CARE OF THE DYING PART 3: ENCOURAGING CONVERSATIONS ABOUT DEATH
by Linda J. Austin
III. How do you want to die? Good death. Fun death.
Learn to listen, and learn to receive in silence. Footnote 15
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Personalization Exercise: Imagine that you are terminally ill. You feel tired, anxious, fearful, and uncomfortable. An ambulance takes you to an unfamiliar, sterile room, that herds of masked strangers periodically enter. They point to parts of you and speak primarily to each other. The staff feeds you food you have not selected. They keep you cool when you want to be warm. They leave you on your back until the skin on your tailbone aches and dies for lack of circulation. Other strangers take you to the toilet or change your Depends. The come and go according to their own schedules, not when you summon them. A hospital chaplain comes for a visit imposing his view of the hereafter on you in his prayers. And sometimes you are simply and totally alone for long, long hours, and your wonderment begins to turn into fear.***
Past civilizations had notions of what might be characterized as a "good death." A death was good if the dying person had some warning that death was approaching, and was able to straighten his or her affairs Footnote 16. "If the pathway for communication . . . was functioning properly . . . notions of death and mourning rituals would have evolved with medical advancements." Footnote 17 Instead to the contrary, the concept of a good death has largely evaporated from the United States, despite the fact that advancements in medical technology have significantly increased the duration of pre-death illness. Footnote 18
In search of what constitutes a good death today, researchers recorded the observations of patients, providers and family members. One of the factors, pain and symptom management, addressed patients' physical needs. Footnote 19 All of the other factors, such as preparation for death, affirmation of the whole person, and others, related to nonphysical needs of people who are dying. Footnote 20
Patch Adams, a physician in the United States who is well known for dressing like a clown, introduced the concept of "fun death." The concept of a "fun death' springs from Dr. Adams' recognition of the value of laughter and humor for the health care system.
Fun (humor in action) and the accompanying laughter bring great medicine into the hospital room. Studies show that laughter relieves pain, relaxes stress, and stimulates the immune system. Footnote 21
Dr. Adams encourages this approach, particularly when facing frightening, life-threatening illnesses, such as cancer.
Do not presume that if the illness is serious you have to remain solemn. I remember a young man who had cancer that killed him in his twenties. He told me how disturbing it was to constantly have people around him treat him as if he were already dead. Friends could not see the cancer in perspective enough to treat him as a regular living person. People are always so much bigger than their illness. Footnote