We’ve lost the art of dying well
LAST week came news that doctors at the Massachusetts General Hospital in Boston are being trained to talk to seriously ill patients not just about their health, but about their goals and values.
It's not exactly news that we enlightened people of the 21st century have lost the art of dying well.
We don't want to see it. We don't want to experience it. We don't want to know about it.
But, as a dying man once said to me: "we're all in the queue".
In his wonderful book Being Mortal, surgeon Atul Gawande writes: "Being mortal is about the struggle to cope with the constrains of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite, and always will be."
Gawande says that dying well takes not just information, but wisdom. We expect the people with white coats, who get us out of all kinds of jams, to know about dying, too.
But they don't. What makes a good oncologist is not necessarily wisdom. So we quiz the scientist in vain for answers to questions that they can't really answer.
We ask "how long have I got?" and "will there be pain?" when really we need to ask "what is going to happen to me?" and "what does my life mean?".
Dying is not about pain. We can endure great pain. But without meaning, even relatively small pains can become unendurable.
And death interrupts the trajectory of meaning that we are on. It seems to provide a full stop to our story. That's an important connection, actually: when we speak about our meaning, we can't but think in terms of a story.
"I've been to a lot of funerals, and I've heard Australians fumble in their pain to make something of the story of the person who has died."
We understand who we are in terms of stories, and death looms as the coming down of the curtain on our story. What we need most of all as we approach death is to find the completion of the story.
"My story is very close to the answer to the question of who I am", we tell ourselves. "It's my identity, my self. The events that constitute my life, as my body and soul pass through time and space, are me."
But if we think about this, we can see how death is so deeply troubling for us.
We're an individualistic culture, prizing above all our own path to the pursuit of happiness.
We see ourselves as the tellers of our own stories. It's nauseating to think of our stories as ended by someone or something else, because the ending is vital to the meaning of stories. How do we know what kind of story it is? We ask: "how does it end?" And if death is the end, then death renders pointless my attempt to write myself a meaningful script.
Mostly, we want it to have been a comedy or a romance, filled with light, and love, and pleasure, and laughter. So, we tell funny stories.
We imagine our friend up in heaven, just opening the first bottle of sauvignon blanc. But the laughter is nervous and no one believes the comic vision, not really.
What we're all thinking is: is this the full stop?
Christians believe that Jesus calls his disciples to follow him, not just in life, but all the way to the cross. It means giving up your telling of your own story and instead letting it be told by Jesus Christ.
Now of course this story does not spare you from pain, nor even from death.
But it is a story in which death becomes not a full stop, but merely a pause. Could death no longer be the thief of meaning?
My friend and church member Becca was diagnosed with pancreatic cancer in July 2015 and died in January 2016, aged 49.
Her faith was actually flourishing at the time she was diagnosed.
Then it faced a test. What did her life now actually mean?
We discussed stories, and the fact that our lives are stories.
She wrestled with the fact that she had not married, and had two miscarriages in her life, that she was on the cusp of some professional breakthroughs, and her fear in leaving her ageing parents behind.
Then Bec was moved into the hospice, and her weight dropped, and then dropped again.
Her mother took me aside and said as we both cried "why?" and I said the only thing I could think of to say: "this is not the end of Bec's story".
I said at her funeral: "Becca hated dying, and she did not want to leave us but, she told me, she did not fear death.
"She knew that death was not the end of her story.
"Death, too, is just a season.
"In her faith she found the hope of more time to come - and not just time, but life: the kind of life that Rebecca had, in its fullness, and joy, and physicality, and beauty. Becca died not in despair, but in hope, confident of finding a welcome in the loving embrace of God."
By this I meant that she died well.
The Reverend Dr Michael Jensen is the rector of
St Mark's Darling Point and the author of My God, My God: Is It Possible To Believe Anymore?