A marvellous book written by a Doctor that addresses many of the dilemmas and fears of the medical profession. As a nurse of 30 years plus, this book dealt with many of mine and my colleagues concerns about dealing with death.
What is a good death? Does it mean pain free, and if so, how is that to be achieved? Enough pain relief to take off the edge so you can talk to your loved ones, or attached to a syringe driver on Morphine, confused and unable to string together a coherent sentence, is that how you want people to remember you? Is a good death a quick one with no time to say goodbye? My in laws both literally dropped down dead following a MI( heart attack) and CVA ( stroke) whereas my parents both had protracted illnesses Communication is so important in order to respect the dying persons wishes about how they want to die, but as most people are nursed on busy general hospital wards, this is sadly not always possible.People must be asked for their input on how they wish their final days to go, do they want to die surrounded by family at home or go to respite care, as most people do not want to be a burden on their family members. DNAR orders must be discussed, there is nothing worse than performing resuscitation on poorly patients when the outcome is likely to be broken ribs and pain , not the best way to die. Religion and rites help the living most, but there is always so much rush when funerals have to be arranged, there is so much expectation involved, from the right flowers to the hymns or readings, grief doesn't surface until weeks later and guilt is always ready to cause rifts in the best families. Death must be openly acknowledged and people given time to say goodbye and expressions of love should be given freely, this is no time for a stiff British upper lip. Memories are to be shared and treasured, regrets shared and apologised for in order to feel at peace. Death comes as an old friend to some sufferers and a shock for other unfortunates, but the more Death is feared means that the way to a good death will remain elusive.
A very good read that deserves to be read by medical and lay persons alike. We are all so far removed from first hand experiences of the process of death and dying , that we are frightened of it. Because of this fear, we ignore what the dying are trying to say to us, we ignore the truth of their decline or we lie to them about the state of their health and prognosis, which cheapens our relationship with our loved ones. Preparing to see a loved one die is one of the hardest things we are asked to do, but to ignore and fail to tell the truth and comfort them is worse.
