My friend and neighbor died last week. In his early eighties, wiry, opinionated, well-read, he never tolerated schooling. He built an excavating business with a perfected aesthetic for contouring soil and also built a few homes in town including mine. When he saw the architect’s lower pitched roof framed on the garage, he had it torn off because: “It just wasn’t right. It looks like a tiny bowler hat on a fat man.” His long-standing pastime was correcting the town council, to their consternation because he was almost always right.
He had died once before, 28 years ago when a doctor from New Jersey rescued him from an arrest on the beach in Florida. This time he was in his garden on a warm, sunny, early autumn day. He didn’t die right away because his tools were laid down neatly and he had written something in the dirt. In the left lateral position, he would have been able to see the soil and the sky. I can’t imagine a better death for him.
We take great care to ensure that babies enter this life in a good way with birthing centers and home delivery. There is soft lighting and music, father present, trained staff, a warm blanket and mother’s milk. On the other end of life, there is too often a miserable wasteland of painful, denigrating therapies offered up as hopeful attempts to stave off the inevitable.
Fortunately, this doesn’t have to happen. Hospice and palliative care are bringing dying back to life. Studies have shown that patients receiving these services are not only more comfortable, calmer and more in control; but they also live longer than those who choose some forms of heroic medical technology.
The nominal normal human life span in every era has been about 1,000 months. If you read history and pay attention to life spans, this is about the best average with or without modern medical care. Even now, it is rare to meet someone over 90 with a good quality of life. We can probably increase that estimate by a factor of 1.5 by living a simple, unpolluted lifestyle with life-long moderate caloric restriction (getting beyond ingestion as gratification) and a psyche detached from anxiety over the fruits of our actions.
Every minute of life is sacred. Our spirit sheds its physical sheath when it is no longer useful. Never worry about death. Give for life. We are not guaranteed as good a death as my friend, but we will know how to try when the time comes.
Please join many of your colleagues and me in supporting hospice referral before it’s too late.
Thomas Birch is an infectious disease physician.
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