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LIFE IS FOR THE LIVING

LIVING WITH DEATH AND DYING(III)

An Overview

“...when we finally know we are dying, and all other sentient beings are dying with us, we start to have a burning, almost heartbreaking sense of the fragility and preciousness of each moment and each being, and from this can grow a deep, clear, limitless compassion for all beings.”

These words recorded by Sogyal Rinpoche, the world-renowned Tibetan Lama and Buddhist teacher, in his highly acclaimed publication entitled “The Tibetan Book of Living and Dying”, simply and effectively describes that area of vague and indescribable uncertainty through which we all travel, in one way or another, as we journey on that final road.

Whenever I think of this subject, I am always reminded of a time, many years ago when as a young, relatively inexperienced physician I shared a particularly harrowing and anxious period with a very close friend and relative. He had been diagnosed with a very serious, often fatal septic condition and there was some doubt about survival. When he was subsequently asked to recall how he felt during that very difficult and frightening experience, he described a series of stages which to me were almost identical to The Five Stages of Grief so beautifully explained by great Swiss-born, American Psychiatrist Dr. Elizabeth Kubler-Ross in 1969. Even today, so many years after that fateful event, his recollection has not changed in any way, and he still vividly describes the stages through which he traveled during that period. He remembers his initial response of DENIAL and his questioning of the physicians’ findings, followed by the feelings of ANGER he felt at life and at God, and his asking over and over, “Why me, Why me?”. This stage then progressed to one of trying to BARGAIN with God; “Give me a break, Lord, I promise I will be devoted to you!” And when things got worse and the end was beginning to look inevitable, he became DEPRESSED. He felt hopelessly overwhelmed with sorrow and self-pity for being cheated by life and increasingly withdrawn from his family. But then for some reason which he still cannot explain or understand, he slowly became aware of a sense of calm and peace within him as he ACCEPTED the reality of his situation, and tried to make the best of his remaining days, and even began to look forward to the end.

This episode and innumerable other episodes I encountered while I practiced my art over more than half a century, under varying conditions and in multiple settings, have helped me to more clearly understand and to appreciate the actions of people as they travel on their final journey. They have also served the very important purpose of teaching me that the act of dying is not a random, unrelated event that takes place at the end of a person’s lifeline, and should best be ignored and avoided as much as possible until it becomes inevitable. Rather, we should make every effort to recognize that life is but a journey of transition on the map of our destiny, and death is but a continuum of that journey.

The great Italian Renaissance painter and intellectual genius, Leonardo da Vinci, more accurately wrote on the subject of life and death that:

“While I thought that I was learning how to live,

I have been learning how to die”

This statement, though initially appearing to be paradoxical, in fact contains a fundamental truth which we should unconditionally accept. The Buddhist view is even more direct that “we begin to die from the moment we are born and from that moment we should be preparing for the final event.” Unfortunately few societies allow for this truth, and in fact, tend to encourage the very opposite, that life should be lived as if it has no end. We give lip service to the inevitability of death, but live our lives as if this fact does not apply to our living. It is no surprise that when the time comes we are so deeply consumed with regrets that we lose the ability to accept the moment of truth. Far too often, those of us who are in a position to help the patient during this period are tempted to hold back on providing the appropriate information and guidance, treating it as an inconvenient truth, for fear of upsetting the patient or the family. Rather, we choose the safer path of being non-committal and hope that we can get by without being challenged. By doing this we are contributing to the unnecessary suffering and long term pain which lingers on long after the loved one has passed on.

Yet the real truth is that in the end we must all anticipate the inevitability of death as an integral part of living and as such we must, as we must do in every other aspect of living, make preparations for its arrival. The most powerful reminder of this fact is contained in a simple statement in the Gospel, in The Book of Ecclesiastes, Chapter 3, Verse1:

"For everything there is a season,

and a time for every matter under heaven:

a time to be born, and a time to die.”

