“How we seek to spend our time may depend on how much time we perceive ourselves to have.” ~ Atul Gawande, Being Mortal: Medicine and What Matters in the End
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In the current Canadian medical climate, nothing is gaining more attention than physician-assisted death. Far from an uncomplicated concept, as with many other sensitive medical services, I believe it has both pros and cons that will continue to be debated for quite some time. For the the most part, healthcare as a whole is very focused on life and helping prolong it, so this will be an interesting shift in our way of thinking for both patients and physicians.
The topic of death is very prominent in my mind these days as I attended the memorial service of a dear friend with my family yesterday. Contrary to physician-assisted death, she approached her cancer with the hopes of finding life-saving treatment options. With respect to terminal cancer, I think we can only postulate how we would approach it without truly knowing until we had to face it head on, as Dr. Paul Kalanithi did in When Breath Becomes Air.
This morning I listened to the latest episode of On Being with Krista Tippett and Dr. B.J. Miller, Reframing Our Relationship to That We Don’t Control. Dr. Miller is a palliative care physician and the executive director of the Zen Hospice Project that brings a mindful and compassionate approach to dying. He talks about living until we die and that dying, like living, is a universally shared experience.
Dr. Miller exemplifies the resilience of the human spirit having lost both legs and part of his left arm in college. Despite being acutely aware of mortality through his own experience and work, he admits to getting caught up in the busyness of life. As much as we try to live knowing our time is precious and fragile, I think it is very easy for us to live not thinking about our mortality.
Hope in life & in death
Ponder this – we all know about life but none of us know about death. For most of us, the most frightening prospect of dying is the unknown. Even for those with the strongest of faith, when they are faced with a known death, they don’t know what either heaven or the afterlife will look like.
During the On Being episode mentioned above, Krista and B.J. talk about hope and just how tricky it can be. Interestingly, hope really depends on the context. Is what we are hoping for realistic and achievable? I think false hope is just as dangerous as no hope.
How can we live well in life & in death?
One of the themes that came out of the memorial service yesterday, and a common theme in funerals in general, is how do we want to be remembered when we die. By recognizing and knowing this, we all can use it as a wonderful footprint toward living well.
Unfortunately, we often hear of the regrets of the dying such as either working too hard or not working hard enough on relationships. What will never be on that list are attributes such as empathy, kindness, compassion and love.
If we “begin with the end in mind”, as in Stephen Covey’s habit number 2 of The 7 Habits of Highly Effective People, we will live well in life and in death. An effective way to do this is by writing a personal mission statement.
Another way is to imagine your eulogy and what you would want to be said about your life. For me, I hope that I have connected with people in such a way that they really know me in my life not just through words on my death.
My final thought on living well in life and in death is that the surest way to do this is to live mindfully. Being aware of our thoughts, actions and behaviors will allow us to truly live until we die.