What is the Death Positive Movement?

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[S]ome of us think of it often, others none at all. Sometimes we joke about it, other times fear it. No matter your approach or point of view, the fact remains: we will all inevitably die. It is literally the one thing we all have in common. And, on top of that, we will have to bear witness to the deaths of those around us. Yet, in spite of this irrefutable fact, Western culture doesn’t seem to be able to talk about the big “it.” Instead of allowing this commonality to bring us together, it often alienates us from each other. This is where the Death Positive movement comes in.

It is allude to in popular culture, through commercials, music, and other types of media. It is the subject of films and novels, and even television series. But even though we are in many ways surrounded by representations of death and grief, its presence and role in our own lives is something many feel afraid or uncomfortable speaking about. It is this internal and societal conundrum that many of us experience that is the focus of the “Death Positive” Movement.

The Death Positive (or Death Positivity) Movement is represented by the general (and growing) movement toward opening platforms for discussion about the inevitability of death and dying. The movement focuses on the importance of encouraging open discussions on the reality of both our own death, and the death of others. This includes the creation of platforms and spaces where such discussions can transpire in a comfortable, honest, open, and curious environment; where individuals may come together with different perspectives and exchange them with one another.

It also has a very practical goal of teaching us how to speak to others (i.e. our parents and partners) about their end-of-life wishes, as well as our own. The hope is that death will become de-mystified, and that as a result, society (and the individuals that comprise it) will be able to prepare for death and the grief that often follows. More importantly, discussing death and dying actually enables us to think about our own immediate lives. It encourages us to lead the life we want to live, and appreciate the little things.

You may be wondering where it is that these death positive discussions take place? How can you become involved? We’ll give you hint- it doesn’t happen in mortuaries or creepy church basements over skeletons and ouija boards. There are in fact a number of platforms- both online and in physical spaces- where death positive discussions take place on a regular basis.

One of the most widely and regularly practiced organized series of discussions on death and dying are known as Death Cafés, and occur all over the world. First established in 2004 by Swiss social anthropologist, Bernard Cretan, with the intention of breaking the taboo surrounding discussing death, they have since been held in cities all over the world. At a Death Café people will gather over coffee and treats to discuss death, dying, and experiences of grief.

Much of this discussion enables the participants to understand what is most important in their lives, allowing them to focus on these positive elements to live more fully and happily. They are often held in different locations throughout a given city, but always with the intention of creating comfortable spaces to discuss personal experiences and questions about death, dying, grief, and all that’s in between.

We highly recommend taking part in a Death Cafe in your area!

Complete Article HERE!

Writing a ‘Last Letter’ When You’re Healthy

Participants in the Stanford Letter Project working on letters to their family members.

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[O]ver the last 15 years, as a geriatrics and palliative care doctor, I have had candid conversations with countless patients near the end of their lives. The most common emotion they express is regret: regret that they never took the time to mend broken friendships and relationships; regret that they never told their friends and family how much they care; regret that they are going to be remembered by their children as hypercritical mothers or exacting, authoritarian fathers.

And that’s why I came up with a project to encourage people to write a last letter to their loved ones. It can be done when someone is ill, but it’s really worth doing when one is still healthy, before it’s too late.

It’s a lesson I learned years ago from a memorable dying patient. He was a Marine combat veteran who had lived on a staple diet of Semper Fi and studied silence all his life. A proud and stoic man, he was admitted to the hospital for intractable pain from widely spread cancer. Every day, his wife visited him and spent many hours at his bedside watching him watch television. She explained to me that he had never been much of a talker in their 50-plus years of marriage.

But he was far more forthcoming with me, especially when it became clear that his days were numbered. He spoke of his deep regret for not having spent enough time with his wife, whom he loved very much, and of his great pride in his son, who had joined the Marines in his father’s footsteps.

One afternoon, when I mentioned these comments to his wife and son, they looked incredulously at each other and then disbelievingly at me. They thanked me for being kind but stated that my patient was incapable of expressing such sentiments.