Irrespective of your belief system, one fact is constant and predictable, and that is, as my friend the late Carlito Alexander repeatedly reminded us: “We are all born with an Expiry date”. Humans, unlike all other members of the Animal Kingdom, find it difficult to accept and adapt to the reality of dying and as a result experience greater pain and suffering. The animal, whether it is the mighty Lion or the humble Otter, will pause to acknowledge the loss and then continue along their way. Humans, by and large, are so preoccupied with the pleasures of living and self gratification, that they either ignore or suppress the reality that death cannot be avoided or worse; believe that they can somehow fool it. There should be no surprise therefore that most of us arrive on that final journey packed with so many regrets that we lose the real impact of that experience until the final moment of acceptance.

In 2009, an Australian nurse, Bronnie Ware, published a brief internet essay based on her 10 year experience as a Hospice nurse entitled “The Top Regrets of the Dying,” in which she recorded the five most common regrets expressed by her patients as they approached death. This was so well received that two years later she expanded her presentation by publishing a book under the same title. In a simple, very personal way, she identified the most common regrets expressed by her patients and their need and desire to have them addressed before the final event occurs. She also reminded us that it was possible to avoid these unfortunate situations and die with peace of mind and dignity, if we took care to make the right choices during our lifetime. She further reinforced the truth, which anyone working in the field will readily confirm, that even in dying it was possible to achieve peace and acceptance, as she noted in her essay:

“I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.”

In my own personal life, I have witnessed the peace of mind and calm that comes from the acceptance of the inevitable, and the subsequent joy and celebration of the life of the departed which followed. And above all, I have appreciated the good memories that remain long after. Along the way, I have also witnessed the overnight metamorphosis that take place in a few instances where an angry, aggressive, antagonistic patient was transformed into a peaceful, caring and accepting person, which he suggested resulted from a “spiritual” visit. But I have also shared the excruciating pain and torment of one who could not and would not accept the truth and who fought to the very end, cursing his lot, his luck, his life and his Lord. That pain lingers on forever, and I and the family are robbed of all the good memories of his life that could have been, but were buried by the resentment.

It is clear to me that quite unlike most of the Eastern societies where dying is considered to be an integral part of life, the Western attitude is one of denial and ignoring its relevance in favor living at all cost. You begin to wonder which of these views are really the more “civilized” culture.

There is a growing tendency in this modern society where so much amazing and wonderful discoveries are being made on a daily basis, and where there appears to be increasing optimism that we will be able to replace and restore destroyed and dying organs at will, that perhaps ultimately we will be able cheat death itself. The most extreme form of this thinking is the increasing interest in the concept of Cryonics where the body is preserved in extremely cold temperatures until such time as science catches up with the ability to restore life. While I endorse and welcome all the scientific advancements that have occurred and encourage aggressive research designed to improve the quality of life, I fear that we might find ourselves further lulled into a sense of security that death is indeed not inevitable and that it could be avoided. Already we increasingly cover up the signs of aging with cosmetics and surgery, and we have no hesitation to reverse some of nature’s fundamental changes with the ambitious use of powerful hormones in a concerted attempt to stay young.

All of this however will serve only to prolong the journey, but not change the outcome. We must never lose sight of this fact, nor should we ever abandon our responsibility to prepare ourselves and those around us to the inevitability of our destiny in God’s ultimate plan.

LIFE IS FOR THE LIVING

LIVING WITH DEATH AND DYING(III)

An Overview

“...when we finally know we are dying, and all other sentient beings are dying with us, we start to have a burning, almost heartbreaking sense of the fragility and preciousness of each moment and each being, and from this can grow a deep, clear, limitless compassion for all beings.”

These words recorded by Sogyal Rinpoche, the world-renowned Tibetan Lama and Buddhist teacher, in his highly acclaimed publication entitled “The Tibetan Book of Living and Dying”, simply and effectively describes that area of vague and indescribable uncertainty through which we all travel, in one way or another, as we journey on that final road.

