I have subscribed to the National Library of Medicine (NLM) for years. From their own website, “NLM is part of the National Institutes of Health (NIH), U.S. Department of Health and Human Services, and located in Bethesda, Maryland. NLM started in 1836 as a small collection of medical books and journals in the office of the U.S. Army Surgeon General. The NLM is the world’s largest biomedical library. NLM plays a pivotal role in translating biomedical research into practice. NLM’s research and information services support scientific discovery, health care, and public health. Every day, millions of scientists, health professionals, and members of the public from around the world use NLM’s online information resources to translate research results into new treatments, develop new products, inform clinical decision making, and improve public health.”
Recently, there was an article on “Defining a Good Death (Successful Dying): Literature Review…” NLM reviewed 36 articles and studies published between 1996 and 2015. In the review, there were several good points brought out that I thought folks might be interested in.
I spoke with several of my friends and asked them if they thought there was such a thing as a ‘good death’. All of them thought, “Yes, there is”. My own father, Leo Green, awoke and got dressed to go to work one day, shaving and showering and putting on his Standard Oil uniform, just like he had for the more than 55 years he owned Green’s Standard Service. Then, he lay back down in bed and quietly died in his sleep. All the folks familiar with Leo were unanimous in saying, “That was the best way to go for Leo.” He always ran everywhere and made sure his employees hustled out on the drive to wait on customers at the service station.
My son, on the other hand, was taken in the middle of the night during a seizure while he was in bed. People who have seizures generally don’t remember their seizures and it’s unknown if he realized what his last moments of life were or not. One can only pray that he didn’t feel or realize the pain and anguish of going through his last seizure of life.
My cousin was pronounced expectant to die of brain cancer after she refused to take any more chemo or radiation treatments because they had left her feeling so sickly and had ‘sucked the life out of her’. I announced, in my North Carolina church, that she had been blessed with brain cancer and the mouths fell open. Everyone wondered, “How in the world can someone be ‘blessed’ with cancer?!”
I explained how my son and others had been taken in the middle of the night or during a car wreck and not left with any opportunity to say goodbye, for either of us. I cry as I write this because I just wanted a last word with my son; to tell him how much I loved him and to say ‘Goodbye’. But that didn’t happen.
When you die suddenly, it’s all over and there are no goodbyes from either the dying or the survivors. When you have cancer or some other prolonged illness, it gives you a chance to not only say ‘Goodbye’, but to say you’re sorry for all the things you shouldn’t have said but you did…and to say the things you should have said, but you didn’t. Things like, “I love you.” Something pretty short, but for a lot of folks around here, their parents and fathers especially, who grew up during the depression, weren’t accustomed to saying. My father even told his second wife Janet, when asked why he didn’t say ‘I love you’ more often, replied, “I told you once I loved you. If I ever change my mind, I’ll let you know.” Seems cold, but my father and others were raised during hard times.
So, is there a good way to die? Those 36 studies “identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spiritualty, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with health care provider, and other. The top three themes across all groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%).”
What I found especially interesting was the difference in what the dying felt was important and what family members thought was important. “Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%–55% each). In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%).” It appears that ‘getting right with God’ is the number one priority for the dying.
Needless to say, the differences in what everyone thought was important was pretty surprising to me. Perhaps it shouldn’t have been, that the feelings of the dying and the feelings of the family were so different. Just as we all grieve differently, we all view death and dying differently.
If you would like a copy of the entire NLM article, please don’t hesitate to contact me at coroner@cedarcountymo.gov. Or you can send a letter to Coroner, 113 South St, Stockton, MO 64785.
Bottom line, maybe the best way to ensure a ‘better’, or ‘successful’ death is to live your life to its fullest. As I taught in Green Beret Survival training, sometimes you’re given the choice of a bad decision and a worse decision and you don’t know which is what. But you’re the one who has to look in the mirror for the rest of your life, so make the best decision you can with the information you have at the time.
It would be nice to think that we would have no regrets when we’re at the end, but I think we all make decisions in life, that in hindsight, we think we could have done better. So, if you have regrets, you’re just human. We can only pray for strength to do better and ask for forgiveness. Here’s to wishing and praying you live a happy and full life,
Danny Leo Green
Cedar County Coroner
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