Living And Dying Responsibly

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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