For those who have been reading my posts for many years, you may remember the one I wrote after my mother passed, entitled: "The Problem With Dying". The focus of that post was our almost universal resistance to accepting death, even among the general hospital staff in the case of my mother's care. It was only when we transferred her to a hospice unit that her care was in support of the process of dying and included those of us who loved her and were keeping her vigil. I am saddened to be writing a similar post in remembrance of my younger sister's death only a week ago. Her medical situation deteriorated rapidly after an initial infection led to another and then another, rendering further treatment pointless. Although not entirely rational, the situation was wrong. It was out of order. Kathie was two years younger than me. It should have been me or my eighty-three year old sister lying there. Not her. In contrast to my mother's situation in which the general hospital staff continued to treat her as if she were going to recover, my sister's caregivers recognized that she was terminal and welcomed the intervention of hospice and a transfer to the hospital's hospice unit. From her admission on a Saturday morning until her death on Tuesday evening, the hospice staff succeeded in providing sensitive care to my sister and to her family in attendance. The result was a dignified and loving process which allowed us to witness her death in peace and with acceptance. My only regret is that she had lost her ability to communicate verbally and, although her facial expressions showed recognition and understanding, we had to guess at her responses. I always instruct my patients to tell love ones how they feel long before the end of life as we never know when the opportunity will be lost. And none of us has tomorrow guaranteed.
Since my mother passed away in 2005, I trust that we are doing a better job at dealing with death. Certainly, this recent experience is testament that, at least in Kansas City, they are. Far better than in Florida in 2005 or in Rhode Island where I practiced for almost all of my career. Some, like myself, believe that the fear of dying is the basis of all anxiety and that our discomfort leads us to deny the reality of our own death and the deaths of those we care most about. It is often said that no one should die alone. No one will if we are willing to accept the reality of death and to talk about it while the dying person is able.