The Paradox of How We Die: Arriving at a “Good Death”
Let me begin by reassuring you that this isn’t going to be a grim post. But it begins in an area people are uncomfortable with. We all must die, yet this is one inevitability that almost nobody feels comfortable talking about. That includes doctors and nurses, as was discovered in a newly published study from King’s College in London. It surveyed the staff that surrounded dying patients in hospices and found that they witness every common end-of-life experience (ELE). These fall into two types, and one of them will seem very strange.
The first type of ELE seeks final meaning. Near the time of death, people often want to be reconciled with family members who have become estranged, and this desire can be so strong that the moment of death is postponed until the estranged person visits. There is often a desire to put one’s affairs in order and to right past wrongs. It is observed that patients who have been semi-conscious will have a moment of sudden lucidity in which they express their dying wishes before lapsing back. This whole category of ELE is psychologically intimate, and a significant number of doctors and nurses feel uncomfortable being present for it. Two inhibitions stand in the way. Doctors spend most of their energy trying to extend life, so learning about dying isn’t part of their training. Secondly, it is still considered a sign of weakness for a doctor to feel emotional about death, which leads to distancing himself from the actual experience.
The second type of ELE is labeled transpersonal, although the common word for it would be spooky. Dying patients, far more often than is acknowledged, have highly mystical experiences. They get visions of departed ones who have come to take them away. They sense the transmission of light and love from other realities and can visit those realities. The study found that such ELEs could not be accounted for by the medical state or treatment of the person — the ELE occurred in clear consciousness.
Yet probably the most uncomfortable ELE in this category was observed by the staff, including seeing something leave the body at the time of death, finding that a peculiar synchronicity occurred, such as the clock stopping at the moment of death. It’s more common than you would suppose for relatives who were not present when the dying person passed away to have them appear at the moment of death. Needless to say, modern society is skeptical enough that ridicule and quick dismissal of these transpersonal experiences will arise, even though they have been reported continually in every culture since history has been recorded.
The study makes the point that ELEs, which of course do not occur with every dying person, bring comfort and consolation; they seem to be a natural mechanism that surrounds the climactic event of death. Which brings us to the paradox of how we die. In the 1930s, eighty percent of people still died at home; now more than eighty percent die in the impersonal setting of a hospital. Massive expense is involved in trying to cure the last disease each of us will have, the one we eventually die from. As medical technology shrouds the dying process, as people become more and more discomfited being around it, nature doesn’t seem to care. Mind and spirit experience death the old-fashioned way. Happily, the paradox resolves itself in favor of death being much less scary than we imagine. There is every indication that we are meant to die at peace, and so we do.
The breakthrough book in this area was Elisabeth Kubler-Ross’s On Death and Dying, which appeared in 1969; we’ve had over forty years to rid ourselves of the suppressed dread and panic that surrounds a natural process. The new London study should help pave the way for even greater clarity and hope about dying, but there is strong resistance still. Kubler-Ross herself, having enjoyed great acclaim for her book, went on to explore the mystical side of ELEs, the transpersonal kind. Her efforts were greeted with hostility by mainstream medicine and various brands of skepticism. In many ways it was a sad turn-around for a brave psychological researcher, yet in the end I think Kubler-Ross, whom I knew when she herself was dying in 2004, will be vindicated. There is much more to dying than lying in bed connected to tubes and praying that you will “go into the light.” The real light we need to shine is here and now. What awaits a great many people is that mysterious thing, a good death, and we would do well to realize that.
Published by The San Francisco Chronicle