Whenever I think of this subject, I am always reminded of a time, many years ago when as a young, relatively inexperienced physician I shared a particularly harrowing and anxious period with a very close friend and relative. He had been diagnosed with a very serious, often fatal septic condition and there was some doubt about survival. When he was subsequently asked to recall how he felt during that very difficult and frightening experience, he described a series of stages which to me were almost identical to The Five Stages of Grief so beautifully explained by great Swiss-born, American Psychiatrist Dr. Elizabeth Kubler-Ross in 1969. Even today, so many years after that fateful event, his recollection has not changed in any way, and he still vividly describes the stages through which he traveled during that period. He remembers his initial response of DENIAL and his questioning of the physicians’ findings, followed by the feelings of ANGER he felt at life and at God, and his asking over and over, “Why me, Why me?”. This stage then progressed to one of trying to BARGAIN with God; “Give me a break, Lord, I promise I will be devoted to you!” And when things got worse and the end was beginning to look inevitable, he became DEPRESSED. He felt hopelessly overwhelmed with sorrow and self-pity for being cheated by life and increasingly withdrawn from his family. But then for some reason which he still cannot explain or understand, he slowly became aware of a sense of calm and peace within him as he ACCEPTED the reality of his situation, and tried to make the best of his remaining days, and even began to look forward to the end.

This episode and innumerable other episodes I encountered while I practiced my art over more than half a century, under varying conditions and in multiple settings, have helped me to more clearly understand and to appreciate the actions of people as they travel on their final journey. They have also served the very important purpose of teaching me that the act of dying is not a random, unrelated event that takes place at the end of a person’s lifeline, and should best be ignored and avoided as much as possible until it becomes inevitable. Rather, we should make every effort to recognize that life is but a journey of transition on the map of our destiny, and death is but a continuum of that journey.

The great Italian Renaissance painter and intellectual genius, Leonardo da Vinci, more accurately wrote on the subject of life and death that:

“While I thought that I was learning how to live,

I have been learning how to die”

This statement, though initially appearing to be paradoxical, in fact contains a fundamental truth which we should unconditionally accept. The Buddhist view is even more direct that “we begin to die from the moment we are born and from that moment we should be preparing for the final event.” Unfortunately few societies allow for this truth, and in fact, tend to encourage the very opposite, that life should be lived as if it has no end. We give lip service to the inevitability of death, but live our lives as if this fact does not apply to our living. It is no surprise that when the time comes we are so deeply consumed with regrets that we lose the ability to accept the moment of truth. Far too often, those of us who are in a position to help the patient during this period are tempted to hold back on providing the appropriate information and guidance, treating it as an inconvenient truth, for fear of upsetting the patient or the family. Rather, we choose the safer path of being non-committal and hope that we can get by without being challenged. By doing this we are contributing to the unnecessary suffering and long term pain which lingers on long after the loved one has passed on.

Yet the real truth is that in the end we must all anticipate the inevitability of death as an integral part of living and as such we must, as we must do in every other aspect of living, make preparations for its arrival. The most powerful reminder of this fact is contained in a simple statement in the Gospel, in The Book of Ecclesiastes, Chapter 3, Verse1:

"For everything there is a season,

and a time for every matter under heaven:

a time to be born, and a time to die.”

Irrespective of your belief system, one fact is constant and predictable, and that is, as my friend the late Carlito Alexander repeatedly reminded us: “We are all born with an Expiry date”. Humans, unlike all other members of the Animal Kingdom, find it difficult to accept and adapt to the reality of dying and as a result experience greater pain and suffering. The animal, whether it is the mighty Lion or the humble Otter, will pause to acknowledge the loss and then continue along their way. Humans, by and large, are so preoccupied with the pleasures of living and self gratification, that they either ignore or suppress the reality that death cannot be avoided or worse; believe that they can somehow fool it. There should be no surprise therefore that most of us arrive on that final journey packed with so many regrets that we lose the real impact of that experience until the final moment of acceptance.

In 2009, an Australian nurse, Bronnie Ware, published a brief internet essay based on her 10 year experience as a Hospice nurse entitled “The Top Regrets of the Dying,” in which she recorded the five most common regrets expressed by her patients as they approached death. This was so well received that two years later she expanded her presentation by publishing a book under the same title. In a simple, very personal way, she identified the most common regrets expressed by her patients and their need and desire to have them addressed before the final event occurs. She also reminded us that it was possible to avoid these unfortunate situations and die with peace of mind and dignity, if we took care to make the right choices during our lifetime. She further reinforced the truth, which anyone working in the field will readily confirm, that even in dying it was possible to achieve peace and acceptance, as she noted in her essay:

“I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.”

