Hello again. Dr. West contacted me recently and stated that there had been a number of responses and question related the column I wrote on Death and Dying some time ago. He asked if I would respond to these wonderful people who voiced their concerns about this issue. I couldn’t believe that it been that long since I have written a column about anything, and I do apologize! I guess it is true that when people retire, they find that they are busier than ever! With Dr. West’s approval, I hope to remedy that situation, and promise to write at least two columns a month, especially if your questions and comments keep on coming.

I’ve read all of the comments from everyone and hope and pray that all of you are still with us. Several of you asked about the possibility of finding peace while living with knowledge that one has a probable terminal illness, and how to actually live knowing that you are dying.

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Thank you all for your wonderful comments on the last column. I thought I would try and answer them in another column since there seemed to be so many questions brought up. If I don’t get to all of them, we may need to do another one!

First, I thought I would address 2 questions that seemed to be about the caregiver. One was about how the death would affect this caregiver, even though she knows that it will happen; including the anticipatory grief caregivers feel when they are totally aware their loved ones death is going to happen sometime in the future. No matter how much anticipatory grief is experienced, it really does not change the grief experience. I believe the reason is true is that as long as the patient is still there and you can speak with them, hold them, touch them, and enjoy just being with them, you cannot experience the utter sense of devastating loss, emptiness, and loss of “life” you will feel when the loved one is gone. If a caregiver has a therapist or a counselor helping them though the patients dying process, that is a good resource to have after the death occurs. Regardless of what emotional or psychological issues the survivor has preceding the patient illness and death; I do not believe their response is
very much different than the average, “normal” person who has experienced a life changing loss. To speak about this aspect any further would bring us into a full blown discussion about the bereavement process, and that is a topic for another column!

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Finally, I’m back!

After what seems like ages away from work and from any involvement in GRACE, I‘m ready and anxious to communicate with all of you again! I’ve been reading the posts that have been written during my absence, and have been fascinated with the depth of the discussions around the issues of death and dying. At the risk of boring or intimidating some of you who may not be ready to tackle this subject, I do feel that it is such an important subject to explore, discuss, and maybe even get relatively comfortable with, that I would like to provide some input as well.

I am the first to admit that this is a huge topic, one that can be approached from a purely existential perspective in which one never accepts the reality that this is a truth for all persons; to a very personal one in which a person feels absolute terror every waking minute from the point that they have been given a cancer diagnosis, or any “terminal” prognosis. Recently I had the experience of feeling this myself, and I was no where near a terminal state. I was in a skilled nursing facility recuperating from surgery, and I suddenly began to experience severe anxiety attacks, literally panic attacks that centered around the idea that I was dying and would definitely die in that institution away from my family and loved ones. I simply could not get my mind around the idea that I, who have worked with cancer, hospice and death and dying for over 25 years could be so terror stricken! I thought I had worked through all of the angles about it, the fear, the religious concepts, whether there is life after death, is there a soul or spirit that survives our body, the meaning of life and death, everything and anything connected with this subject. And yet, there I was, totally fearful, unable to be consoled, except for some medication finally, and ultimately left to make some sense out of all of it. So, I learned one thing for sure: no matter how much you think you are prepared for something, until it happens to you, you are never prepared! And for most of you, whose death is not imminent, but somewhere out there in the future, we know not when, until our physician tells us that there is really nothing more that can be done medically, except to keep us as comfortable as possible, there is this enormous state of limbo… how do we live, knowing that we all dying?

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