Death is (Not) the Enemy

Hospice always fails you. With few exceptions, our patients . . . die.

Death is a defeat, often perceived as a human failure.

Death is to be battled, and everyone schemes to beat it.

Death is a problem to be solved. On the moon-bound and suddenly crippled Apollo 13, Commander James Lovell famously said, “Houston, we’ve had a problem.” The prospect of death, between earth and the moon, between our first wail as a newborn and before whatever last breath is taken, should be confronted and conquered.

Avoid death!

Anyone working in hospice has joined the grim reaper gang. We mingle with the life insurance sellers and funeral directors, the coroners and the grave diggers. We are purveyors and surveyors of the forbidden topic. While the rest of society runs from the dying, we stay.

A hospice nurse, training similar to her counterparts in the hospital corridors and emergency rooms, begins the day with a list of patients to visit. While her colleagues are calming a mother about to give birth or prepping for surgery, and will give their all to bring and extend life, the hospice RN has other thoughts . . .

  • Will my patient die today?
  • How can I help her or him die peacefully?
  • How can I honestly answer the family’s request to know when death will come?

In hospice, whether it’s a social worker serving a patient’s needs or an administrator grumbling about a budget, death casts a shadow. We don’t do our professional best and send folks home to live many longer and better and healthier tomorrows. Instead, we try to create a quality of life today for our dying patients.

But even our successes can feel like failures since death . . . wins?

Writer Anne Lamott humorously and bluntly noted, “A hundred years from now? All new people.”

True? True.

We may skirt the subject of death, but death never avoids ruining all conversations. It’s the period at the end of everyone’s short, long, boring, exciting, famous, infamous, sinful, righteous, life sentence.

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I’m afraid of death.

What about you?

How can I fear death?! Though I work for hospice—a place, yes, a business, which serves people of every faith and no faith—I am a Christian. I have faith. It’s not a great faith. I’m flawed, hypocritical, and can be wishy-washy in my beliefs. A dose of Buddhism, and its absence of any afterlife, has rubbed off on me. Jewish and Muslim friends have convinced me that Christianity doesn’t have all the answers. I’ve had difficult (for me) conversations with atheists who can succinctly state that heaven, or a “better place,” with streets paved in gold and happy folks strumming harps at every corner, is hogwash. Worse yet, some atheists do a darn fine job of being generous, kind, and neighborly compared to, say, some Christians.

My core beliefs in my chosen faith—or the faith that chose me—are about loving the neighbor today. Of being open to God and glory and forgiveness and hope . . . today. Heaven help me, but I don’t know for 100% sure that there is a heaven.

All I “know” is God’s call for me trust God’s forever love.

Maybe I dread death because of having habits and attitudes that still seem so childish. How can a “good death” be contemplated if I continue to (yeah, okay, sometimes) chew my nails? Why didn’t I overcome that “problem” decades ago? Clearly, I’m not mature enough for death!

There’s this too: I fear death because I hate it. I hate that in this meager life, I’ve experienced the death of people who died too young. Not fair! I’ve experienced the death of friends and colleagues that I’ll never see again on this green, glorious earth. Death stopped the sharing of one more glass of wine or funny story or bear hug. Not fair! Death prevented taking another walk with Mom and listening to one of Dad’s convoluted stories. Death means all you will have left are memories. And while I treasure memories, all things considered, I’ll take flesh and blood over reminiscing.

Death never loses. I so resent that.

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I’m reading Jessica Nutik Zitter’s “Extreme Measures.” She’s a doctor with a background in emergency medicine* and palliative care. That odd combination means she has confronted dying every professional day while balancing on the medical high wire between cure and care.

But she was trained, an enlightened physician with high-tech tools, to demonize death. It’s the enemy. What if it’s not? In a 2014 article before the book’s publication, Zitter wrote,

“[W]e’ve done some amazing things with medicine, but I think that with that, we’ve oversold the capabilities of what we can actually do in terms of chasing or beating death. And we have to be careful, because everybody is going to die. It’s inevitable. So, despite our abilities with medicine—and we’ve done some incredible things—we also have to acknowledge the fact that people are going to die, and accept it, and treat it with the same kind of aggressive care that we treat other kinds of organ failure.  What I advocate for is patient-centered care. Whatever a well-informed person would choose for themselves, I completely support. There are people who want their bodies kept alive, no matter what the situation might be. If that’s what they want, I’m happy to use my tools to support that. But what’s interesting to me is that most people with serious illness, nearing the end of their life, don’t seem to want that.”

I’m not through with “Extreme Measures,” but already sense Dr. Zitter’s urgency to view death as part of life. In our 21st century health care “industry,” her longing remains a minority opinion . . . for physicians and patients.

Knowing there will be a last breath, I need others in my life who will honestly and non-judgmentally talk about death. My death. Your death. Realize that sometimes I’m afraid. Realize that we’ve been raised in a modern culture that views death primarily as an enemy (and a subject to avoid). Realize that your faith is not my faith. Realize that what you want may not be what I want.

But realize this common ground: time is limited and precious and deserves our full attention when we are living and when we are dying.

Please talk. Please listen. Death is defeat when there are only secrets and silence.


*Dr. Zitter is featured in the award-winning 24-minute film Extremis. I’ve streamed it on Netflix. A powerful glimpse into emergency room decisions, the documentary follows Zitter as she works with patients, families, and medical staff. Difficult to watch; worth the effort.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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