12 LIFE LESSONS FROM A MAN WHO HAS SEEN 12000 DEATHS

By

Bhairav Nath Shukla
Bhairav Nath Shukla

Rooted in the hearts of many Hindus is the belief that if you breathe your last in Kashi (Varanasi) you attain what is popularly known as ‘Kashi Labh’ or ‘the fruit of Kashi’—moksh or “release from the cycle of rebirth impelled by the law of karma”.

Kashi Labh Mukti Bhawan in Varanasi is one of the three guesthouses in the city where people check in to die. The other two are Mumukshu Bhawan and Ganga Labh Bhawan. Established in 1908, Mukti Bhawan is well-known within the city and outside.

Bhairav Nath Shukla has been the Manager of Mukti Bhawan for 44 years. He has seen the rich and the poor take refuge in the guesthouse in their final days as they await death and hope to find peace. Shukla hopes with and for them. He sits on the wooden bench in the courtyard, against the red brick wall and shares with me 12 recurring life lessons from the 12000 deaths he has witnessed in his experience as the manager of Mukti Bhawan:

1. Resolve all conflicts before you go

Shukla recounts the story of Shri Ram Sagar Mishr, a Sanskrit scholar of his times. Mishr was the eldest of six brothers and was closest to the youngest one. Years ago an ugly argument between the two brothers led to a wall to partition the house.

In his final days, Mishr walked to the guesthouse carrying his little paan case and asked to keep room no. 3 reserved for him. He was sure he will pass away on the 16th day from his arrival. On the 14th day he said, “Ask my estranged brother of 40 years to come see me. This bitterness makes my heart heavy. I am anxious to resolve every conflict.”

A letter was sent out. On the 16th day when the youngest brother arrived, Mishr held his hand and asked to bring down the wall dividing the house. He asked his brother for forgiveness. Both brothers wept and mid sentence, Mishr stopped speaking. His face became calm. He was gone in a moment.

Shukla has seen this story replay in many forms over the years. “People carry so much baggage, unnecessarily, all through their life only wanting to drop it at the very end of their journey. The trick lies not in not having conflicts but in resolving them as soon as one can,” says Shukla.

2. Simplicity is the truth of life

“People stop eating indulgent food when they know they are going to go. The understanding that dawns on many people in their final days is that they should’ve lived a simple life. They regret that the most,” says Shukla.

A simple life, as he explains, can be attained by spending less. We spend more to accumulate more and thus create more need. To find contentment in less is the secret to having more.

3. Filter out people’s bad traits

Shukla maintains that every person has shades of good and bad. But instead of dismissing “bad” people outrightly, we must seek out their good qualities. Harbouring bitterness for certain people comes from concentrating on their negatives. If you focus on the good qualities though, you spend that time getting to know them better or, maybe even, loving them.

4. Be willing to seek help from others

To know and do everything by yourself might feel empowering but it limits one from absorbing what others have learnt. Shukla believes we must help others, but more importantly, have the courage to seek help when we’re in need.

Every person in the world knows more than us in some respect. And their knowledge can help us, only if we’re open to it.

He recounts the incident of an old woman being admitted on a rainy day back in the 80s. The people who got her there left her without filling the inquiry form. A few hours later, the police came to trace the relatives of the old lady who, they said, were runaway Naxalites. Shukla pretended to not know nothing. The police left. When the lady’s relatives returned next morning, Shukla asked the leader uninhibitedly, “When you can kill 5-8 people yourself why didn’t you simply shoot your Nani and cremate her yourself? Why did you make me lie and feel ashamed?” The grandson fell to his knees and pleaded for forgiveness saying no one amongst them is capable of helping his religious grandmother attain salvation. He respects that, and is the reason why he brought her to Mukti Bhawan.

5. Find beauty in simple things

Mukti Bhavan plays soulful bhajans and devotional songs three times a day. “Some people”, he says, “stop and admire a note or the sound of the instruments as if they have never heard it before, even if they have. They pause to appreciate it and find beauty in it.”

But that’s not true of everyone, he adds. People who are too critical or too proud, are the ones who find it hard to find joy in small things because their minds are preoccupied with “seemingly” more important things.

6. Acceptance is liberation

Most people shirk away from accepting what they are going through. This constant denial breeds in them emotions that are highly dangerous. Only once you accept your situation is when you become free to decide what to do about it. Without acceptance you are always in the grey space.

When you are not in denial of a problem you have the strength to find a solution.

