I recently lost a great friend. He was one of the premier leaders in pulmonary medicine. He died of kidney cancer at the age of 56. Naturally I feel a great loss and a substantial amount of grief. We had worked together closely in program planning, research and writing for approximately 25 years. Right now I am reflecting on this loss and how I tried to be of assistance to my friend and his family and how I can cope with my own emotions. Perhaps these thoughts will be useful to others.
I heard that his original cancer had spread (metastasis) and, in his own words, things don't look too good. I called him at fairly regular intervals. Since he was busy I couldn't always make contact. I then began sending cards, notes and handwritten letters whenever I was thinking about him. It is good, I think, to express concerns and to offer hope and prayers, but also to be yourself in your communications. If humor seems appropriate, keep this up. Just because one is dying doesn't mean that they have to lose their sense of humor. Reflect about the dying process yourself and consider it a normal part of living. After all, death is a natural process to be postponed as long as possible, of course, as I have written in these pages before. See "When the Party is Over" (February 1988) and "Try Not to Die of Anything Serious" (October 1988).
When possible I would meet with my friend and his wife for lunch. We always had a very meaningful time discussing the future and exploring philosophies about life and death and what lies beyond. These profound discussions are good for all including the person who is dying, the family, and one's self as we continue along life's process to its final transition. A cheerful, realistic view of this evolution is appropriate. Denial and false hope, though superficially attractive, usually fail under the onslaught of reality.
The most important thing is to increase, not decrease, your communications with loved ones. The dying fear abandonment. Most dying people are not concerned about the fact of death. But they are concerned about how they will die. Making sure that pain relief is achieved through skillful use of narcotic and other agents, keeping the dying at home and not in the hospital, and avoiding desperate heroic gestures in the final days of life are extremely important. These principles should be understood and practiced by all health care providers but, sometimes, the technological imperative overrules reason. We must adhere to the principle of reason, love and caring at all times. That is the way to deal with family and friends who are dying. That is the way to deal with our own impending mortality, a thought which we prefer not to contemplate many times. As we help our friends and family die, so do we prepare ourselves.
Thomas Petty, MD