Can A Person Thrive in the Face of Terminal Illness?

This may seem like a difficult question to pose, since much of the conventional wisdom in our death-fearing and death-denying culture encourages the terminally ill and their loved ones to put on “a game face” and “fight” until the bitter end.  Fight what exactly?  The inevitable?  What is the point in that – each one of who is living will die someday.  So how did we develop this idea that somehow “our disease” is not really our own but rather something that has come upon us to relieve us of what is rightfully ours, some perceived entitlement to a life that we have envisioned as how it is supposed to play out?  Many survivors of terminal illness mark the disease as a transformation in their lives, while others simply view it in the broader context of life.  Each of us has our own way of living just as we have our own way of dying.  It is no surprise that modern medicine’s advances have fortunately separated us from the specter of early death due to chronic diseases and conditions that can now be successfully managed to extend life.  These advances have often come at a cost of separating us from death, treating death as failure of medical treatment, not as the inevitable conclusion of a life well-lived.  In case you’re wondering, I’m talking about adults and elders, not kids or younger adults . . .

So back to the title of this post – I admit it is not original but comes from this recent post by Rick Reynolds.  This is a great post, his answer is a resounding yes .  He recounts the story of a young woman who committed herself to “thrive” in the face of her struggle with terminal illness.  She embraced her fear, her grief, and sent it on its way so she could get on with the real work of her life – thriving.  Reynolds, a hypnotherapist, noted that this woman  lived more life in the three years after her terminal illness diagnosis than all of his other clients combined.

In her groundbreaking work “On Death and Dying,” first published in 1969, Dr. Elisabeth Kübler-Ross identified the dying as teachers and went on to identify five stages of grief:

1. denial and isolation
2. anger
3. bargaining
4. depression
5. acceptance

How can we work through the difficult words, feelings, and conversations;  what can we  say as the end of life nears?   Life is fragile and uncertain!  Acknowledge fear and embrace it.  Fear can diminish in size when it is appropriately regarded instead of viewed from a far off vantage point.   Acknowledging, naming and embracing the fear can dissipate anxiety.  We can pretend the certainty exists in our lives, or we can actively negotiate the uncertainty.  How do we acknowledge fear and embrace hope in the face of our own mortality? Practice!  Here I’m thinking of Dr. Jerome Groopman’s book “The Anatomy of Hope” (2004: Random House), and in particular chapter eight “Deconstructing Hope,” in which he writes about his meeting and interview with psychologist and professor Richard Davidson. )  Davidson is also associated with the Mind & Life Institute  an organization dedicated to promoting cross-cultural dialogue concerning the advancement of scientific and spiritual understanding of how our minds work.)  Groopman writes about Davidson’s definition of hope as a feeling that has both cognitive and affective parts, which work together to provide affective forecasting and is something that most healthy brains can relearn.  The Anatomy of Hope at 192-95.  Indeed, there is hope for hope. . .

More about fearlessness – in the face of uncertain future and, BTW, isn’t all future uncertain, by its very nature? I liked this post about what can be lost as a result of tragedy – this another lesson from 9/11.  Watch the video of 9/11 survivor Roy Cohen here.

What survives death? Death is a mystery, but most likely not the biggest mystery.  The biggest mystery is love.  This is the basis of human immortality, because love is the only thing that survives death.  I want to mention Warren Zevon’s song “Keep Me in Your Heart,” the song he wrote after his mesothelioma diagnosis.  It beautifully combines love and fearlessness.  You can listen to it here.    And speaking of heart . . .  it was the author of one of my favorite books – The Little Prince (I have it in different languages), Antoine de Saint-Exupery who noted:

 It is only with the heart that one can see rightly.

We are not powerless in the face of uncertainty.  We can offer words and presence.  Presence is a form of compassion, and we can offer both to those struggling through or being with challenges from an illness.  What kind of words? Check out this article about how to offer comfort to those nearing the end of their lives.

Where is a person at the end, and how did they get there? This is another great article by Paula Span in The New Old Age series in the NY Times is “Where the Oldest Die Now,”   which cites to recent evidence that more elders are dying in their homes than in hospital ICUs.  I think we can call this progress, progress toward recognizing the humanity of death.