Indifference, avoidance, and denial of a certain truth, Shukla believes, cause anxiety; they develop a fear of that thing in the person. Instead, accept the situation so you are free to think what you want to do about it and how. Acceptance will liberate you and empower you.

7. Accepting everyone as the same makes service easier

The secret to Shukla’s unfazed dedication and determination towards his demanding job can be understood via this life lesson. He admits that life would’ve been difficult if he treated people who admit themselves to Mukti Bhavan differently, based on their caste, creed, colour, and social or economic status. Categorisation leads to complication and one ends up serving no one well. “The day you treat everyone the same is the day you breathe light and worry less about who might feel offended or not. Make your job easier,” he says.

8. If/When you find your purpose, do something about it

To have awareness about one’s calling is great, but only if you do something about it.

A lot of people, Shukla says, know their purpose but don’t do anything about realising it, making it come to life. Simply sitting on it is worse than not having a calling in the first place. Having a perspective towards your purpose will help you measure the time and effort you need to dedicate to it, while you’re caught up in what you think you can’t let go or escape. Take action on what truly matters.

9. Habits become values

Shukla recommends cultivating good habits to be able to house good values. And building good habits happens over time, with practice. “It’s like building a muscle; you have to keep at it everyday.”

Till one doesn’t consistently work towards being just or kind or truthful or honest or compassionate, every single time he is challenged, one cannot expect to have attained that quality.

10. Choose what you want to learn

In the vastness of the infinite amount of knowledge available to us it is easy to get lost and confused. “The key lesson here is to be mindful of choosing what you deeply feel will be of value to you,” he says. People might impose subjects and philosophies on you because it interests them and while you must acknowledge their suggestions, the wise thing to do is delve deeper into what rejoices your own heart and mind.

With a smile on his face Shukla says, “In the last days of their life a lot of people can’t speak, walk or communicate with others with as much ease as they could, earlier. So, they turn inwards. And start to remember the things that made their heart sing once, things that they cared to learn more about over the course of their life, which enriches their days now.”

11. You don’t break ties with people; you break ties with the thought they produce

You can seldom distance yourself from people you have truly loved or connected with in some way. However, in any relationship, along the way, certain mismatch of ideologies causes people to stop communicating. This never means you are no longer associated with that person. It simply means that you don’t associate with a dominant thought that person brings with him/her, and to avoid more conflict you move away. The divorce, Shukla affirms, is with the thought and never with the person. To understand that is to unburden yourself from being bitter and revengeful.

12. 10 percent of what you earn should be kept aside for dharma

Dharma, Shukla doesn’t define as something religious or spiritual. Instead, he says it is associated more with doing good for others and feeling responsible about that. A simple calculation according to him is to keep 10 percent of your income for goodwill.

Many people donate or do charitable acts towards the end of their life because death is hard on them. In their suffering, they begin to empathise with others’ suffering. He says those who have the companionship of loved ones, the blessings of unknown strangers, and an all-encompassing goodwill of people exit peacefully and gracefully. That is possible when you don’t cling on to everything you have, and leave some part of it for others.

Complete Article HERE!

Death Changes Everything. Time Changes Nothing

death-changes-everything

“Dost thou love life? Then do not squander time, for that is the stuff life is made of. “ —- Benjamin Franklin

By Hospice of the North Coast

Time is our greatest commodity, yet we often squander it. It’s not until we’re faced with the death of a loved one when we realize just how much time has passed away, and how much of our time we spent “being busy” instead of “being with” the people we love. We get so busy with our day-to-day lives, often time just trying to make ends meet, that we forget that the time we spend interacting with someone may very well be our last day with them.

When our minds are being so distracted, be it with work, or in Information Overload mode, it’s difficult to enjoy the moment we’re currently in. As they say, we’re not “in the here and now.” We dwell on the past, dream of the future and ignore the present.

It takes a lot of hard work, time and energy to reach a level of success — however you define success — that results in acquiring whatever possession you desire. Then we spend even more time and resources protecting our possessions.

What if we protected our time as diligently as we protect our possessions and lived as if we just found out we only a few months left? Would we spend more of our time with family, friends and loved ones? Or would we spend more time working, or texting and emailing those we hold dear instead of actually spending time with them? Would we procrastinate even more, or go visit a friend who has been feeling alone and isolated since h/her spouse passed away? Or go visit a family member in Hospice that you’ve been putting off due to your busy schedule.

