Learning that one will die soon can be the most devastating news to hear. Depending on the psychology of the listener, many reactions can follow, ranging from total rage and panic to a type of serenity and pressure to finish one’s business in this life.
Reading Tuesdays With Morrie by Mitch Albom3 or Intoxicated By My Illness by Anatole Broyard4 can be helpful in making the experience as positive as possible and in negotiating the undeniable loss at hand. Perhaps the strangest experience is feeling well physically and sound mentally but living with the knowledge that a metastatic cancer will soon become lethal.
I believe it becomes paramount to focus on the individual’s immediate needs in the context of his or her own psychology. There is no prewritten algorithm to follow in managing death successfully.
Each dying per-son must discover her own. I will tell a patient that I cannot help her with her death, but I can help her with her life; what does she want to do with the time remaining? What business would she like to finish and to whom does she wish to say goodbye? Realizing the finality can precipitate major fears of losing control and not knowing the next step; consultation with a psychiatrist at this moment can be invaluable.
Time takes on new meanings as it becomes finite, per-haps for the first time. As death draws near and physical symptoms emerge, involving a hospice care specialist can address major questions of physical dis-comfort and the specifics of how a person would like to die, thus reducing the immediate anxieties of pain and end-of-life procedures.