The Choice In Dying


My good friend and mentor, Marie Ennis-O’Connor shared with me her eloquently phrased article, “Is Dying Of Cancer Really The Best Way To Die.”

A beautiful response in my opinion.

Marie (@JBBC) wrote her response to an article posted yesterday in the The BMJ written by Richard Smith, entitled “Dying of cancer is the best death.

I have taken the time to read both Marie and Richard’s articles a few times today and think back on my own personal experiences.

I have seen children diagnosed with cancer. I have seen their lights shine bright when most of our own lights would fade away and become extinguished. I have seen miracles happen with people diagnosed with aggressive cancer who have lived to beat the odds.

In the past 13 months I have seen my own father diagnosed with pancreatic cancer. He died 6 weeks later. I watched my grandmother and grandfather placed onto hospice and die of “natural causes.” I have seen a friend die unexpectedly. I have had a cousin die due to complications of a surgery. I have another cousin just told that her “cancer is back and is only a matter of time.”

The reality is that we do not get to choose how we are going to die. We can be told what we are going to die from, and we may be told what is going to cause our death.

We do have the power to choose how we react to dying.

Do we roll over and accept it? Do we choose to fight because we want to be there for our loved ones? Do we choose to share more with this world? Do we have the time to say our goodbyes? To make our peace with our enemies? Do we have the ability to articulate our love for our family?

Reality is simple.

When you are told you are going to die, whether it is cancer, natural causes, suddenly, or by any other means, no one has enough “time.”

The notion of having “time” to have one last hooray before death answers the door…it doesn’t happen. That is not reality. Not for the vast majority of us.

My professional career has touched the lives of over 250,000 cancer patients and their families.

Few have had the choice to be active, walk around, and have a final visit.A last goodbye.

More have made the choice to fight, to hopefully have another day, for the chance to have that romanticized final farewell as Richard Smith describes.

Even more, like my own father, choose hospice. They make the choice that they lived their life, that fighting was not worth another day, and that they were ready to go on to the next phase of existence.

The reality in that choice is that their physical body withers away, the color leaves their skin, the bodily functions go uncontrolled, the need for food is replaced in the struggle between taking their last breath in life and taking their first breath in death.

Richard Smith used a “interesting” title to get people to read, to think, and to discuss an important topic, dying. For that I applaud him.

Yet I think that since Richard is the chair of Patients Know Best he would realize that the problem is not overzealous oncologists, but in the sheer fact that physicians are not completely open, honest, and forthright with their patients.

Physicians romanticize in their ability to heal, to help, to shelter patients from the reality that we all die. The general public prefers to think we are immortal.

Death is not a topic that physicians, patients, or families enjoy discussing. Most do not know how to address the topic of death.

There are a set of choices that each of us and our families can make when death comes knocking, and like a fractal, each of those choices has a specific set of circumstances. A harsh reality. For us to make the best choice, we need to have all the information. The good, the bad, the ugly.

It is not all love, morphine, and whiskey.

The reality is more like it is bowel movements, coughing, and skin covered skeletons.

Which brings me to my final thought. One of my favorite poets is Dylan Thomas who wrote the poem, “Do not go gentle into that good night.” In the second paragraph of his poem Dylan says,

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Which makes me realize that each day I need to be mindful. I need to approach people, work, situations, and my choices as if they were my most important.

If I can live each choice of each day in answering yes to the following: this is what s/he wanted, is this the right thing to do, is this the ethical way to act, and is this what my heart is telling me to do then it doesn’t matter when death comes.

I can chose to go gently into that good night.

Just like my father.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek



3 responses to “The Choice In Dying

  1. Pingback: Dying a “good death” | Cobalt-60

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