Where do you want to die?
Oops, did I just ruin any chance of us having a nice chat?
In our youth-obsessed, media-mad, win-the-lottery culture, this is not a popular question. In a conversation that matters with the people who matter in your life, it’s tough to ask. And maybe, it’s tougher to answer.
There are many questions that are easily answered or eagerly avoided:
- Do you have a crush on that girl/boy?
- What’s your major?
- Did you serve in the military?
- What’s your favorite team?
- When are you two getting married?
- What do you do for a living?
- What will you name your child?
- What’s for dinner?
- Should we buy a house or keep renting?
Questions are age-related or relationship-based or inspired by situations. We all ask them, since they help us get to know another person. When we venture to ask, we may also be wondering about our own responses. Another person’s response often helps us better understand our own thoughts. All of our innocent to intimidating questions help keep an encounter lively and ongoing and . . .
However, the Where do you want to die? question is probably a conversation killer. Who wants to make the time for that question? It’s morbid. Personal. Upsetting. And, since we don’t like to think about dying and death, we haven’t thought about it. So, ask me next year. Or . . . never.
Is it easier to answer the question’s “negative” version?
Where don’t you want to die?
Please, I don’t want to die a hospital. Even more, not in a sterile room in intensive care, with machines humming and tubes snaking in and out of my body.
Please, not in a nursing home. Not in a place where I’d have to share a room with strangers or no one ever visits. Not in a place where I have to conform to their schedule and can never do anything on my own. Where the smells are bad even on the good days and the lights are never switched off and the noise doesn’t stop.
I just want to be at home.
What about you?
But before exploring what that answer means, are there other places where you don’t want to die? And, if so, why? Here, I’m tempted to list a few more don’t-want-to-be-there examples, but it’s more important that you ponder your singularly unique response.
How many would say they want to die at home? I’ll guess . . . almost everyone. My parents did. For years, Mom and Dad would express some variation of, “Just keep me home and take me out of here feet first when I die.” It was a joke, and it was serious, and usually the conversation would veer onto safer subjects. However, both of them died away from home. Sometimes, there aren’t choices.
In some of my past work at hospice, I’ve been responsible for explaining Medicare benefits to potential patients. Many of those visits occurred in hospital rooms. With a wife or husband nearby—and often with children, parents, and grandchildren crowding the room—I’d provide the basics about what hospice could or could not do. Some patients, hugging their hospital gowns close to their chests, asked lots of questions. Others, drowsy in bed, seemed to barely listen. But I don’t recall anyone saying they hoped they’d stay in the hospital longer . . . instead, it was always:
I just want to go home.
I think there’s another question that could be asked before the “where” question. (I’m not the first to ask it*.) But this question is one that should be more important than the “what is your major” or “is it time to buy a house” or all the other safer questions in the various stages of our lives. Here ‘tis:
How do you want to live?
Which is to say . . .
- What are your values?
- Who are the most important people to you?
- What do you truly like to do with your time?
Don’t fantasize with the question (and its companion questions). Don’t imagine you’ll win the lottery and get rich. Don’t imagine you’ll be the next Bill Gates or Jeff Bezos, with whiz-bang ideas and eventually a pile of ever-growing cash. Wealthy or poor, young or old, all can equally, honestly ponder: how do I want to live?
Your answer will likely be different in your twenties versus your seventies. The mileage of life and the accumulation of birthdays change us! But whatever your answer is, I hope it is your answer.
If the hard question (where do you want to die) with the easy answer (home) is posed with the how do you want to live question, I believe your unique answers will help you make better decisions for every part of your life, from birth to death.
*Two recent books I’ve read openly struggle with these questions. I wish I could make them required reading for everyone. Dr. Jessica Zitter’s Extreme Measures (2017) takes you into the anguished decision-making for physicians and families when a patient—a loved one—faces end-of-life issues in a hospital setting. Surgeon Atul Gawande’s Being Mortal (2014) is the other “good read.” Read it, and I think you’ll ask better questions of yourself, your loved ones, and your doctors. In one of the many powerful recollections in the book, Gawande asked a terminally patient if he wanted a high-risk surgery (with more time in the ICU and uncertain recovery). The patient’s answer: I’d like to be home, watching football, eating chocolate ice cream . . .
How do you want to live?
(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.)by