You and I Are Dying
BY ROGER C. BONE, MD Reprinted with permission.
This is the first of several articles from Reflections: A Guide to End of Life Issues for You and Your Family, distributed by the National Kidney Cancer Association. Written from a personal as well as a professional perspective, it offers a thoughtful, gentle introduction to the difficult subject that all of us at one time or another will have to address. "You and I Are Dying" sets the stage for other chapters we've excerpted or reprinted in their entirety.
I am a physician and I am dying of metastasis of renal carcinoma. As I write these words, I understand I may live a week, a month, a year — perhaps two. If I beat all the odds, I may live five years.
I have spent the majority of my adult life as a clinician, author, researcher, and professor. As a result, I have felt a strong impulse to write about the mental, spiritual, and practical aspects of the dying process. The Journal of the American Medical Association has published some of my thoughts in a series of personal commentaries entitled "The Taste of Lemonade on a Summer Afternoon," "Another Taste of Lemonade," "Lemonade — The Last Refreshing Taste," and "Maumee: My Walden Pond." In addition, I have investigated the topic of dying in great works of literature. My findings were detailed in "As I Was Dying: An Examination of Classic Literature and Dying" in the Annals of Internal Medicine, a professional medical journal.
Of course, dying is not a new subject at all. It is one of the oldest subjects known to humanity and certainly the first and greatest mystery of our existence. It is a topic familiar to almost every person. Though we seldom speak openly of dying, we all have been touched by death. A child's grandmother dies when he is seven. A teenager's best friend dies in an auto accident. A young woman's favorite uncle dies of a heart attack. A colleague at work commits suicide.
Any death makes us sit up and take notice. A favorite movie actor dies of AIDS. A country's president is assassinated. Some of us take a moment every day to scan the obituaries in the local newspaper for a familiar name. At times death comes closer and we find we have certain social responsibilities. We must attend a funeral or cook a casserole for a wake.
Sometimes death strikes close to home and things get very, very personal.
We all think about our own death-or at least try not to think about it. In reality, few people actually spend much time under a death sentence. Most are unaware of their own deaths or only conscious of their fate for a short period. Individuals suffer from mortal heart attacks or strokes everyday. We often hear of tragic and sudden accidents where someone is perfectly healthy one minute and gone the next. Patients with a chronic or curable disease may experience medical complications and die for unknown reasons. Or, Alzheimer's victims who lose their mind and reason may not care that they are slowly slipping away from the world.
Yet, there are still many of us who know death is irresistibly approaching. In some ways, death is an intriguing topic. There was the mythic king who was so fascinated by death he ordered his own beheading and dictated that no one could save him. How would loyal subjects react to such a command? Obey their king and lose him or disobey his commandment and risk treason? A more important question is whether or not the king found what he was looking for.
I observed death every day for more than twenty-five years in a series of operating rooms and intensive care units, including a surgical field hospital in Vietnam. As a pulmonologist and critical care physician, I often was the patient's last ally in his or her stand against death. For many, many people, I was the last person they saw.
It occurred to me once: who will be the last person or persons I will see? I hope it will be my wife and my two daughters. That is a very personal and private goal. However, I have discovered that dying is not necessarily a private business. The nineteenth-century sounding phrase, "Setting one's affairs in order," is still full of meaning today.
This small book [see above] is intended for terminally ill individuals who are not going to be surprised by death. It is also a book we can share with family and friends who will survive us. Hopefully, these pages will help everyone understand what a dying patient experiences so they can both deal with the practical matters surrounding death comfortably. It is for all of us to make one last effort together with grace, humor, dignity, and courage.
©1997, National Kidney Cancer Association |