In my own personal life, I have witnessed the peace of mind and calm that comes from the acceptance of the inevitable, and the subsequent joy and celebration of the life of the departed which followed. And above all, I have appreciated the good memories that remain long after. Along the way, I have also witnessed the overnight metamorphosis that take place in a few instances where an angry, aggressive, antagonistic patient was transformed into a peaceful, caring and accepting person, which he suggested resulted from a “spiritual” visit. But I have also shared the excruciating pain and torment of one who could not and would not accept the truth and who fought to the very end, cursing his lot, his luck, his life and his Lord. That pain lingers on forever, and I and the family are robbed of all the good memories of his life that could have been, but were buried by the resentment.

It is clear to me that quite unlike most of the Eastern societies where dying is considered to be an integral part of life, the Western attitude is one of denial and ignoring its relevance in favor living at all cost. You begin to wonder which of these views are really the more “civilized” culture.

There is a growing tendency in this modern society where so much amazing and wonderful discoveries are being made on a daily basis, and where there appears to be increasing optimism that we will be able to replace and restore destroyed and dying organs at will, that perhaps ultimately we will be able cheat death itself. The most extreme form of this thinking is the increasing interest in the concept of Cryonics where the body is preserved in extremely cold temperatures until such time as science catches up with the ability to restore life. While I endorse and welcome all the scientific advancements that have occurred and encourage aggressive research designed to improve the quality of life, I fear that we might find ourselves further lulled into a sense of security that death is indeed not inevitable and that it could be avoided. Already we increasingly cover up the signs of aging with cosmetics and surgery, and we have no hesitation to reverse some of nature’s fundamental changes with the ambitious use of powerful hormones in a concerted attempt to stay young.

All of this however will serve only to prolong the journey, but not change the outcome. We must never lose sight of this fact, nor should we ever abandon our responsibility to prepare ourselves and those around us to the inevitability of our destiny in God’s ultimate plan.

LIFE IS FOR THE LIVING

LIVING WITH DEATH AND DYING(III)

The Final Road

“...when we finally know we are dying, and all other sentient beings are dying with us, we start to have a burning, almost heartbreaking sense of the fragility and preciousness of each moment and each being, and from this can grow a deep, clear, limitless compassion for all beings.”

These words recorded by Sogyal Rinpoche, the world-renowned Tibetan Lama and Buddhist teacher, in his highly acclaimed publication entitled “The Tibetan Book of Living and Dying”, simply and effectively describes that area of vague and indescribable uncertainty through which we all travel, in one way or another, as we journey on that final road.

Whenever I think of this subject, I am always reminded of a time, many years ago when as a young, relatively inexperienced physician I shared a particularly harrowing and anxious period with a very close friend and relative. He had been diagnosed with a very serious, often fatal septic condition and there was some doubt about survival. When he was subsequently asked to recall how he felt during that very difficult and frightening experience, he described a series of stages which to me were almost identical to The Five Stages of Grief so beautifully explained by great Swiss-born, American Psychiatrist Dr. Elizabeth Kubler-Ross in 1969. Even today, so many years after that fateful event, his recollection has not changed in any way, and he still vividly describes the stages through which he traveled during that period. He remembers his initial response of DENIAL and his questioning of the physicians’ findings, followed by the feelings of ANGER he felt at life and at God, and his asking over and over, “Why me, Why me?”. This stage then progressed to one of trying to BARGAIN with God; “Give me a break, Lord, I promise I will be devoted to you!” And when things got worse and the end was beginning to look inevitable, he became DEPRESSED. He felt hopelessly overwhelmed with sorrow and self-pity for being cheated by life and increasingly withdrawn from his family. But then for some reason which he still cannot explain or understand, he slowly became aware of a sense of calm and peace within him as he ACCEPTED the reality of his situation, and tried to make the best of his remaining days, and even began to look forward to the end.