I wanted to prove my credibility and to make sure that his wife could actually hear her husband professing his love. I knew he was unlikely to speak to them directly. So I took my huge family camcorder with me the next morning on medical rounds and – with the patient’s consent — recorded an open letter from him to his family. When I gave them the taped letter as a keepsake, both his wife and son were moved to tears.

The experience inspired an idea that has grown into the Stanford Friends and Family Letter Project. With guidance from seriously ill patients and families from various racial and ethnic groups, we developed a free template for a letter that can help people complete seven life review tasks: acknowledging important people in our lives; remembering treasured moments; apologizing to those we may have hurt; forgiving those who have hurt us; and saying “thank you,” “I love you” and “goodbye.”

A letter by a project participant named Harvey Brown, written with the help of his wife, Wanda Brown.

While these may seem intuitive, many people don’t complete these steps before they die, leaving their family members with unanswered questions and regret.

(A video showing people participating in the project can be seen here.)

The letter template, which is available in eight languages, allows writers to express gratitude, forgiveness and regret. In one letter, a participant wrote to his wife, Lily, “I wish I had loved you more.”

Many writers use the templates to express pride in their children in ways they might not do in person. One wrote to a son, Michael: “You are so courageous to change your major and do what it takes to be successful to reach your dreams.” Another wrote, “Life for us was never easy but you overcame obstacles.”

And some apologize. A man named Tyrone Scott wrote to his daughter, “I’m sorry that I wasn’t there when you were growing up. If I could relive my past, I would not have let your mother take you away from me.”

The letters can be a chance to let go of grudges. Shirley Jones wrote, “To Harold: You have forgotten to repay some of the personal loans you obtained from us. We are wiping your account cleared.”

So we invite you to use the “Dear Friends and Family” template and write your letter now while you still can.

Those with chronic or serious illness may use the illness letter template; there is also a healthy letter template for those in good health. In working with people from diverse cultural backgrounds, I found that some were reluctant to complete the “goodbye” task for fear that it might become a become a self-fulfilling prophecy. I recommend that people write only the parts they feel comfortable with.

Once the letter is written, you can choose to share it with your loved ones right away. You can also store it in a safe place or with a trusted person to be given to your family in the future. Some people prefer to use the letter as a living legacy document and update it over time.

It may take tremendous courage to write a life review letter. For some people, it evokes deep and troubling emotions. Yet it may be the most important letter you will ever write.

Complete Article HERE!

Veteran? Terminally Ill? Want Death With Dignity? That Could Get You Evicted.

By JoNel Aleccia

[C]alifornia voters passed a law two years ago that allows terminally ill people to take lethal drugs to end their lives, but controversy is growing over a newer rule that effectively bans that option in the state’s eight veterans’ homes.

Proponents of medical aid-in-dying and residents of the Veterans Home of California-Yountville — the largest in the nation — are protesting a regulation passed last year by the California Department of Veterans Affairs, or CalVet, that requires that anyone living in the facilities must be discharged if they intend to use the law.

That’s a position shared by most — but not all — states where aid-in-dying is allowed. As more U.S. jurisdictions consider whether to legalize the practice, the status of terminally ill veterans living in state-run homes will loom large.

“It would be a terrible hardship, because I have no place to go,” said Bob Sloan, 73, who suffers from congestive heart failure and other serious cardiac problems. He said he intends to seek medical aid-in-dying if doctors certify he has six months or less to live.

“I’m not going to be a vegetable,” said Sloan, a Vietnam War-era veteran who moved into the Yountville center five years ago. “I’m not going to end up living in so much pain it’s unbearable.”

A CalVet official said the agency adopted the rule to avoid violating a federal statute that prohibits using U.S. government resources for physician-assisted death. Otherwise, the agency would jeopardize nearly $68 million in federal funds that helps run the facilities, said June Iljana, CalVet’s deputy secretary of communications.

California is not alone. Three other states where aid-in-dying is legal — Oregon, Colorado and Vermont — all prohibit use of lethal medications in state-run veterans’ homes.

In Montana, where aid-in-dying is allowed under a state Supreme Court ruling, officials didn’t respond to multiple requests about whether veterans would be able to use the law in the residences. However, Dr. Eric Kress, a Missoula physician who prescribes the lethal medication, says he has transferred patients to hospice, to relatives’ homes, even to extended-stay hotels to avoid conflict.

