What Matters at End of Life: Physicians Perspective

Americans are increasingly coming to terms with their mortality. This insight is reflected in the growing popularity of personal narratives, best-selling books, and social entrepreneurs' projects about death and dying. Doctors can be valuable guides in this process. However, they often die differently than most people, often avoiding the same late-stage treatments they prescribe for patients. The experiences of dying doctors can teach us about living fully for whatever time we each have left.

Ira Byock, M.D. posted an article in the New York Times titled “At the End of Life, What Would Doctors Do?" In it, she provides a few examples of physicians' revelations at end of life.

• Dr. Jane Poulson, who lost her sight to diabetes while still in medical school, said that she felt more alive than ever before after being diagnosed with cancer. She said that she had found her "Holy Grail" in surrounding herself with her loved ones and enjoying her time with them.
• Dr. Bill Bartholome, who was diagnosed with esophageal cancer, said that he felt like he was finally free from the "tyranny" of all the things that needed to get done. He said that he had come to appreciate the importance of relationships and had learned more about what it means to receive and give love unconditionally.
• Dr. Paul Kalanithi, a neurosurgeon who was diagnosed with lung cancer, and his wife, Lucy Kalanithi, decided to have a child even though he knew he was unlikely to see her grow up. He said that this decision was a way of defying death and living fully in the present moment.

As a physician, I have often thought about how my end-of-life experience will be. Like the physicians above, I come to grips with the reality that it will happen. To be present, and appreciate the relationships around me, is important. The experiences of these doctors and my own thoughts, show that it is possible to find meaning and joy in the face of death. They also suggest that the medicalization of dying can be a way of avoiding the reality of death. By talking about death and dying more openly, we can learn to live more fully and appreciate the time we have. I encourage you to contact your health provider and start your end-of-life care plan and get it documented. You can always make changes as your opinion changes about death and how you want your end-of-life experience to be.

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