I recently received an e-mail from the Zen Hospice in San Francisco. It contained a copy of an article from the San Francisco Chronicle titled, "On His Own Terms, S.F. Coach Nate Lewis Lives Out His Last Days in Peace at Zen Hospice." When this message came, I was preparing for our current volunteer training, and thinking about the question, "What do we mean we talk about someone dying a 'good death?' "
When asked this question, people answer fairly quickly, and though their answers are different, most would prefer to die a quick and painless death: "In my sleep;" "Struck by lightning on the golf course after making a hole in one;" "Hit by a bus."
Rarely does anyone wish to die from cancer or some other lingering illness. So is dying suddenly what defines a "good death?"
As someone who has experienced a loss through sudden death, I can say that it may be good for the one who dies, but for those of us left behind, it can be an unbearably painful time filled with shock and confusion. The grieving process is often prolonged and complicated. Certainly not my idea of a good death.
Dr. Ira Byock, former president of the American Academy of Hospice and Palliative Medicine uses the term "dying well" rather than "good death." In reality, most of us will not die suddenly, and our illness or old age will provide us with the opportunity to create our own definition of what it means to die well. Which brings me back to coach Nate Lewis in San Francisco. At the age of 56, Lewis was diagnosed with multiple myeloma and was expected to die within a year and a half.
Chemotherapy was an option, but would probably extend his life only by a few short months. He tried the chemo once, but found the side effects intolerable. Rather than fight his illness, inevitably a losing battle, he chose to do something tougher. "He shut down the anger and desperation and moved on with living and controlling his life." What is it that allows some people to more easily accept a terminal diagnosis and live fully in the time they have left, rather than use all their energy to fight their disease until the moment of death?
In Western society, we put our trust into medical technology the way other cultures put their faith in a higher power or in the order of the natural world. We have little time or patience for mystery. We want the facts, and if we have a problem, we expect a solution. The fact is, all of us are going to die and there is no solution to that. We do have a choice, though. We can choose to see death as either a problem or as a mystery.
In his book, "Learning to Fall", author Philip Simmons offers us this, "At its deepest levels life is not a problem, but a mystery. The distinction is fundamental: problems are to be solved, true mysteries are not. Each of us finds his or her own way to mystery.
At one time or another, each of us confronts an experience so powerful, bewildering, joyous or terrifying that all our efforts to see it as a 'problem' are futile. Each of us is brought to the cliff's edge. At such moments we can either back away in bitterness or confusion, or leap forward into mystery. And what does mystery ask of us? Only that we be in its presence, that we fully, consciously, hand ourselves over. That is all, and that is everything. We can participate in mystery only by letting go of solutions. This letting go is the first lesson of falling, and the hardest."
What about hope, you might ask? If we give up the fight, are we also giving up the hope? At Hospice and Home Care we believe there is always hope. First there is the hope for a cure. Then there is the hope that one can live fully until the time of death. Finally there is the hope to always be remembered.
Simmons writes, "We are all - all of us - falling. We are all, now, this moment, in the midst of that descent...And so let us pray that if we are falling from grace, let us also fall with grace, to grace. If we are falling toward pain and weakness, let us also fall toward sweetness and strength. If we are falling toward death, let us also fall toward life."
Mary Cook is the volunteer coordinator at Hospice and Home Care of Juneau.