In Washington, D.C., where an aid-in-dying law took effect last summer, the Armed Forces Retirement Home won’t assist patients in any way. Those who wish to use the law would be referred to an ethics committee for individual consideration, spokesman Christopher Kelly said in an email.

Only Washington state has a policy that allows veterans to remain in government-run residences if they intend to ingest lethal medications.. At least one veteran has died in a state-run home using that law, said Heidi Audette, a spokeswoman for the state’s Department of Veterans Affairs.

Paul Sherbo, a spokesman for the U.S. Department of Veterans Affairs, said the choice is up to the states.

“VA does not mandate how states comply with federal law,” Sherbo said in an email. “There are a number of ways individual states can choose to handle such situations and still be in compliance.”

To date, none of the 2,400 residents of California’s veterans homes has formally requested medical aid-in-dying, said Iljana. That includes the more than 900 residents of the Yountville center, located about 60 miles north of San Francisco.

“We would respectfully and compassionately assist them in transferring to a hospice, family home or other location,” Iljana said in an email. “We will readmit them immediately if they change their minds.”

But Kathryn Tucker, executive director of the End of Life Liberty Project, an advocacy group that supports aid-in-dying, said that CalVet is interpreting the federal regulations too broadly and denying terminally ill veterans the right to choose a “peaceful death” through medical assistance.

“Nothing exists in the federal statute’s language that would prohibit a resident from receiving aid-in-dying services at state homes, so long as they are not provided using federal funds or employees,” she said.

Ed Warren, head of the Allied Council, a group representing veterans at the Yountville site, co-signed a letter to CalVet officials protesting the ruling.

“My point of view is that it is inhumane to expect people in the last stages of dying to go through the hullabaloo of leaving their homes,” he said.

In Washington state, a 60-year-old man diagnosed with terminal chronic obstructive pulmonary disease, or COPD, died in June 2015 after ingesting lethal drugs at the Washington Soldiers Home in Orting, where he lived.

“It was all done very much in the open,” said Chris Fruitrich, a volunteer with the group End of Life Washington, which assisted the man.

There has been no indication that the policy jeopardizes the nearly $47 million the agency receives each year in federal funds, said Audette, the state VA spokeswoman.

In California, additional protests have centered on allegations that CalVet suppressed information about the aid-in-dying law.

Critics at the Yountville home contend that CalVet passed the discharge rule quietly, with little public input. Then the agency refused to broadcast a public meeting about medical aid-in-dying on KVET, the center’s state-run, closed-circuit television station.

Iljana said the Aug. 21 meeting, led by Tucker and Dr. Robert Brody, also a supporter of aid-in-dying, violated state rules that prohibit using public resources to promote political causes.

“Free speech is great and criticizing the government is great, but not using the government’s own resources and paid staff to advocate for a change in the law,” Iljana wrote in an email to prohibit the broadcast.

That decision, however, prompted Jac Warren, 81, who has been KVET’s station manager for eight years, to resign last month in protest, citing censorship.

“What is at issue is whether a state may completely suppress the dissemination of concededly truthful information about entirely lawful activity,” Warren wrote in an email to CalVet.

The hour-long meeting, attended by about 50 people, was not propaganda, Tucker said, but “an educational event with information provided by an attorney and a physician who both specialize in their respective fields in end-of-life care.”

Bob Sloan, who works as an engineer at KVET for a $400 monthly stipend, disagreed with the decision not to broadcast the meeting on the system that serves residents of the Yountville home.

Sloan said he knows other residents who would like to be able to use California’s aid-in-dying law if their illnesses progress.

“The only other option that people have in this state is committing suicide,” he said. “If I can’t find some way of doing it legally, I’ll do it illegally.”

Complete Article HERE!

Grieving the death of a spouse/partner

[T]he death of a spouse or partner can be one of the most devastating events in a person’s life bringing with it it’s own particular difficulties. As a result of this death you may have lost your life’s partner, lover, confidante, father or mother of your children, breadwinner, home-maker and possibly your best friend. You may be forced to make more changes than from any other event you will ever experience.