This episode and innumerable other episodes I encountered while I practiced my art over more than half a century, under varying conditions and in multiple settings, have helped me to more clearly understand and to appreciate the actions of people as they travel on their final journey. They have also served the very important purpose of teaching me that the act of dying is not a random, unrelated event that takes place at the end of a person’s lifeline, and should best be ignored and avoided as much as possible until it becomes inevitable. Rather, we should make every effort to recognize that life is but a journey of transition on the map of our destiny, and death is but a continuum of that journey.

The great Italian Renaissance painter and intellectual genius, Leonardo da Vinci, more accurately wrote on the subject of life and death that:

“While I thought that I was learning how to live,

I have been learning how to die”

This statement, though initially appearing to be paradoxical, in fact contains a fundamental truth which we should unconditionally accept. The Buddhist view is even more direct that “we begin to die from the moment we are born and from that moment we should be preparing for the final event.” Unfortunately few societies allow for this truth, and in fact, tend to encourage the very opposite, that life should be lived as if it has no end. We give lip service to the inevitability of death, but live our lives as if this fact does not apply to our living. It is no surprise that when the time comes we are so deeply consumed with regrets that we lose the ability to accept the moment of truth. Far too often, those of us who are in a position to help the patient during this period are tempted to hold back on providing the appropriate information and guidance, treating it as an inconvenient truth, for fear of upsetting the patient or the family. Rather, we choose the safer path of being non-committal and hope that we can get by without being challenged. By doing this we are contributing to the unnecessary suffering and long term pain which lingers on long after the loved one has passed on.

Yet the real truth is that in the end we must all anticipate the inevitability of death as an integral part of living and as such we must, as we must do in every other aspect of living, make preparations for its arrival. The most powerful reminder of this fact is contained in a simple statement in the Gospel, in The Book of Ecllesiates, Chapter 3, Verse1:

"For everything there is a season,

and a time for every matter under heaven:

a time to be born, and a time to die.”

Irrespective of your belief system, one fact is constant and irreversible, and that is, as my friend the late Carlito Alexander repeatedly reminded us: “We are all born with an Expiry date”. Humans, unlike all other members in the Animal Kingdom, find it difficult to accept and adapt to the reality of dying and as a result experience greater pain and suffering. The animal, whether it is the mighty Lion or the humble Otter, will pause to acknowledge the loss and then continue along their way. Humans, by and large, are so preoccupied with the pleasures of living and self gratification, that they either ignore or suppress the reality that death cannot be avoided or worse; believe that they can somehow fool it. There should be no surprise therefore that most of us arrive on that final journey packed with so many regrets that we lose the real impact of that experience until the final moment of acceptance.

In 2009, an Australian nurse, Bronnie Ware, published a brief internet essay based on her 10 year experience as a Hospice nurse entitled “The Top Regrets of the Dying,” in which she recorded the five most common regrets expressed by her patients as they approached death. This was so well received that two years later she expanded her presentation by publishing a book under the same title. In a simple, very personal way she identified the most common regrets expressed by her patients and their need and desire to have them addressed before the final event occurs. She also reminded us that it was possible to avoid this unfortunate situation and die with peace of mind and dignity, if we took care to make the right choices during our lifetime. She further reinforced the truth, which anyone working in the field will readily confirm, that even in dying it was possible to achieve peace and acceptance, as she noted in her essay:

“I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.”

In my own personal life, I have witnessed the peace of mind and calm that comes from the acceptance of the inevitable, and the resulting joy and celebration of the life of the departed which followed. And above all, I have appreciated the good memories that remain long after. I have witnessed the overnight metamorphosis from an angry, aggressive, antagonistic patient to one of a peaceful, caring acceptance which he suggested resulted from a “spiritual” visit. But I have also shared the excruciating pain and torment of one who could not accept the truth and who fought to the very end, cursing his lot, his luck, his life and his Lord. That pain lingers on forever, and I and the family are robbed of all the good memories that could have been. It is clear to me that quite unlike most of the Eastern societies where dying is considered to be an integral part of life, the Western attitude is one of denial and ignoring its relevance in favor living at all cost. You begin to wonder which of these views are really the more civilized culture.

