We
should learn lessons on living from those that have died successfully. If that sounds convoluted, or even
fatalistic, it is not. Succinctly put,
dying successfully involves living even more triumphantly. Many of us neither
live well nor die well. Substantially,
that is because we not only have been indoctrinated with false assumptions and
values, but also have been conditioned to live comparatively and competitively,
in every aspect of our lives.
I want
to draw on four people in my life as examples of dealing with the prospect of
dying, or, at least, dealing with a life-threatening illness.
The
first, diagnosed with breast cancer in the 1960s, responded by angrily
determining to beat the disease, even though radical surgery was required. Her prognosis was terrible, but she lived
another ten years, at last weakened beyond recovery in a serious car accident.
The
second died of throat cancer, after denying that his smoking was a contributor
and refusing to deal with the growth on his neck for over a year. When, in the latter stages of cancer, he was
told that he might gain a few weeks or months of life if he quit, responded,
“It isn’t worth it,” and smoked to his last day.
The
third bemoaned his fate, gave up and died quickly.
The
fourth person accepted the diagnosis, looked into alternatives, made
adjustments in his life and continued on with daily activities, letting the
diagnosis have as little impact on the way that he lived as possible.
These
people are representative of the world at large, and dealt with their illnesses
in typical manner, with varying degrees of success. Two, of course, decreased the quality and
duration of their lives significantly by their inaction.
Dr. Fiore, a specialist in issues of dying, recommends that a person with a fatal illness
starts by taking charge of his or her life, asking lots of good
questions, and making informed choices regarding doctors, hospitals and
treatments. He further suggests that the patient should express his feelings
through talking or writing them down, singing or even screaming. He concludes
by telling his patients that they should treat the illness, not like a Rocky
Balboa fight, but trusting the body to know what to do.
Psychological researcher, Dr. C. Scanlon, in his 1989 article
entitled, “Creating a vision of hope: The challenge of palliative care.” (Oncology
Nursing Forum, 16(4), 491-496.), itemizes the following as the primary worries
of a person with a terminal illness: 1) Further debilitation and dependency, 2) Pain
and suffering, 3) Consequences for
dependents and arranging affairs, 4) An uncertain future, 5) Lingering, 6) Dying alone, 7) Loss of control, 8) Changing
relationships, 9) Existential concerns, 10) Change in mental functioning and 11) Afterlife.
As we
examine each of these concerns, we find that, in a nutshell, people facing
death primarily focus on issues relating to loss of control. By placing health management responsibly in
the hands of the patient, the stress associated with loss of control is
diminished.
This
concern over control in death is the same with control in life. Most of us ride life, instead of
steering. We are not in control, and, in
turn, we experience stress. More stress,
less happiness. Less happiness, less
fulfillment.
Such a
simple conclusion seems --- well, too simple!
It is not. Those people with an
external locus of control, who give their lives into the hands of others, are
less fulfilled that those who take control of those things that impact on their
own lives, and those things over which they can exercise responsible control. They are less stressed, more vibrant, more
explorative, more willing and able to face hurdles, not as insurmountable
problems, but as challenges to be faced and overcome.
Death is an insurmountable problem. Dying is not, and should be approached by
seeking to maintain as much control over the process and facts as
possible. Living, equally, is a process
that demands that to be successfully navigated and enjoyed we must be involved
in and managing the events in our lives.
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