Happier Endings How to Design Your Dying

as my daughter was dying

two years ago she said mom i don’t

really want to think about

what the process of actually dying is

going to be like

i’d rather imagine myself dancing on a

beach

with my late grandmas and hot men and

margaritas

we live in a culture which tends to deny

that death is a really natural part of

life

and not talking about dying doesn’t make

dying not happen

the stoics say momento mori meaning

you too will die and perhaps in some way

this can spur

us or encourage us to really live before

we die

yet we still refer to death as pushing

up daisies or

kicking the bucket we can hardly say the

word

death it’s almost like the monster in a

scary movie

we push it over into the corner it’s

lurking

but isn’t it almost scarier there i’ve

been a nurse and an end-of-life

caregiver for

22 years and dr peter saul

says that in medicine we don’t really

save lives

perhaps we can extend life sometimes for

a day

or a month or perhaps many decades but

we don’t really save lives do we

and so it was with my daughter i

received that

world-stopping phone call and she said

mom

they think i might have cancer

in just five months

one week and three days later i held her

hand as she took her last breath

tomorrow is not promised to any of us

and so i want this for you i want you to

get more of what you want as you die

and in turn to be the hero for your

family

removing the burdens of decision-making

and regrets for them

for our personal self-interest and to

plant seeds

for future generations let’s

revolutionize this conversation about

dying as a natural part of life are you

with me

it seems to me that there are three

recurring actions that some families

take

which seem to benefit both the dying and

their families

these are the legal relational

and personal parts of our lives let’s

start first with

the legal aspect of preparing for the

end of life

whatever you decide for yourself when

the time comes that you cannot make the

decisions for yourself anymore

someone will need to does your someone

know what you want

and what you don’t want my daughter had

small cell lung cancer an insidious

beast of a cancer

and really rare in a girl her age her

health became

a roller coaster of good days and not so

good days

but she took control of her living

before she couldn’t she took two

specific legal actions

first she made me her healthcare power

of attorney which means that

i was the person to make medical

decisions on her behalf

when she wouldn’t be able to do so

anymore she also filled out what’s

called a medical advanced

directive which helped define for her

the way that she wanted people to care

for her

and so she was able to tell us i really

don’t want cpr

to extend my life even if just a little

bit longer

through this pain mom and here’s the

beautiful thing about creating these two

documents

she was able to make decisions for

herself by telling us what she wanted it

was also a gift for us

you see i’ve never had to second guess

the medical decisions that i made

with her doctors and the rest of her

family that’s not to say that these

choices were easy

there were so many decisions that were

excruciatingly hard

but i don’t have the burdens of regrets

because everything that i did every

choice that i made

was in line with what she told us she

wanted and that was a gift for me

have you ever thought about what it

would be like for your family to

need to make decisions on your behalf do

they know what you want

how will you design your dying action

number two

the relational part in addition to

making your legal medical decisions

have you told the people in your life

what you really need them to know

dr ira bayak is a palliative end-of-life

care physician

he shares four phrases that can help

bring peace

at the end of life please forgive me

i forgive you thank you

and i love you is there someone in your

life that you need to share these words

with

for your sake or for theirs is there

something you need to say

to somebody in your life while you still

can during lauren’s final months we

worked hard to

nurture our relationships on saturday

morning

she would wrap her hairless head in a

silky scarf and go garage sailing with

her sister

they didn’t really need those bargain

basement deals

but they needed time together lauren

planned a trip to

california with her dad and she planned

that bucket list cruise to alaska with

her grandma

she never got to go but the time spent

dreaming and planning and being together

was really important to her

some people start a binder or a file on

their computer or make a memory box

to give to their loved ones describing

where they might find

important documents and information in

lauren’s case

we named hers her croak file

hey life can be too serious to always be

so serious

in lawrence croak file we made sure that

her husband had all the passwords and

access to their bank account and someday

when lauren’s little girl is all grown

up herself

she’ll find a really special video of

her mama

reading a story to a precious little

three-year-old cuddled in her lap

lauren told people what she needed to

say before she couldn’t

how will you design your dying

action number three the personal and

this is my

favorite once you have your legal ducks

in a row

and you’ve said the most important

things to the people in your life that

you need to say before you die

i recommend that you also consider

sharing the really personal the brazenly

bold outrageously beautiful personal

parts of your life

that might bring you comfort and joy in

the end

beyond the physical care of your body

would you like it most if your

favorite songs were playing in your

hospital room or if your friends would

gather in your living room with you

reminiscing about your

escapades together over the years would

you rather be alone in your room

reading your favorite book for the

seventh time

surprisingly to face my monster in the

room

i needed to actually accept the fact

that lauren might die

it was only then that i was able to

really

hear what she needed those seemingly

small

things that would bring her comfort

or peace and so i learned that lauren

wanted her room to smell like

cinnamon candles and she wanted the hot

pink stripe

sheets on her hospital bed that she had

had in her room as a teenager

she wanted her toenails to be painted

call girl red

these aren’t things that you’re going to

be asked in advance directives

these are things that you can share from

your heart lauren loved to travel and

she told me i’m so

mad that i won’t be able to travel the

world with you anymore mom

i want you to put me in little vials and

take me with you everywhere you go

and because i know what she wanted of me

i have been spreading her ashes around

the world

and from ireland to copenhagen

russia to the london bridge her

traveling ashes

are now in 11 countries and yes

she is on that beach in mexico with hot

men and margaritas

because lauren had the brazenly bold

self-centered beautiful

idea to tell us what it is that she

really wanted

to bring her peace and comfort and joy

she got more of what she wanted as she

lived

and i got the gift of being able to

provide those things for her

how will you design your dying what do

you want

what do you not want and who knows it

so that you can get more of what you

want as you die

and have the possibility of an even

happier ending

whenever your ending might be and

to help relieve the people who love you

of the burdens of

regrets in decision making tell me this

what legal medical plans do you need to

communicate

what relationships do you need to

strengthen

and what do you want your own brazenly

self-centered

personal last moments or days

or years to be like how will you design

your dying as a gift for yourself

and for the people who love you

you