Dying Well

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DYING WELL

Ira Byock

Riverhead Books

March 1, 1998

320 Pages


This book came on my radar years ago—I mean, seriously, like a decade ago, at least. I heard really good things about it, but I was too scared to read it, because, well, death. It wasn’t until a family member was diagnosed with lung cancer recently that I finally decided that enough was enough, death was here to stay, so I may as well get comfortable with it. I never did get quite “comfortable” with it, but reading this book definitely helped me feel calmer about dying.

Ira Byock is a prominent palliative care physician. He’s made it his mission to ensure that his patients 1) do not die in pain, and 2) do not die alone. And he’s written many books educating others on how to accomplish those goals. Dying Well isn’t a how-to guide. Byock gives general advice and guidance, but mostly the book just shares stories of patients and families he’s worked with. Each story is unique. The families he works with obviously have different personalities, and everyone experiences different levels of acceptance (or not) with their situations.

My two main takeaways from this book are that 1) death doesn’t have to be scary, and 2) emotional intelligence and connection (or lack thereof) matter BIG TIME in how a death unfolds.

First, there is always something you can do for a person who is physically suffering—and I’m not talking about a “just dope ’em up!” attitude, though there are lots of medications to ease pain and discomfort. According to Byock, there should never be a point when a physician or nurse says, “Welp, I can’t do anything else for you. My work here is done.” The patient doesn’t need to suffer, and there are all kinds of options available to help make that happen.

Second, mindset matters. This book kept making me think of giving birth. I birthed all three of my kids naturally, no pain medication at all. Giving birth is a natural part of life. It also sucks. It’s painful, like really, really painful. But your mental attitude goes a long way. If you focus on the pain, it genuinely hurts more. But if you focus on the end of a contraction, the absence of pain between contractions, it hurts less. Maybe that sounds like I’m being Pollyanna-ish about the pain, but I’m not. I did this THREE times! I don’t take it lightly. It hurt like a bitch, and it was hard work. But when I put my focus on what was helpful to me, I could manage it.

This also seems to apply to death. Death is a natural part of life, and it also kinda sucks. It’s an ending, for better or worse. And I’m guessing it’s probably not going to feel great. But how do you want to go out? Angry and lashing out at your loved ones? Or will you take the time to repair broken bonds and forge stronger connections to people in your life?

I think of that scene at the start of Iron Man, where Tony Stark is talking to his new friend, Yinsen, about escaping the prison cell they’re in:

Tony Stark: I shouldn’t do anything. They could kill you, they’re gonna kill me, either way, and even if they don’t, I’ll probably be dead in a week.

Yinsen: Then this is a very important week for you, isn’t it?

Dying is not fun. We don’t want to do it. But we don’t get to choose to not die. What we can choose, though, is our response. We can choose what we focus on, who we focus on, with the time we have left. We can make the choice to connect, to reach out, to look inward and come to terms with who we are and who we’ve been. Basically, if there’s no peace in life, there will be no peace in death.

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