If you could choose the way you will die, what would it be?” Many people cavalierly answer “old age” or “in my sleep,” as if either of these answers will offer relief from an event they’ll do almost anything to avoid thinking about. But for some of us, the answers have less latitude and little humor. We have a better idea than most people what will do us in. In my case, it will most likely be prostate cancer, unless something else beats it to the punch.

I often think about the deaths of patients I’ve served for the past eight years as a bedside hospice volunteer. Some of the patients I developed a close friendship with, while others tested my reasons for serving. They ranged from an Episcopalian priest with stomach cancer who approached his death with inspiring solemnity, to the schizophrenic homeless man who preferred sleeping in a fetal position on the floor of his hospice room so he could “watch the lung cancer grow.”

What I’ve come to realize is that the question “what do you want to die from,” is a canard-something that hides an existential issue of much greater significance. The answers “in my sleep,” and “old age,” blanket over the a more basic fear: what will lead up to the moment of death. Dying isn’t a static event. The physical and emotional aspects of it flow with the same meandering as a flooded stream bed on an open plain. And it is in this vulnerable state—watching yourself in constant physical and emotional flux—that people confront what they have done in their lives and what they fear the most.

In the Middle Ages death was considered a part of living. A child was born and the beginning of a new life was celebrated. A loved one died and their contribution to others was remembered. Now, we look at death as if it was an embarrassing relative. We cloak it with dread and seriousness, construct bizarre answers to our children about what happens when someone dies, and invent a myriad of terms to make death more acceptable.

So now, with the above preamble, what do you want to die from? There is no necessary correlation between some diseases and pain. Palliative medicine (pain reducing) does wonders with pain management close to death.

And what would I choose? I don’t think it really makes a difference. If I’ve taken care of all the past issues what would have made dying more difficult and I’m totally aware of what’s happening to me, I’d settle for anything, even prostate cancer.

10 Responses

  1. Carmen Lee

    Great article, Stan!

    The only thing about “Palliative medicine” for pain is I hope to be lucid and concious of all that it going on at the end of my life.I’ve heard that pain medicine makes you sleepy and unaware of what’s really happening.

    Reply
    • Stan Goldberg

      Hi Carmen,

      Thanks for your kind words Carmen. I’ve found that it’s always a balance between being alert and not being in pain. There are gradations in the amount of palliative medication that can be taken. Some of my patients were able to use medication to just take “the edge off” the pain. Others felt they had no choice but to deal with the pain even if it reduced their alertness. The problem I’ve noticed with pain is that when it’s consuming, the only thing you can be alert about is the pain. Hope this helps.

      Reply
  2. Dr. Linda Sonna

    As coordinator of the alternative treatment team for Hospice San Miguel in San Miguel de Allende, Mexico, all I have to say about this article is, “Well said!”

    Reply
  3. Lynne

    Well said, Stan! You are right on about the fear of the events leading up to death – not actually death itself. The Terri Schiavo case really brought it home for a lot of people years ago…

    Reply
  4. Henry Shen

    Stan, I love every piece of what you write. As a Buddhist, I think the best death would be a planned and controlled one, to the point that you decide when and how you die, as a crucial part of your practice. Freedom, huh? Most people shun death; a few like you can look at death with courage and wisdom; and only a couple of us can really be in full control of our death. Shall we all go for that summit level of mastering death? At least it sounds fabulous to me!

    Reply
    • Stan Goldberg

      Hi Henry,

      If only we could plan perfectly for our deaths! Planning and control as you get closer to death is not as perfect as we would like, but definitely better than if we ignored what’s important in living.

      Reply
  5. Mary Hamilton

    As long as one has given all they can give to those who need them and believe they can’t live without them, however torn in two different directions they may become; I think one can handle whatever the good Lord has in store for them. A life well lived is one that is spent giving of oneself completely even when you think there’s nothing else to give; never giving up and never doubting the power of believing. If the heart is compassionate and the task complete, there should be no suffering. One should go peacefully with a joyous heart. Don’t you think, Stan? And since we CAN’T plan perfectly for our deaths, we just need to follow our paths as though today were our last and give our all to the moment or moments we have left. I love your work! It provokes so much inner thought in those who read it. You’re such an inspiration!

    Reply
    • Stan Goldberg

      Thanks for your kind words Mary.

      I wish life was linear and if people just tried hard enough and believed strongly, they would be prepared for the deaths of their loved ones and themselves. But I’ve been with too many people who were dying and their caregivers that I realize other things may be necessary. That was the motivating reason for writing Leaning Into Sharp Points.

      Take Care,
      Stan

      Reply

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