Were all going to die. Heres how to do it well
[Applause]
everybody wants to go to heaven
but nobody wants to die after 18 years
as a hospice chaplain
i can’t guarantee we’ll all go to heaven
but i can guarantee you
we’re all going to die some of us will
die better than others
personally i’d like to go like my 93
year old patient
who at the exact moment of death raised
her arms to heaven
and demanded those welcoming her pull
harder
modern medicine comfort care
is so advanced that we need not fear the
physical pain
that was once associated with dying
so what keeps us from a better death
why do so many of us think of death with
fear and anguish for some
it is the unknown the fear of the
unknown
others fear dying alone or in pain
some fear dying young or unexpectedly
but to have a better death
we really must make peace with death
preparing for death is one of the most
rational
rewarding acts of a lifetime
early in my hospice career i heard about
a large hospital
in los angeles where terminal patients
were warehoused in a large hospital
setting sterile and impersonal called
a red room patients were kept
comfortable
basic medical needs were met but the red
room
was just an antiseptic waiting room for
death
near that same time i read stephen
levine’s book
a year to live stephen spent more than
25 years working in hospice in hospital
settings
and on death row his words were
reassuring and hopeful
i began searching for the positive
aspects of death
i was struck by the similarities between
birth and death
one the beginning the other the ending
each an essential part of life
only a decade ago
a physician took charge of the
pregnancy and birth in a sterile and
personal environment
the mother was sedated the father was
isolated
and the family was excluded now
babies come into the world in
comfortable birthing suites
with the family included oftentimes
the family is attended by a midwife
with doctors and medical staff playing a
supporting role
in my position as a hospice chaplain
i assist at the end of life
just as a midwife in traditional sense
assists at the beginning of life
i help my patients imagine and design
a gentle and untroubled death similar to
the way
a midwife helps a family and a mother
design a
unique and joyous birth
that’s why i call myself a midwife
for souls
designing a better death begins with
looking at our fears about dying these
fears typically fall into
three categories fear of the
dying process fear of what
the moment of death is like and fear of
what comes after
let me share a few examples with you
at age 40
lisa had just completed her final round
of
chemotherapy her doctor called our
office to arrange for hospice care
when i visited with lisa i gently
explained to her
that she had only a few weeks to live
her response was but i don’t feel like
i’m dying
oh i know you don’t i said
but when you do go how would you like to
die
her response was immediate and decisive
she said i would like to die at night
and
just go dance in the stars
lisa’s family helped her realize her
wishes
her bed spread was printed with images
of the moon and the sun
her sheets showed the night sky
and her ceiling was decorated with
reflective stars
one week later it was night time
when lisa slipped away her family and
her friends were at peace
knowing that lisa had indeed gone to
dance in the stars
like many of us jim was afraid of
what comes after death jim was a veteran
of the vietnam war
and he felt guilty about the lives he
had taken and the
friends he had lost he chose hospice
early
in his diagnosis so we had time to
address those demons
during our months together i asked jim
what do you regret answering this
question
helped jim reframe his guilt and fear
he found new meaning in his military
service
he was at peace and lost his fear of
death
later jim’s wife told me those
conversations saved jim’s life
well no but maybe they had saved his
death
sometimes death comes unexpectedly
ken was a victim of a devastating
accident
he was rushed to the hospital and
diagnosed with
irreparable brain damage the only
choices
ken’s family had where when and
how to take him off life support
ken was lying in his hospital bed
intubated but looking robust and
seemed to just be sleeping with his
family gathered around his hospital bed
i stepped to his side and put my hand on
his arm
i spoke of his goodness his family
legacy
and his lifetime of service i encouraged
his family
to share their memories of ken
through laughter and tears they
reminisced
each expressing how ken had been a hero
in their lives
building on those stories i asked them
to consider
that their next story about ken would
not be about his life
but about his death
what would his hero’s death be like
the tender details of ken’s death were
designed with
purpose and dignity
ken’s obituary led with his family’s
view of his death it read
ken passed away quietly and peacefully
surrounded by family beautiful music
love and happiness for his new journey
using guided visualization and by
reframing expectations about death
patients and families can overcome their
fears
and reimagine death as a cause for
celebration
a reaffirmation of life a new birth
and so i ask you as i ask
my patients and my friends
what do you regret
what is left unsaid
and most importantly how
do you want to die
to look squarely at death to accept its
inevitability
to plan for ourselves and consider for
ourselves
and our loved ones a better death
gives us a better life right now
one of the most poignant descriptions of
this idea
came from matthew ricard a buddhist monk
his faith teaches that death
is a natural part of the life cycle
many people in modern western societies
are unprepared for death he states
in buddhism we think about death
all the time simply to give value
to every moment that passes by
in other words when we embrace our death
we embrace our humanity and we embrace
life
foreign