The art of living well and the art of dying well are one. Epicurus
Unless there is some time for being together psychologically - emotionally and cognitively - the psychological family may disappear. Without time for talking, laughing, arguing, sharing stories, and showing affection, we are just a collection of people who share the same refrigerator. Dr. Pauline Boss, The Myth of Closure
We received word yesterday that a friend who has been living with cancer for five years, has decided to go into hospice. Though I get it, that none of us gets out of here alive, death still feels...well, a lot of things. Weird is a word that still comes to me after grappling with the concept for over seventy years.
As a young person I greatly feared death. I remember crying when I was five years old while considering that my parents would one day die. What would it feel like to die? What would life be without my parents?
Death boggles the mind. From all my mental stumbling around the topic of death. One practical question has emerged. How does one die well?
Philosophers, poets, artists, and many psychologists urge us to live a meaningful life, then we’ll be able to slip away peacefully with a smile on our face. Da Vinci sums that idea up with…as a well spent day brings happy sleep, so life well used brings happy death.
Certainly, it can’t hurt to live a meaningful life which is intrinsically rewarding. If a meaningful life leads to a good death, that’s a big bonus.
What, however, contributes to meaning when we’re on our deathbeds? According to Dr. Charles Garfield, an expert on dying well, the dying person finds meaning in two ways.
First, people get meaning by reviewing who has loved them and who they have loved. Second, the dying person finds meaning in thinking about what they have done to contribute to the greater good – to helping others and to making the world a better place.
We might need to get a good head start on these things if we want to die well. As I think about my friend’s life, she has loved greatly and has been loved greatly in return. Her life has been immensely purpose driven. She’s been a continual courageous voice for fairness and justice, compassion. She, herself, has sat by the death bed of many including her own mother. I didn’t make it to be beside my own mother. But I do believe she died well. She too was loved by many and had a very purpose-driven life.
My mother also did something else which, according to experts, is helpful in dying well. She worked hard to resolve significant interpersonal conflict before she died. She continued to work on her relationships even with people who were dead. She did it particularly with my brother who committed suicide.
That may seem strange, but many continue to have a relationship with a person who is dead. Someone recently told me she talks every day to her mother and to a son-in-law who died tragically.
I read about a Japanese man who built a telephone booth with a phone which he constructed to carry messages through the air so the alive and the dead could continue to be in relationship. He built it so that he could continue talking with his beloved cousin. The booth became a sensation. Tourists flocked to talk to their dead loved ones. There are now booths in several places around the world.
Dr. Pauline Boss author of The Myth of Closure (a book recommended by my friend) understands this. Boss writes that many of us think we want closure, but it is the wrong thing to be looking for after we lose someone. She tells us that we can have continuing bonds and live with loss and grief.
Dr. Ira Byock, a palliative care doctor, wrote in his book, The Four Things That Matter Most, that there are four basic messages people need to work out and express before the end of life. Their loves, as mentioned previously (who they have loved and who loves them), who they want to thank, who they forgive, and who they want to forgive them.
Though Mom had one sister from whom she was estranged, she had done her part in openly expressing her love. She had also given her forgiveness and asked to be forgiven though her sister did not reciprocate.
That’s okay if it ends up being one-sided according to Byock. Expressions of love, gratitude, giving and asking for forgiveness can be acknowledged even with people who have already died… just as my mother did.
With meaning and relationships in order – what remains for a good life ending? Directives. Mom had given me clear health care directives which I relayed and had enforced though she lived in Tennessee and I was in Washington. No artificial nutrition by tube, no artificial resuscitation. Pain relief through medication. Still, it was hard for me to do. Up until the day before her death, I was still hoping for her recovery.
Fortunately, friends and caregivers, helped me see when it was time for hospice care. Afterwards, I realized how helpful that was for Mom at the end. She had also hoped to see her sisters. One of them was able to come see her and she was able to talk daily with the other.
Other than those things (finding meaning, cleaning up relationships, following health directives and other desires), what I realized, and researchers agree, is that loving presence as one is dying is extremely important for most people. It still pains me that I did not make it to Mom’s bedside in time to be with her as she took her last breaths.
What gives me some comfort is knowing that Mom had wonderful caregivers and friends who continued to talk to her, play her favorite music, hold her hand, and to treat her as an important person even after she had several strokes which left her with no ability to speak, move, eat, or even smile.
One of her favorite people, we all called him “Chief” (because he was a chief of police), visited Mom a few days before she died. Chief leaned over and kissed Mom and told her he loved her. Miraculously she whispered, “I love you too.” She was still in there! These role-models, like my mom my friend, help me continue the journey toward a good life and dying well. There’s still a lot to do.
Seeing the wonders of the world, both my husband and I have already decided is fine and fun. We will continue to do some of that. But not our top priority.
I am making sure that I remember the people in my life whom I love and who love me. I bring them to mind regularly. Even though I cannot always be physically with my loved ones, each night I’m sending friends and family individual good wishes, “may you be happy, may you be healthy, may you know that you are loved. May you use your suffering to be stronger, more resilient, kinder to yourself and others….” sort of messages.
Compassion looms large in a life well lived and in dying well. We are human creatures. We have many avenues for experiencing meaning and joy, particularly through our relationships. We also suffer. We die. As strange as the process of death seems, even wilder is this feeling that even after death we are still connected.
How might we live the good life all the way until the end and perhaps even after… particularly by staying connected to those we love and who love us?