The Reality of Dealing with Death

As a Physician Assistant working with cancer patients, sometimes at the brink of death or dealing with metastatic cancer, I would make it my business to be logical, without too much emotion.  It is always easier to be that way, but it never lasted because I would put myself in their place (both the patient and their loved ones) and return to reality.

 I learned to use the words “cancer, death, died, do not resuscitate, pound on the chest” as easily as the words “happy, sunshine, coffee.” Because I had to; while working there I didn’t sleep well for years and fondly remember so many of my patients.

 Now, to another type of reality. An old, old friend (the platinum kind, not in age) is dealing with metastatic cancer. She lives out of state, and there are times when I want to hug her and tell her all will be okay and times when I want to shake her, you need to” get it.”

 But would I be able to do what, logically she should do. Is there any “right” way to approach an impending death, a terminal diagnosis?   Would I be going out and buying birthday cards to give to my loved ones for special events, graduations, engagements, marriage, or a new house when I am not physically there but actually dead? I don’t know if I can do what I suggest. I have a feeling I would not be that great at it.

 So, what do we do? When she asked me how to tell her young adult grandchildren, I thought about it and suggested she turn the question around. Ask them, “What do you think is happening?” Do you think I will be here to see you get married?” Their thoughts may be way off the mark. But it can open much-needed conversations. And don’t be afraid to cry and admit you are scared too.

 My `biggest and most important suggestion is to “have no regrets.” Spend whatever time you have (and remember, no doctor, nurse, hospice, or psychic can guarantee how much time anyone has) doing fun things. Calling old friends, not to say goodbye, but just ‘thinking of you.” Don’t waste precious time fighting with anyone. If someone isn’t nice to you or is “toxic,” stop speaking to them. It’s really okay. Tell your family you love them, apologize for any mistakes you made (who hasn’t), and look into the present and beyond.

 Most importantly, take time to grieve for what you have lost or will lose. I call it a mini pity party. Do it for a whole weekend or just 30 minutes a day. Whatever works. Just don’t wallow all day long for weeks on end.

 We are all going to die. We don’t have much control, but use what time you have and make it as good as possible. Try to understand everyone’s differences and give love and support.  As you help those you love to process what is happening, you will find peace and have started the painful process of saying goodbye or “see you later.”  It’s the best we can do.