There is a growing tendency in this modern society where so much amazing and wonderful discoveries are being made on a daily basis, and where there appears to be increasing optimism that we will be able to replace and restore destroyed and dying organs at will, that perhaps ultimately we will be able cheat death itself. The most extreme form of this thinking is the increasing interest in the concept of Cryonics where the body is preserved in extremely cold temperatures until such time as science catches up with the ability to restore life. While I endorse and welcome all the scientific advancements that have occurred and encourage aggressive research designed to improve the quality of life, I fear that we might find ourselves further lulled into a sense of security that death is indeed not inevitable and that it could be avoided. Already we increasingly cover up the signs of aging with cosmetics and surgery, and we have no hesitation to reverse some of nature’s fundamental changes with the ambitious use of powerful hormones in a concerted attempt to stay young. All of this however will serve to prolong the journey, but not change the outcome. We must not lose sight of this fact nor should we ever abandon our responsibility to prepare ourselves and those around us to the inevitability of dying.

03/20/12

LIFE IS FOR THE LIVING

LIVING WITH DEATH AND DYING(III)

The Final Road

“...when we finally know we are dying, and all other sentient beings are dying with us, we start to have a burning, almost heartbreaking sense of the fragility and preciousness of each moment and each being, and from this can grow a deep, clear, limitless compassion for all beings.”

These words recorded by Sogyal Rinpoche, the world-renowned Tibetan Lama and Buddhist teacher, in his highly acclaimed publication entitled “The Tibetan Book of Living and Dying”, simply and effectively describes that area of vague and indescribable uncertainty through which we all travel, in one way or another, as we journey on that final road.

Whenever I think of this subject, I am always reminded of a time, many years ago when as a young, relatively inexperienced physician I shared a particularly harrowing and anxious period with a very close friend and relative. He had been diagnosed with a very serious, often fatal septic condition and there was some doubt about survival. When he was subsequently asked to recall how he felt during that very difficult and frightening experience, he described a series of stages which to me were almost identical to The Five Stages of Grief so beautifully explained by great Swiss-born, American Psychiatrist Dr. Elizabeth Kubler-Ross in 1969. Even today, so many years after that fateful event, his recollection has not changed in any way, and he still vividly describes the stages through which he traveled during that period. He remembers his initial response of DENIAL and his questioning of the physicians’ findings, followed by the feelings of ANGER he felt at life and at God, and his asking over and over, “Why me, Why me?”. This stage then progressed to one of trying to BARGAIN with God; “Give me a break, Lord, I promise I will be devoted to you!” And when things got worse and the end was beginning to look inevitable, he became DEPRESSED. He felt hopelessly overwhelmed with sorrow and self-pity for being cheated by life and increasingly withdrawn from his family. But then for some reason which he still cannot explain or understand, he slowly became aware of a sense of calm and peace within him as he ACCEPTED the reality of his situation, and tried to make the best of his remaining days, and even began to look forward to the end.

This episode and innumerable other episodes I encountered while I practiced my art over more than half a century, under varying conditions and in multiple settings, have helped me to more clearly understand and to appreciate the actions of people as they travel on their final journey. They have also served the very important purpose of teaching me that the act of dying is not a random, unrelated event that takes place at the end of a person’s lifeline, and should best be ignored and avoided as much as possible until it becomes inevitable. Rather, we should make every effort to recognize that life is but a journey of transition on the map of our destiny, and death is but a continuum of that journey.

The great Italian Renaissance painter and intellectual genius, Leonardo da Vinci, more accurately wrote on the subject of life and death that:

“While I thought that I was learning how to live,

I have been learning how to die”

This statement, though initially appearing to be paradoxical, in fact contains a fundamental truth which we should unconditionally accept. The Buddhist view is even more direct that “we begin to die from the moment we are born and from that moment we should be preparing for the final event.” Unfortunately few societies allow for this truth, and in fact, tend to encourage the very opposite, that life should be lived as if it has no end. We give lip service to the inevitability of death, but live our lives as if this fact does not apply to our living. It is no surprise that when the time comes we are so deeply consumed with regrets that we lose the ability to accept the moment of truth. Far too often, those of us who are in a position to help the patient during this period are tempted to hold back on providing the appropriate information and guidance, treating it as an inconvenient truth, for fear of upsetting the patient or the family. Rather, we choose the safer path of being non-committal and hope that we can get by without being challenged. By doing this we are contributing to the unnecessary suffering and long term pain which lingers on long after the loved one has passed on.