Even if you maintained a great deal of personal independence within your relationship you can be surprised and frightened to discover just how ‘dependent’ you have been on your partner. Over the years you may have related closely to one another’s fears and joys so that when one dies you feel incomplete. Your life has lost its structure and its purpose. You may be left with many unfulfilled needs – emotional, physical, practical, intellectual and social. It is hard to imagine all the areas of life your spouse once filled until you experience the gaps.

Grieving, in itself, is emotionally and physically exhausting. When you have the additional burden of taking on the roles that were previously performed by your partner, going on living may appear to be just too much. New tasks should be embarked on slowly with as much help as is available. Major decisions should not be taken when vision is clouded by anxiety and panic.

Friends may avoid social contact with you because of embarrassment. You are now a single person. Some may see you as a threat to their relationships. You may feel isolated, no longer part of a group, not invited out, or you may exclude yourself as you feel uncomfortable without your partner. Many surviving partners experience the unwanted sexual advances from those whom they counted among their or their partner’s friends.

The feeling of loneliness can be overwhelming and will probably come to you at your most vulnerable times – at night, weekends and holidays. Plan for this – at night keep the radio on, change your routine. Plan a project or outing for a weekend or holiday. Make contact with another lonely person.

Financial difficulties may arise – especially if your spouse or partner died without making a will. You may not be aware of your financial state and even if matters are in order there is often a delay in getting things sorted out. If there is a reduction in income the effect on your standard of living may cause family problems especially when children’s expectations also have to be adjusted. This can add to feelings of fear, anxiety and anger. Your local Citizens Information Centre may be of help with practical matters.

Sexual loss. The loss of love making which included touch, warmth and sharing a bed with your partner can be very painful. It can be tempting to succumb to sexual advances from another. However, such action based on acute need and deep grief is potentially hazardous. Until you have let go of the past, it is better not to make a commitment to someone new.

If your partner dies in the early years of the marriage / relationship not only do you grieve the loss of a beloved person but also the loss of a new, exciting romantic relationship with the prospect of years of mutual love and companionship. You may also grieve the hope of parenting a child or more children together. You may feel that you are the only one of your generation who has been cheated out of hopes for the future. Young widows and widowers may also be expected to comfort the parents of the dead partner.

If the death occurs in your mid-life years you may have the additional stress of feeling trapped by the total responsibility for all the many needs of teenage children which can also prevent you from expressing your own grief. The agency ‘Parentline’ can be helpful in assisting with parenting problems. At this time you may also feel a loss of identity especially if you have no interests or work outside the home.

For the elderly bereaved – the loss of a life’s partner can cause increased trauma, create health problems and may affect your will to live. Sometimes, with the best of intentions, adult children may smother the surviving parent with care and attention. They do not allow you space to grieve or to make your own decisions. If your family are far away you can feel all alone and may even feel abandoned.

For those in same sex relationships there may be added difficulties. The relationship may have been ignored or denied by the family of one or both partners. This can create added stress for you in the grieving process. As the surviving partner, you may find yourself excluded from decision-making concerning the funeral and burial. You may even be precluded from attending.

Perhaps work colleagues and the wider community may just think that a ‘friend’ has died, but you have lost your life partner and companion and you have to keep your grief hidden. This intensifies all aspects of the grieving process, leading to strong feelings of loneliness, isolation, anger and, at times, frustration. If the death has been from Aids, this can lead to further social isolation. It is important that you can find someone to whom you can unburden your feelings.

Whatever your age when you are bereaved, your feeling and reactions will be influenced by the nature and duration of the relationship. If the relationship had been ambivalent, feelings of relief, regret and guilt can be confusing. It is important, when dealing with these feelings, to be totally honest with yourself. Put words on your feelings, voice them aloud or write them down. It is always helpful to talk about your feelings with someone who will listen in a caring and confidential way. This will help you to discover what you are feeling, why you are feeling like this and what you can do about it. Joining a support group for bereaved people may be helpful.

