Christopher Hitchens and the universal experience of dying

Christopher Hitchens, noted author and philosopher died December 15, 2011 leaving behind many essays, books, and other writings as well as contributing to several lectures, ethics/religion debates, and TV talk shows.  His acerbic style often ruffled feathers as he attacked religious dogmatism.

As one of the most famous outspoken atheists of this era, his thoughts on being diagnosed with an incurable disease would be a powerful insight into how atheists might approach illness and death.  Where others might retreat from the public spotlight, Hitchens attacked his cancer through writing.

As a doctor caring for patients facing their own mortality, understanding their spirituality becomes an important part of caring for the whole person.  I have seen many caring family members and friends inquire to me if their was enough time to get the appropriate clergy to help a patient convert or be saved.  A person dying as an agnostic/atheist or even not the right religion becomes a very important focus for some people.  Some have asked me or chaplains if we have ever seen any ‘deathbed conversions’ or someone who died without being saved.  I never really expected this before I became a palliative medicine fellow.

What surprises me about the inside peek that Hitchens gives us with his writings is that many of his feelings, thoughts and experiences are really about the human condition and I have seen and heard similar things from religious patients as well.  In reading his articles it helps me understand that despite all our differences we are all human and as we die our experience is both unique and universal.

I wanted to share a few choice quotes from his articles here.  Any one of them would be a good review for your team or learners on discussing the different approaches to dying that our patients experience.

The quotes come from the following Vanity Fair articles:

Unanswerable Prayers - Oct 2010
Miss Manners and the Big C – Dec 2010
Unspoken Truths – June 2011
Trial of the Will – January 2012 (published posthumously)

On stories about any possible deathbed conversions:

In which case, why not cancer of the brain? As a terrified, half-aware imbecile, I might even scream for a priest at the close of business, though I hereby state while I am still lucid that the entity thus humiliating itself would not in fact be “me.” (Bear this in mind, in case of any later rumors or fabrications.)


On holding hope and realism:

The absorbing fact about being mortally sick is that you spend a good deal of time preparing yourself to die with some modicum of stoicism (and provision for loved ones), while being simultaneously and highly interested in the business of survival.

On losing his voice:

Now, if I want to enter a conversation, I have to attract attention in some other way, and live with the awful fact that people are then listening “sympathetically.” At least they don’t have to pay attention for long: I can’t keep it up and anyway can’t stand to.

On sharing stories about other people’s cancer:

…your narrative may fail to grip if you haven’t taken any care to find out how well or badly your audience member is faring (or feeling).

On a false cliche (What doesn’t kill you makes you stronger.):

After all, if it were otherwise, then each attack, each stroke, each vile hiccup, each slime assault, would collectively build one up and strengthen resistance. And this is plainly absurd. So we are left with something quite unusual in the annals of unsentimental approaches to extinction: not the wish to die with dignity but the desire to have died.

On pain:

It’s probably a merciful thing that pain is impossible to describe from memory. It’s also impossible to warn against. If my proton doctors had tried to tell me up front, they might perhaps have spoken of “grave discomfort” or perhaps of a burning sensation. I only know that nothing at all could have readied or steadied me for this thing that seemed to scorn painkillers and to attack me in my core.

Christian Sinclair is a palliative care physician who blogs at Pallimed.

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  • elliocentric

    “inquire to [1] me if their [2] was enough time”

    *inquire of me/ask me

    *there

  • http://www.linkedin.com/in/annelizhannan Anneliz Hannan

    Impressive clarity of emotion while the body in such utter chaos. A must read for palliative and hospice caretakers.
     

  • amadeaus

    I am English but have lived in Paris for 23 years. Quite a few years ago I needed a triple byepass. Shortly after thaat chronic esto-arthris set in. I have now endured 15 surgeries for this. Mainly joint replacements (prothesis). I have two new knees, a new left foot, new toe on the other, new tibia, new left shoulder (3 operations), new right hand four operations. During the surgery on the left knee the surgeon noticed a huge lump at the back of the knee. This was removed and was just full of blood, nothing else, not malignant.
    In order that I cope with the pain  I am on 120 mgs morphine three times perday (skennan), actiskennan
    40mg every four hours, topalgic six per day, zoloft for sleep 3, antiinflamatory dugs, medicine to prevent vomiting (that’s all I get from morphine). Do you consider this excessive ? I make the point that my pain level is really awful, I can only just cope. The surgeon wants to give me a new right shoulder next. Tomorow
    (Tuesday) I have an operation on my eyes. During the last surgery I picked up septocemia in the hospital
    (15 days in intensive care)  This has now spread to my eyes & must be removed. The surgeon will get in by an incision on the eyelashes What did I do to deserve this ? I was an ochestra/opera/movie soundtrack conductor. I travelled the world with my wonderful partner. Now I have lost 80% of my site but the doc says he can restore this. IF I return to the glamoures world of conducting I doubt the arthritis would allow me this pleasure. I am only in my exact mid 60s. Is, in your opinion, the morphine dose too much ? The sugeon said with such a high level of arthritis I may have to be on it for the rest of my life. ANY comments would be helpful. Aplogies for the typos I can’t see the screen & just rely on hitting the right lettes on my keyboard.
    My other half reads the net to Me  .”Amadeaus”. Gary Brain conductor Paris Fance.

  • http://twitter.com/JasonBoies Jason Boies

    Regardless of the topic, and regardless of where you stand politically, Hitchens was always worth reading.

    Some terrific quotes here from one of our finest writers. Truly, an atheist in a foxhole right up to the end.

    Nice post, Dr. Sinclair.

    Jason Boies
    Radian6 Community Team