How often have you said, “Life is too short for this (enter the first word that comes to mind)?” During those times, what was it that made you feel life is too short for you to be wasting your time on? A pointless argument? Being stuck in traffic? Being dragged into other people’s dramas? To some extent, you have to put up with things forced upon you by circumstances, such as being stuck in traffic because you really need the job you’re trying to ge to (or return home from), so quitting and relocating is not an option.

Some things that waste our precious time on are, unfortunately, necessary and inevitable. It’s the time-draining (and by extension, life-draining) events that we can absolutely avoid yet choose not to. A perfect example is the time we spend on social media sites and/or getting engaged in an online argument. Another example is always having your smartphone turned on so that you can immediately text and/or answer emails… even while you’re having lunch with a friend.

How you live affects how long you live. Keep a good watch over your time, and spend it wisely.

“So it is: we are not given a short life but we make it short, and we are not ill-supplied but wasteful of it… Life is long if you know how to use it.” — Seneca, Roman philosopher

Complete Article HERE!

Here are 5 things you may regret at the end of your life, from a nurse who works with dying people

If you had a crystal ball to see what you’d regret as you were dying, would you make changes now?

By Angie Aker

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You might think watching people die would depress a person. It actually taught her how to live.

Bronnie Ware spent years as a palliative care nurse, helping patients be as comfortable as possible in the time just before their deaths. She compiled their stories and the most repeated regrets she heard them utter in their final days.

Do you ever imagine what the final years and months and days of your life will be like?

Shared originally on her blog, ” Inspiration and Chai,” here are the top five regrets, with quotes from her blog as she recorded them.

Regret #1: I wish I’d had the courage to live a life true to myself, not the life others expected of me.

Look at yourself in the mirror. Are you living your best life right now? What’s stopping you?

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“This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realise, until they no longer have it.” — Bronnie Ware

Regret #2: I wish I hadn’t worked so hard.

This one speaks for itself.

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Regret #3: I wish I’d had the courage to express my feelings.

What if getting the words out is essential to your growth as a human?

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“Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming.” — Bronnie Ware

Regret #4: I wish I had stayed in touch with my friends.

Is there someone you treasure who you haven’t spoken with in much too long?

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“Everyone misses their friends when they are dying.” — Bronnie Ware

Regret #5: I wish that I had let myself be happier.

If you didn’t wake up joyful today, why not? What can you do to change that?

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“This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again.” — Bronnie Ware

Were there any regrets on this list that felt familiar to you? Others that you didn’t see listed?

These are five universal wake-up calls we all need to be reminded of. There’s no shame in tagging all the friends you need to call when you share this.

Complete Article HERE!

“I want to die at home, surrounded by people who love me”

For Dr Kate Granger, preparing for a ‘good’ death has allowed her to accept her diagnosis of incurable cancer

Kate and her husband Chris at the renewal of their wedding vows
Kate and her husband Chris at the renewal of their wedding vows

“Facing death is not something anybody ever wants to contemplate. But that is exactly what I’ve had to do for the past five years. At the age of 29 I had the perfect life. Happily married, successful career, great network of friends and family, beautiful home and in the early stages of planning to conceive our first child. My life was all I’d ever dreamed it would be. But all that was shattered into minuscule pieces when the cancer sledge hammer hit us, and we discovered my incurable diagnosis; a diagnosis that came completely out of the blue and destroyed our lives as we knew them.

As a doctor specialising in the care of older people I had some familiarity with dying. I’d sat and held the hands of patients as they drew their final breaths. I’d comforted families through difficult conversations around end of life care for their loved ones and their eventual bereavement. But now it was my own mortality that had come into a sharp, unavoidable reality.

The cancer was very aggressive and advanced; my kidneys had failed; I was in intractable pain. There really was no hope of cure no matter how optimistic your view. As a clinician I didn’t know any way to get through something so life changing, other than addressing it head on. Within days of discovering I had bone and liver metastases, I had made the decision that I did not want to undergo cardiopulmonary resuscitation. I wrote my Bucket List. I made a will. I started work on a memory box for Chris. I specified my end of life care preferences in writing. Attending to these practical considerations gave me a peace of mind that allowed us to accept what was happening, and then move on with living in the present with a degree of calmness.001

Thoughts about death often creep into my consciousness though. I wonder about what it will feel like, what symptoms I might experience and I reflect frequently on my personal vision of a peaceful, ‘good’ death. I’ve picked out my favourite music, particular candles with soothing scents and the books I’d like my Mum to read to me. I desperately want to die at home, surrounded by the people who love me. These preparations are designed to create an environment with comforting childhood memories, making me feel as safe as I can despite the horrendous circumstances.

