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Your dying changes what your life means.
may already have come to pass that what the world does need of us to continue at all is our willingness to live as true human beings, by which I mean deeply obedient to the natural world, inextricably bound to the health of the world for our health, permanently indebted to the world for whatever gives us the capacity to be human.) Nothing naturally occurring in this world depends upon human beings for its life.
If making the most of your mental and physical health and maximizing your potential is the hammer of your life, then dying is turned into something that insults and endangers your health. Dying is the opposite, not the result, of your health, just as dying is the opposite, not the result, of your life.
The crucible for meaning in your life is how you wrestle with the way things are.
There are no atheists in a foxhole.
you fight your terminal diagnosis with the chemo and positive thinking and the rest, and you end up realizing that you’ve been dying all along—if you end up realizing that a dying person is what you have become—it means one thing: that you lost. That is the gray secret of your end-times: Fight your executioner to your heart’s content if you will, but he will no less be your executioner. You might change how you feel about him, but if you fight him you will not change his job description. In
What the obituary means but never says is that after a long a courageous battle, you lost.
Suffering, learning how to suffer, is how you make meaning from what seems random, chaotic, or pointless. This is what I mean by wrestling. Meaning comes from this kind of wrestling.
know that asking you to imagine dying as an angel without losing sight of the finality and the sorrow and the grief that dying must bring amounts to a tough sell, but that is what I’m asking.
Demonize death and you turn life into a factory-farm canola field: flat, hollowless, no place for mysterious things of substance to gather.
But come to your death as an angel to wrestle instead of an executioner to fight or flee from and you turn your dying into a question instead of an edict: What shall my life mean? What shall my time of dying be for? What is it going to be like, that cottage of darkness? If you work hard in your dying days, the answer could be, “Not like anything you’ve known.” Dying turns into something you live. The trick here is that to be able to ask questions like that you have to know, somewhere in your bones, that you will die.
Wonder is part fascination, part ability to believe in things as they are, part willingness to be confused, even devastated at times, by the epic mysteriousness of ordinary things.
Great questions, given half a chance, are our intelligence.
“Of all the people that are admitted while you are here, a third of them will get worse no matter what we do, a third will improve no matter what we do, and a third will leave the way they came in, no matter what we do. Your job will be to figure out which third your patients belong to.”
Someone you don’t know asks what you’re thinking about most of the time, and you may have to think long and hard to figure out what it is.
“The other possibility, strange as it might sound, is that your prayers have already been answered, and you missed it entirely. Pretty hard to imagine. Not impossible, though, not at all. What if the fact that you and I are here talking about it is all the proof you’re likely to get or need that you are in the middle of your More Time? What if this is what More Time is, nothing more and nothing less special than this? If that’s true, then you could already be the person whose prayers had been answered, instead of being the person waiting to find out, and you could walk and talk and feel like
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Hopeful people do not as a rule hope for what they have. They hope for what they do not have. They hope for what they once had to come again. Hopeful people do not in their hopefulness often vote “yes” to the present. They vote for the future.
In a death-phobic culture like our own, knowing you are dying is not as healthy as hoping you aren’t dying while you are.
you bargain for More Time, you never live in the land of More Time. Your more time is spent bargaining or praying or hoping for More Time.
No one seems to hope for what they have, and hopeful dying people rarely get the More Time they hope for, no matter how much More Time they get.
Dying is traumatizing when it is happening in a place and time that will not make room for dying in its way of living. It is not dying that is traumatic; it is dying in a death-phobic culture that is traumatic.
Hope is very often a refusal to know what is so, and steadfastly it is a refusal to live as if the present moment is good enough and all we really have.
Living and dying hope-free: that is a revolution. The chance to die that way is what dying people deserve.
The truth is that, no matter how loved the dying person is, few people around them really know how to have a dying person in their midst.
No matter how strongly they resist the dying of their loved one, families become organized around the looming end of the unwanted thing, the end itself unwanted.
Often people don’t look sick when they are dying. They look like something is coming in the night and taking small handfuls of energy and body mass and eye light from them.
when you knew your parents to be the flawed people they were and not the arbiters of the Way It Is,
You find out by heading out that way and by things not often going as you wish that life isn’t your life, and that your life isn’t what you intend for yourself.
If you are lucky and have something like a mentor around you when you are still young, you can survive the air going out of the helium dream you had for yourself, and life will take you in tow. The cost for being tutored by life is what you insist life should be and who you insist you were born to be.
This belief in autonomy and mastery is imported whole and mostly unawares by dying people into their dying time.
The expectation that this illusion of autonomy and mastery be protected from the vagaries of dying is to me the principal cause of intractable suffering as people begin fingering the symptom rosary of the end of their lives.
legitimate and even a necessary falsehood in teenage years, the illusion of personal autonomy and mastery can be a compound disaster in adulthood and so often is a haunting, taunting affliction in the time of dying.
The legitimate, necessary realities of dying are nowhere to be found in Quality of Life scales.
Quality of Life is measured in terms of how successful you can be at resisting the diminishments that come with dying.
Quality of Life is hostile in principle to the realities of a dying body and a dying heart and a dying self.
He then told me that he had considered the situation mightily, and he now knew that the point at which continuing to live made no sense, the point at which the burden upon his wife and family for his care would be indefensible, is when he would not be able to make his way up the stairs to the bathroom on his own.
He had become a North American in this, where the make or break point for Quality of Life is so
often found in the bathroom.
This insistence on being in control of life is not the creation of any medical system or counseling organization. It is a culture-wide mandate, something medical and counseling practitioners are steeped and trained in along with the rest of us. It is really an addiction to competence that I am talking about, part of the inheritance from our hard-scrabble immigrant beginnings on this continent, rooted in self-reliance, mastery over the environment around us, autonomy.
This mad insistence on competence and Quality of Life instead of Quality of Death is the principal reason you need experts to tell you that you are dying. It is why, in the ending part of our lives, we so often have no idea where in our lives we are.
fought against the bottle, but I had to do it drunk.”
Quality of Life is competence addiction. It is a competence junkie’s solution for the addiction to competence, a gesture of impotence tarted up as an accomplishment.
Quality of Life sells you control and mastery and competence in the face of something so singular, so personal, and so incontrovertible as Your Own Death because Your Own Death is the largest and latest and last incarnation of what beggars your insistence on control and mastery and competence.
“Let’s make cancer history,” they say. What are we supposed to die of, then? Old age only? How old is old enough to die? When are we supposed to die? Are we supposed to die? If the raft of your dignity is bound together by the frayed rope of things going as you believe they should, what of this kind of dignity is there left to conserve as the raft of your life plans begins to take on water?
As long as our shared understanding of Quality of Life is driven by unmodified demands for competence and mastery, and as long as our shared understanding of what dying does to us is a pageant of diminishment, dependency, and loss of dignity, then our work at the end of a person’s life will continue to be trying to forestall the end of that life.
The news of our dying can be the time when we finally shuck off that binding illusion that we were supposed to be driving the bus of our lives because we thought we knew how the thing worked. Before then our lives give us plenty of practice at being good at not being in control. That is a skill worth learning, and worth teaching our kids.
You have to learn how to die, or you probably will not die wisely or well.
For those who are relying on instinct as their guide, please consider the possibility that our instincts are now so domesticated, so stupefied by our insistence on being safe and comfortable, so rarely drawn upon and
so psychologized that they are more mediated refl...
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Her health was stable. She lived a particular kind of hell that might be a unique creation of our own time: She couldn’t live, and she couldn’t die.