The Bereavement Counselling Service is there to listen and provide support as you struggle with your grief. In our modern world just surviving can be hard work. It is doubly hard to pull yourself out of an emotional trough but it is not impossible. Each time you cope with a crisis and make a major decision you will feel good about yourself. When you reach a goal you will gain satisfaction and self-assurance through your own competence. With time and effort you will recover to lead a full and rewarding life once again.

Complete Article HERE!

Doulas provide compassionate end-of-life care at North Hawaii Hospice

North Hawaii Hospice Volunteer Coordinator Bobbi Bryant developed an end-of-life doula program for volunteers earlier this year.

By Jan Wizinowich

[S]ince 1986, North Hawaii Hospice has been providing end-of-life care and support for their local community members. The in-home care by their trained staff and volunteers has eased the journey out of life and given support to family and friends left behind.

Recently, through the efforts of Bobbi Bryant, the hospice’s volunteer coordinator, training has been offered to volunteers to become end-of-life doulas, returning to old wisdom and benefits that can be derived from it.

“Caring for the sick and dying before the Civil War happened in the home. It was just a continuation of women raising children. They cared for the elders at the end of their life,” Bryant said.

But with the rise of medical technology, the end-of-life stage was taken out of the hands of the family, and the knowledge and wisdom was lost.

“People were being brought to the hospital to die, and then they were embalmed so we weren’t really caring for people at the end of life. We lost our skills,” Bryant said.

The resurgence of end-of-life doulas are a reflection of the return of birth doulas beginning in the 1970s.

“Midwives to the dying have been around for a long time. It started as a result of the resurgence of birth doulas and midwives. The model transferred to how we can care for people at the end. There was a lack of education around the dying process and when people wanted to start caring for their loved ones, there was a lot fear. The conversation around death had come to a standstill,” Bryant reflected.

Recognizing the need for doula training, Bryant attended a conference on death and dying on Maui last April.

“When I came back, I spent the next several months creating a curriculum and trained 14 people including nurses, an ER doc and health aids,” she said.

The decision to enter hospice care can be difficult, but once made it can free the family and caregiver to focus on the patient.

“If you come for hospice support early, you can have so much support. There’s so much pain and suffering that isn’t necessary,” Bryant shared.

The North Hawaii Hospice team includes a lead, general and vigil doula. Initially, the lead doula meets with the family and the patient to provide information about all the ways they can assist them, and establishes a relationship of trust.

The doula’s role is to provide non-medical comfort and to be a facilitator; both subtle and profound. On a practical level, the doula does whatever needs to be done — offering companionship, running errands, assisting with household chores, providing healthful meals and helping with bathing and personal care.

“You just be there, be grounded and love them. You need a way to get trust from people. As soon as I get there, I get my hands on them. The medicine doesn’t always help. So when they’re in a lot of pain I’m running energy with that pain and helping them to move the pain through, and helping them to relax,” said Rose Riedesel, a hospice volunteer and healing body worker.

But a primary role for the doula is to sit, listen and be aware of what’s happening with the various aspects of the patient’s care in order to act as an information conduit between the medical care team and the patient.

“The doula is an adjunct to the professional people involved. They’ll find out some information that the care team needs to know and they’ll pass that on, or if the family needs some information the doula will pass that on to them,” Bryant said.

Emotional well-being is vital to ease the dying process. A big part of the doula’s role is to encourage the patient to “talk with people about their life and find places of deep meaning; a deep connection in life, the people who meant something to them in their life, the experiences, what their passions were and what their difficulties were. It allows the person to sink into this process of dying,” Bryant observed.

Another role for the doula is to notice any unresolved issues, which can cause anxiety and tension in the patient.

“They listen in the stories for anything that’s unresolved. Sometimes you’ll hear something about a family member who needs to be forgiven. We want that person to have as much relaxation as possible in the end,” Bryant said.

The lead doula also helps the patient and family with a vigil plan that includes the creation of a peaceful space, along with a team of doulas sitting in shifts when the active dying phase begins.

“They help create a beautiful space for the dying person to be in with things such as art, quilts, photos and a certain scent. They ask, ‘Would you like something read to you? Who do you want with you? Can somebody get into bed with you?’” Bryant said.

