One Day Closer to Death

Started a new class this week called Living With Life-Threatening Illness. In this class we visit with and learn from patient-teachers who are in the end-stages of life and then share our experiences weekly in groups.

On this first day we met to learn more about the course, to meet one another and to discuss our motivations and reasons for being there. At the halfway point, we broke into smaller groups and sat in a circle, so we could all see one another. The group leaders asked us to describe in more detail any events in our lives that had caused us to be interested in end-of-life care and in wanting to be part of the class. The instructors told their stories and several others also told theirs. As I began to speak, my brain disengaged and my heart began to speak as memories flooded my conscious awareness. Thoughts bounced from one to another, completely out of chronological sequence. They all seemed to be emotionally tinged as the pump had been primed by the moving stories of others in the group.

I must have perceived that gathering and room to be a safe place since we were advised that shared information must remain confidential. I trusted them because they trusted me. I gave them glimpses of deaths I had been near and how they had impacted me. I told them about how I want to help people die with some comfort and dignity, with joy and clarity. I told them I want to discuss death and make it a part of life that we accept and embrace with less fear and more understanding. My voice broke as tears flowed. I can’t completely say why I felt so much emotion. I suppose I’ve seen so many people die with so little fanfare or so little care. I would like to help people know they are loved before they leave this place. I suppose that’s not an easy thing for some people to hear or believe. Too bad you can’t just come out and say that as a doctor. We have another job to do. That one takes precedence. Professional distance and objectivity have their value. There are some things that most patients simply aren’t looking for in doctors. Family, friends, clergy, counselors and advocates fill those roles.

But we can help to get this right. We can learn what works and what doesn’t. We can learn how to listen to patients' needs as they encounter an end to their path here. They can choose how those days will be spent. Maybe they will believe in an afterlife. I believe in a purpose and existence far beyond this one. I know what I know. I have experienced what I have experienced. My faith runs deep.

Will be interesting to see what I learn here – about how people approach death and how we can improve that experience, about skills that I can obtain in order to facilitate their final moments, about what lies inside of me that has been shoved into long-forgotten corners.