On Death and Dying
Thoughts
In the 1970's, the seminal work of Elisabeth Kubler-Ross on Death and Dying gave me my first insights on the subject. She provided a sound framework for what happens to a person's thinking when faced with their own death, whether close at hand or a bit farther in the future. I found it helpful to understanding what my dad and later my mom went through when they died, both unexpected and expected. However, the concept of death remained abstract because I told myself that it was something that mostly happens to old people, not someone young, like myself.
Today death lurks menacingly closer. I'm struggling with a fate that increasingly envelops my thinking, putting me in an upside-down world, not of my own making. In the past 50 years, "advances" in modern medicine have blessed us with a prolonged life of 20 to 30 healthy years beyond the expectations of our parent’s generation. The bad news is that it will become, sooner or later, a life filled with a continuous stream of treatments, unexpected emergencies, creeping decline, chronic painful conditions, and terminal illness, all for which "extreme" modern medicine is ready to attempt cures. Our parents had few choices. Today, we have too many, overflowing with buckets of hope. Dare I deal with the reality of it all or live in denial, hoping to escape it by dying in my sleep?
I look around me. There are the near misses that took my breath away -- friends and family who, when faced with a life-threatening illness or arthritic joint replacement, drove headlong into its reality, sought treatment immediately, worked voraciously to live, and took the time and discipline to recover. Now, once again, they take joy in the life they chose to pursue. That scenario I can face, because if that happens to me, I can keep a hand on the wheel, making conscious decisions as I proceed down that road.
However, what truly unnerved me was the experience of several close friends who became caregivers to husbands; men who, from my vantage point, although clever, witty and assertively their own persons, lived with disregard of their health, never worrying about how bad the end of life might be. When frightening terminal illnesses brought them near death unprepared, everyone was plunged into days filled with dread, chaos, pain, confusion and a mind-bending mix of emotional and physical exhaustion. As caregivers, my friends ran the gauntlet of the medical industry's multifarious solutions and cross currents searching for support and answers as their husbands rapidly declined. The guidance they sought was at times elusive, incomplete, or quite frankly, byzantine. I witnessed two strong, healthy and competent women dive into these uncharted care giver waters that almost drowned them. Kubler-Ross' conceptual psychological stages were of little practical help. The thought that my husband and I would end up in the same place one day was doubly terrifying.
It was soon afterwards that I discovered the work of B.J. Miller, MD and Shoshana Berger. Their work is focused on palliative care and preparing for dying. I grabbed their book, A Beginner's Guide to the End: Practical Advice for Living Life and Facing Death, binge reading it cover to cover. It answers all those before, during and after questions for the person faced with death, but most importantly, the caregiver. It confirmed my suspicions – if properly prepared, dying can be comforting and peaceful, not painful or chaotic. For caregivers, it will be a heartbreaking time, but it doesn’t have to be a near drowning experience.
Please learn and prepare yourselves.