After the patient has passed, the doula assists the family in making arrangements, and follows up with them.

“The doula assesses how to help the family at that time and backs out. In a couple of days, they give the family a call and ask to come and talk about what happened, maybe a beautiful touch or an interaction before the person actually stopped speaking,” Bryant said.

Just as with the birth process, dying is a time of loving connection.

Complete Article HERE!

Grieving My Boyfriend’s Death… with His Ex-Boyfriend

Being gay can feel isolating. So can loss. Conquer both, together.

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[I]t’s never easy meeting your boyfriend’s exes, but it’s even harder when it’s at your partner’s funeral. So it was that I first met Donal, the love of Simon’s life. Handsome and charming, eloquent in his grief, I hated him before I even gave myself the chance to know him. While we got on fine at the wake, I had every intention of that being the only time we ever spoke.

This was made a lot harder by my decision to run the London marathon in our Simon’s name. As soon as the torrent of sweaty finish line selfies hit Facebook, Donal knew exactly why I had just run 26.2 miles, even though I’d done everything in my power not to bring his attention to what I was doing. It was about my pain, not anyone else’s.

“I wish we could have been better friends,” Donal messaged me.

“Well, we’re not the ones who are dead yet mate,” I wrote back. “So let’s Skype?”

We agreed to talk a few days later. Donal was immediately the most charming man I’d ever met. He was pleasant, complimentary, truthful, funny, and open about the fact he had felt just as alienated at Simon’s funeral as I had.

“What do you miss most about him?” he asked.

“His eyes,” I said. Donal nodded and smiled.

“I miss that ass, frankly.”

He paused, and then told me that I was the only other person who truly understood how he felt about Simon. I felt the same way: to speak to the only other person who had slept next to Simon was, perhaps, the most liberating thing in the world. Like the first time you make a Sean Cody joke with a new gay friend and realize that, for once, you’re speaking to someone who gets your shorthand.

We were both incredibly similar people—and both equally unaware of the chemsex and meth epidemic in London before meeting Simon—and both of us were trying to respond to his loss proactively. I wrote a play, he was making a film. He was helping support people he met who were in recovery, and I’d just run across half of London for Stonewall.

As we sat there, talking about our experiences with the same man, he started to cry as he told me that he wished he’d fought more for Simon to move out with him and get help in California, where the community was a lot better than it was in London.

This was not the first time Donal had told me this. At the wake, I had seen this as the most selfish opinion in the world: Didn’t I have a right to have met Simon too? This time round, less salty than I was when recently bereaved, I told him to stop being a fucking hero. Neither of us could have saved him, and we’d be arrogant to think otherwise. He smiled and told me he understood exactly why Simon fell for me.

We pledged to speak more, and we do. When Donal was back in England recently, we even popped into the bar where Simon and me—and Donal and me—had first met. Donal introduced me to the manager behind the counter, a man who I had bought pints from many times, knowing that we both had the same loss in our hearts, but had never spoken to.

“You won’t believe it,” said Donal, “but David here ran the marathon for Simon.”

The manager turned to look at me. He shook my hand. All three of us were choked up.

“Well then you’re not paying for those drinks,” he said.

Fran Leibowitz said in “The Impact of AIDS on the Artistic Community” that the crisis killed off the greatest audience for art New York had ever seen. For me, it also seems to have decimated a generation of mentors. Not just because of the body count, of course, but because of ageism in the gay community, a lack of social spaces that aren’t for clubbing, and because I’m sure we, as a generation younger, can seem uncomfortably ignorant of the defining moments of the gay liberation movement in the 20th century. Before Donal I had met nobody who could say certainly that what I was experiencing was not entirely new, and could confidently tell me when what I was feeling was important or when I was being a fucking idiot.

And this is as true for bereavement as it is for homosexuality. Both can feel incredibly isolating: many experience it, but it’s almost like everyone is speaking a different language when they try and share their stories. What Donal and I give each other as Simon’s partners is also what I was desperately in need of as a gay man: A confidante. Much-needed perspective. And an understanding that we are all part of something tough and beautiful together. And, I hope, I will give somebody else that when I’m older.

Complete Article HERE!

