Death at our shoulder

Death seems to be having a feeding frenzy this year.  David Bowie, Caroline Aherne, Alan Rickman, Muhammad Ali, Prince, Victoria Lane, Ronnie Corbett, Paul Daniels and Terry Wogan to name some.  These are the people and names I grew up with.  My mum loved Terry Wogan and he was the breakfast time voice, after Jimmy Young, of my school girl mornings.

When Paula Yates died in 2000 it seemed unreal, shocking, she was only 12 years older than me, so young and full of energy; or so it seemed.

Then closer to home, 2 more deaths, one a friend just turned 70 and another my age.

MY AGE.

Ready for Death?

‘But I’m not ready for people my age to die’, I want to tell death.  These other people are older, albeit only a decade or 2, but older.  ‘NOT MY AGE.  Not my generation. It’s too soon, I’m not ready, there is still too much life to live’.

But it is true and my thoughts go out to the young family in their grief.

I met death first when I was 24 when my first love died.  I’ve written about it in other places so I won’t go on about the details here, but I remember feeling that I had to make a choice between shutting down from pain and never trusting again, or letting the loss change me how to live.  I chose the latter.

Death reminds us that life is short, that it is finite and that none of us know when our time will come.

Being Mortal

I’ve been reading ‘Being Mortal’ this week and it seems to me that this is a book we should all read, although none of want to.

Written by a medical doctor who draws on research as well as his own experience, the book takes us into the last days of our life.

For some of us it will be a prolonged decline, our memory going, tripping, falling, shaking, not able to digest, not able to get on and off the toilet.  For some of us, it will be a ‘battle’ with an illness, a cancer, a condition.  For some it will be sudden and shocking for those left behind.

Our Choices

Gawande gently brings us to an awareness of our options.  Do we want to be in a nursing home, where routine rules, where we may have to share a room, without our belongings, without our pets, our neighbourhood, our privacy and our autonomy; all for the sake of ‘safety’ and because there is no one else to take care of us?  Do we struggle on living alone? Do we live with our busy offspring?

When faced with a terminal prognosis, will we ‘fight it’, with chemotherapy, operations, radiotherapy, all of which will make us sick with their side effects, all of which will have a risk, some of which, Gawande acknowledges, do more harm than good.  Or will we use the time we have left to focus on what matters to us?

In our culture where sex is out of the closet, death has taken it’s place in hiding.  No longer to we lay out bodies in our front rooms, having cleaned and dressed them ourselves.  We have handed over death to the professsionals; the under takers, the doctors, the surgeons, the nurses, the nursing homes, the care homes.

Preparing for Death

And yet it wasn’t always so.  The Ars Moriendi was the medieval text advising people how to die well, and the Tibetan Book of Living and Dying is a comprehensive exploration of preparing for death as well as travelling into it.

We prepare for birth, we talk about it, learn about it, read books about it.  We are prepared for puberty, we are taught about it and guided through it and yet as we turn the corner of middle age, there are few guides for the menopause, for aging, for infirmity.  In our perfect, youth loving world, death, aging and sickness are messy and shameful and to be hidden away.

A Good Death

Ira Byock’s says ‘The Four Things That Matter Most’ are:

  1. I love you
  2. Thank you
  3. I forgive you
  4. Please forgive me

Instead of focusing on how to escape death, how to prolong life no matter what it’s quality, we need to learn how to accept aging, infirmity, illness and death so that we can live well until we die.

This great blog written by The University of Berkeley, California outlines what a good death looks like:

  1. Control pain
  2. Resolve interpersonal conflict
  3. Satisfy any remaining wishes
  4. Review life to find meaning
  5. Nominate a trusted person to take control to someone we trust to look after us when we can’t make decisions
  6. Be protected from needless procedures
  7. Decide how alert you want to be

Knowing When Enough is Enough

The trouble is, we don’t all get the chance to say goodbye and to put our affairs in order, so these things need talking and thinking about now, today, because death can come as swiftly as it comes slowly.

For those of us who will die slowly Gawande, the surgeon, admits that even the medics don’t like to admit when enough is enough, when yes there is a treatment but it will make you so ill you won’t get chance to enjoy the days you have left because you’ll be vomiting or trapped and hooked to machines.  Patients continue treatments for the sake of their families who can’t bear to let them go, even against their own will.

It seems to me that we have to talk about death now, today, because none of us know when it will come and we need to be clear about what ‘living’ means to us and to our parents and partners. Is it that we want to live for as long as possible, or as well as possible? What does a good life, until death look like for each of us?

You have read the book and start those conversations today.

What is life?
It is the flash of a firefly in the night.
It is the breath of a buffalo in the wintertime.
It is the little shadow which runs across
the grass and loses itself in the sunset.

Crowfoot, Blackfoot warrior and orator 1830 – 1890

 

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julieleoni.com@gmail.com