Yet the real truth is that in the end we must all anticipate the inevitability of death as an integral part of living and as such we must, as we must do in every other aspect of living, make preparations for its arrival. The most powerful reminder of this fact is contained in a simple statement in the Gospel, in The Book of Ecllesiates, Chapter 3, Verse1:

"For everything there is a season,

and a time for every matter under heaven:

a time to be born, and a time to die.”

Irrespective of your belief system, one fact is constant and irreversible, and that is, as my friend the late Carlito Alexander repeatedly reminded us: “We are all born with an Expiry date”. Humans, unlike all other members in the Animal Kingdom, find it difficult to accept and adapt to the reality of dying and as a result experience greater pain and suffering. The animal, whether it is the mighty Lion or the humble Otter, will pause to acknowledge the loss and then continue along their way. Humans, by and large, are so preoccupied with the pleasures of living and self gratification, that they either ignore or suppress the reality that death cannot be avoided or worse; believe that they can somehow fool it. There should be no surprise therefore that most of us arrive on that final journey packed with so many regrets that we lose the real impact of that experience until the final moment of acceptance.

In 2009, an Australian nurse, Bronnie Ware, published a brief internet essay based on her 10 year experience as a Hospice nurse entitled “The Top Regrets of the Dying,” in which she recorded the five most common regrets expressed by her patients as they approached death. This was so well received that two years later she expanded her presentation by publishing a book under the same title. In a simple, very personal way she identified the most common regrets expressed by her patients and their need and desire to have them addressed before the final event occurs. She also reminded us that it was possible to avoid this unfortunate situation and die with peace of mind and dignity, if we took care to make the right choices during our lifetime. She further reinforced the truth, which anyone working in the field will readily confirm, that even in dying it was possible to achieve peace and acceptance, as she noted in her essay:

“I learnt never to underestimate someone's capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.”

In my own personal life, I have witnessed the peace of mind and calm that comes from the acceptance of the inevitable, and the resulting joy and celebration of the life of the departed which followed. And above all, I have appreciated the good memories that remain long after. I have witnessed the overnight metamorphosis from an angry, aggressive, antagonistic patient to one of a peaceful, caring acceptance which he suggested resulted from a “spiritual” visit. But I have also shared the excruciating pain and torment of one who could not accept the truth and who fought to the very end, cursing his lot, his luck, his life and his Lord. That pain lingers on forever, and I and the family are robbed of all the good memories that could have been. It is clear to me that quite unlike most of the Eastern societies where dying is considered to be an integral part of life, the Western attitude is one of denial and ignoring its relevance in favor living at all cost. You begin to wonder which of these views are really the more civilized culture.

There is a growing tendency in this modern society where so much amazing and wonderful discoveries are being made on a daily basis, and where there appears to be increasing optimism that we will be able to replace and restore destroyed and dying organs at will, that perhaps ultimately we will be able cheat death itself. The most extreme form of this thinking is the increasing interest in the concept of Cryonics where the body is preserved in extremely cold temperatures until such time as science catches up with the ability to restore life. While I endorse and welcome all the scientific advancements that have occurred and encourage aggressive research designed to improve the quality of life, I fear that we might find ourselves further lulled into a sense of security that death is indeed not inevitable and that it could be avoided. Already we increasingly cover up the signs of aging with cosmetics and surgery, and we have no hesitation to reverse some of nature’s fundamental changes with the ambitious use of powerful hormones in a concerted attempt to stay young. All of this however will serve to prolong the journey, but not change the outcome. We must not lose sight of this fact nor should we ever abandon our responsibility to prepare ourselves and those around us to the inevitability of dying.

03/20/12

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