation, wondering and dreaming with them, recognizing that it is a part of life, not a bad thing. And one of the greatest gifts we can offer our children and grand children is a gracious and honest look at death so they have something to hold on to when it is their turn. This is a sacred thing to pass on. It is legacy. It is holy. And in this act we will be remembered.