Dying with dignity requires love, compassion and spiritual support

www.bethyam.orgMarch 28, 2014 

Dr. Sherwin Nuland, author of "How We Die," died this past month. He is remembered as someone who started a nationwide conversation on the meaning of dying in a modern world.


I was sitting next to a woman as her husband's doctor explained that when they removed his tubes he would not live beyond a few hours. The physician then said, "I suggest you look at a book by Sherwin Nuland titled 'How We Die,' before he expires."

It was a bit late for the physician to be making book recommendations, I thought.

When someone is in the process of dying, it is a confusing and difficult time. What people say to each other can be amazing -- both good and bad. I have heard the dying utter the most comforting and sage-like wisdom to their families -- and I've heard families say the same to the dying.

Health care professionals, such as physicians, have a lot of experience with patients dying, but this doesn't mean they always know how to talk to patients and their loved ones in a way that is comforting and helpful, especially in the last days, let alone hours, of life.

Sherwin Nuland, a professor of surgery at Yale, became one of the nation's most respected experts on the topic of dying in America. This month he died. Nuland will be remembered as one who helped start a nationwide conversation about the meaning of dying in today's world.

He wrote, "We must detach ourselves from the medical world ... and reach beyond the horizon of the here and now to the elsewhere that exists inside us.

"We cannot allow ourselves to fall victim to the imposed conditions of regimented men and women who would have us die under the unnatural conditions of a medical, economic and bureaucratic order in which love and humanity have no place."

His book is a classic, and I heartily recommend it for a deeper understanding about the existential moment when a person contemplates mortality. Frankly, I wish we as a society would spend more time understanding the dying process and how to make the best of our time as compared to reading about what comes after death.

Life after death is a critical component of theology because most religions have their own doctrines and rituals. Dying, however, is another story because it does not fit into typical categories of theological speculation.

Nuland spends a great deal of his book trying to explain why medicine is skewed toward fulfilling the mandate to save lives. We chase after longevity to the point that we sacrifice the last days of dignity and solace by having our loved ones hooked up to machines in sanitized hospitals, which cannot provide them with the quality of end-of-life solace. We do it regardless of the moral and spiritual needs of the patient.

Hospice movement has been a godsend in restoring patients' humanity. Many of us have witnessed the quality of compassion that hospice nurses exhibit with their patients.

The great physician Elizabeth Kubler-Ross wrote a seminal book called "On Death and Dying" in which she outlined five stages that ultimately lead from the initial period of shock and anger to the final stage of acceptance. Her groundbreaking research into this process revealed just how difficult it is for us to cope with death.

I once read a story in which the rabbi said to his disciples, "I lived my entire life so that I could learn how to die." What did he mean? I suspect he was trying to teach his students that dying is a part of living and how we die reflects much about how we wanted to live.

In another statement from Jewish sacred texts, a rabbi teaches, "Repent each day lest you know not when the day of your death will be."

Aging can convey wisdom. It is not about death; rather, it is about making life count even in the last month or days. It can take an entire lifetime to make those days sacred for our loved ones and for ourselves.

By the way, the physicians who prepared my congregant for her husband's imminent death turned out to be wrong. Months later I had lunch with her and her husband. The Lord works in mysterious ways.

Physicians still serve as the high priests in the medical world, but dying with dignity requires a larger team of loving family and friends, compassionate medical care and spiritual support.

Dying is still part of living.

Columnist Rabbi Brad L. Bloom is the rabbi at Congregation Beth Yam on Hilton Head Island. He can be reached at 843-689-2178. Read his blog at www.fusion613.blogspot.com and follow him at twitter.com/rabbibloom.


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