Talking About Death
Responses to my last post, “The End of Life”, have reminded me of the importance of talking about the possibility of death when someone has a serious, potentially fatal, illness. Why do we shy from having this conversation?
I know why. It sounds like we are giving up, that we are no longer anticipating a cure. That is certainly the struggle that doctors have, when deciding whether to bring up the subject. I find that I can bring up awkward subjects more easily when patients are alone in the clinic room. When I’ve been people’s doctor for a while, I’ve had a chance to study their personalities, and can anticipate how they will respond to the information I want to share. I choose different words depending on how I want to approach an issue.
But when people are being treated for a serious illness, they are more likely to have family members or friends with them. I usually don’t know these people as well. How are they responding to this delicate conversation?
Don’t get me wrong – I love having family members and loved ones with patients in the clinic. Having extra people adds texture and depth to the doctor-patient relationship. I see people in a bigger context, getting a glimpse of the parts of their lives that doesn’t involve medicines and health.
The goal is twofold: One, to keep trying, keep working to beat back the disease, keep maintaining hope. And two, becoming prepared for the possibility that this will be the thing that leads to death. (There is a 100% death rate for humans, unless you are Enoch or Elijah from the Bible, who were taken straight to heaven.) Keeping these two goals in balance is tricky. Not impossible, but tough to achieve.