What terminally ill children taught this doctor about how to live

Dr Alastair McAlpine asked some of young patients what gave them joy and meaning – their answers surprised him

Dr Alastair McAlpine asked some of young patients what gave them joy and meaning. Their answers were surprising and positive.

By Alastair McAlpine

[A]s a pediatric palliative care physician, I spend my days working with children who have life-threatening or life-limiting illnesses and their families.

Although many people think of us as the harbingers of death, in reality, doctors like us aim to maximize quality of life, especially when that life is likely to be shortened. We recognize that these children are so much more than just their illness and that they are part of a family. We focus not just on their medical needs but also on their psychosocial and spiritual ones as well.

Last year, as part of my diploma in pediatric palliative care, I was tasked with evaluating the attitudes of my little patients towards life. I asked some of them what gave them joy and meaning. Their answers were surprising and positive.

In fact, they made me completely re-evaluate my relationships with friends and family. I now spend more time with the people I love and I tell them how I feel about them. I have tried to make kindness a priority in my life.

I decided to share some of the children’s responses on Twitter, to provide some perspective to the fractiousness that is so prevalent there. The response was overwhelming, to say the least (my thread has been retweeted nearly 100,000 times).

The kids were not hung up on “stuff”. What mattered were the things that we all intrinsically know are important, but often forget in the hustle and bustle of daily living. The biggest takeaway for me is that the happiest, most meaningful moments were simple ones that did not require vast sums of money or effort to attain, but instead embraced the importance of human connection. It was also surprising how frequently the so-called small things were the ones that turned out to have enormous significance at the end.

Here are the top six lessons that my little patients taught me about life:

1. Spending time with family and pets is incredibly important.

Whether talking, laughing, playing, or just sharing silence, time spent with loved ones and pets was priceless. Towards the end, the only regret many of the kids had was that they didn’t get to spend more time “with mum and dad and my big brother”.

2. Humor and laughter are vital.

Even though they were squarely facing death, these kids derived amusement from the same things that normal children do: silly antics; clumsy adults; slapstick humor. Laughing is so important for many reasons but key among them is that it reduces pain.

Finding levity in the face of overwhelming tragedy can be difficult, and some of the parents dug into unimaginably deep wells of courage to provide mirth when their hearts were breaking. One dad pulled funny faces through his tears. But it always paid off. And whether ill or healthy, children will always be delighted by farting.

3. Good stories told and read by a loved one offer inspiration.

The written word and vivid fantasies told with basic toys enabled children to create alternate realities away from the often sterile hospital environment. They were sources of inspiration to continue fighting, even when the “battle” seemed lost. After all, if Harry Potter could continue to face Voldemort, then they could defeat their own “monsters”.

Stories also allowed the children to construct a meaningful narrative to explain the often incomprehensible diseases they were so bravely facing. Many believe that our ability to create and share stories is what defines us as human beings, and these kids demonstrated that. Stories inspired, captivated and transported them.

4. Swimming in the sea, playing on the sand and eating ice cream (even on a cold day) are simple, memorable pleasures.

Children vividly remembered the simple pleasures that cost little except the effort of being truly present; the moments that may have seemed small at the time were often, upon reflection, priceless.

5. Children as young as four worried about what would happen to their parents.

Many of the kids had made peace with their fates but wanted to protect mum and dad from additional heartache. This role-reversal is surprisingly common and indicates that children are far more attuned to their bodies than we think they are. Death is the elephant in the room. Part of my job is to encourage honesty and to get everyone talking, even when it’s painful.

6. Simple acts of kindness were treasured and remembered until the very end.

Kindness, whether from the classmate who offered a sandwich or a nurse’s smile, was the virtue that made the biggest impact on the children. They loved kind people and remembered acts of kindness until the very end. The last words I heard from one little girl were: “Thank you for holding my hand when I was scared.”

None of these revelations are new or earth-shattering, but when they come from children who are bravely facing death, an extra level of profundity is added, which has prompted many (including myself) to re-evaluate just what is important with the very limited time we have. Now, if you’ll excuse me, I’m off to the beach to eat an ice cream.

Complete Article HERE!