Choosing How to Die. Does it Make a Difference?

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. In my experience, I’ve found that what people hold on to from the past and what they refuse to give up in the future, has a greater effect on the peacefulness of their death than they illness they are dying from.Often I’ve seen emotional pain overshadow physical pain.

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. We look at death as if it was separate from life. Something so terrible that even thinking about it cause great trepidation. Yet, life and death are intricately tied together. Without one, the other can’t exist.

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.

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