A friend of mine lost his mother to cancer this summer. She seems to have accepted the diagnosis immediately and her last days were spent at a hospice where the staff knew their job and pain relief was generous and effective. There was some minor fuss as she tried to arrange for her business – of no interest to her offspring – to survive her. But there was no raging at the dying of the light, no attempt to make her children feel worse than they already did, no manipulative use of the will. Hers was a remarkably good death. In that, I now realise, it was pretty unusual.
Over the past year and a half, I have followed from afar the deaths of three people who knew they were on their way out. The experience has brought home how shockingly bad at dying we are. It’s a disastrous lacuna, because how you go about dying is arguably far more important than how you lived. A bad death can destroy much of the good work done in an exemplary life. A good death can make up for a multitude of sins. But when it comes to working out how to engineer the one and avoid the other, each individual is on his or her own.
How many articles have you read, how many programmes watched, suggesting ways to improve your sex life, get on better with your husband, relate to your teenage children? From moving house to winning promotion, there is no aspect of human existence about which we are not constantly being offered sensitive, thoughtful advice. With one exception. I know of no “How to die well” articles, no “dos and don’ts” list for one’s approaching demise, no “Expiring Anonymous” (“My name is John and I’m dying”) support groups. You would think we were all immortal.
It is strange that we are so very bad at it, when medicine increasingly requires us to demonstrate this skill. Not so very long ago, none of the three people who feature in this article would have known, with such adamantine certainty or in quite such detail, how and when they would die. As science advances, we are all being given far too much information.
And, boy, do we screw it up. Having rarely bothered to think through what is, after all, life’s greatest challenge, we really can make a pig’s ear of it.
Another friend of mine had always cherished the affectionate relationship he enjoyed with his feisty mother, who raised five children pretty much single-handed. As a woman whose shelves were crammed with New Age books on reincarnation, she might have been expected to accept her approaching death with resignation. Instead, panicked and frantic, she refused to accept the truth, spent tens of thousands of pounds on ineffective alternative treatment and dragooned family members into being amateur nurses. Sibling was turned against sibling as she berated each for not caring enough, speculating aloud about rewriting her will. By the time she died, a once-united family had been torn apart. In six months, a woman who should have been remembered as a loving matriarch had jeopardised her life’s greatest achievement, leaving enough bitterness behind to keep therapists busy for decades. “There are worse things than dying,” my friend now says. “There’s the damage you can do in the way you handle your death.”
My third friend, diagnosed with the same type of cancer, accepted that he was a goner from the start. He was a bloody-minded individual and he chose a characteristically bloody-minded route out. Rigidly maintaining his office routine, he kept employers, friends, ex-wife and adored child in the dark until the very end. I am awestruck at his strength, but I’d be lying if I didn’t admit I also feel horribly rebuffed. I had shared his joy at fatherhood, his fury at career reversals, the pain of his divorce. I’d believed us as close as friends could be. By excluding me, he made a mockery of my mourning. Each time I find myself missing him, a little voice pipes up: “Yes, but he didn’t trust you enough to tell you.”
I’m sure that’s not what he would have wished. I’m sure my friend’s mother, if only she had been able to master her terror and pain, would have preferred to leave a harmonious family behind. Making it up as they went along, both were overwhelmed by the most mundane and banal of experiences. Trouble is, if you screw up in daily life, you can always fix it afterwards. When you bungle your last days, it’s for all eternity, because last impressions are the ones people retain.
I don’t know how to combat a social taboo that leaves us surprised and ill-prepared for this most predictable of events. But we would do well to remember that, whatever our religious beliefs, there is one afterlife we can be really sure of, and it consists of the memories of those left behind. For the dying and those who survive them, love is a two-way street. With so much at stake, our strategies for dying should not be left to chance.