However given my professional experience I know only too well that I may not achieve my serene death ambitions. I know that my symptoms may become uncontrollable at home, especially if I develop a bowel obstruction. I fear being bundled into an ambulance and carted off to hospital. I fear my eventual loss of independence. I fear not being strong enough to see it through to the end.

I have been extremely publicly transparent about my health problems by writing books and using social media. Looking back I think this is thanks to my inner teacher; I want to share my experiences to improve care for other patients. I felt so useless and lacking in purpose at the beginning of my illness. Getting my laptop out to write the whole sorry saga down seemed a natural response. I needed to process what I was going through and I wanted to emphasise how healthcare professionals’ behaviour impacts the people they look after. This project has now gone one step further, and I plan to share the end of my life on Twitter using the hashtag #deathbedlive. Unexpectedly I now have a huge social media following, and I hope one of my final legacies will be to promote a national conversation in society around death and dying by using this powerful voice.

I’m one of the lucky ones. I genuinely believe that. I have the support of an amazing husband, who has been there for me every single step of the way. He has made our lives truly incredible and I never know what the next lovely surprise might be. We are able to live comfortably in our own skins, with the lurking existence of the death gremlin, because we are honest and open with each other. Talking about death is never going to be an easy task, but Chris knows my wishes and I am absolutely sure that he will protect them right up until the end.

Complete Article HERE!

Prince’s death illustrates importance of having a will

By Gail MarksJarvis

Prince

Pop music star Prince apparently died without writing a will, and it’s likely that his relatives and business contacts will be fighting in a Minnesota court for years over his estate, estimated at $150 million to $300 million.

With no wife or children, first in line, according to estate law, are Prince’s six siblings. Under simple court rules governing inheritances when there is no will, each of the siblings will get an equal share. That will apply whether Prince was fond of each of the siblings or not. And with Prince’s complex estate, massive business dealings, his practice of secrecy and millions in wealth at stake, attorneys don’t expect this case to culminate quickly or simply.

“It’s ironic,” said Avi Kestenbaum, a New York estate planning attorney with Meltzer Lippe. “Prince, at age 57, spent 37 years making his legacy. He fought the music industry for control, and now he has no control.”

It’s a lesson for other people, whether rich or poor, famous or regular. When you die without a will, you get no say. If you hated a relative, your children might end up in that person’s care. If you divorced and forgot to take a previous spouse’s name off an account or insurance policy, your new spouse or children might not benefit. If you have a business, and children with no interest in it and no business savvy get control, the value of your life’s work could be destroyed.

After a death, if there’s no will, a house with both spouses’ names on it will go to the surviving spouse. But in an era of multiple marriages and divorces, inheritances get sloppy. Consider a father with grown children who have sweet memories of the home where they were raised. With no will, a second wife could inherit the house and give it to her own children from her previous marriage, leaving out the children who were raised in that house, notes estate planning attorney Adam Damerow, of McGuireWoods in Chicago.

On the other hand, estate planning attorneys recall instances in which second wives have been left homeless because a husband died without updating an old will to incorporate a second wife. In an old will, he leaves his home and everything else to his children.

“The kids kick the woman out of her own house,” said Kestenbaum.

In situations where everyone gets along, the children might ignore the will and let the woman stay in the home. But in some families not everyone gets along, Damerow said.

The court can’t guess what might have been in a person’s head, but certain rules apply when there is no will: If a person has a spouse and children, the estate is divided half to the spouse and half to the children. If there are only children, the estate is divided equally among them. If there are no children, siblings come next and inherit an equal share of the wealth.

Many people don’t write wills because they assume they are young and have plenty of time. Yet Prince was only 57 years old. Many people also do not want to think about dying, or worry about giving up control, said Kestenbaum. They say: “I’ll be dead anyway. Why should I care?”

But the Prince case illustrates one reason to care: His siblings now could be targets of people trying to exercise business interests that are not favorable to them, and even if the siblings got along well the pressures can divide them.

Estate attorneys say that they often see families torn apart as they deal with the division of property and control after a death. “The most fights occur where there is a business or real estate that is given to children equally,” said Kestenbaum. “How do you run a restaurant with four chefs in the kitchen?” he said. “So maybe you leave a business to one child and insurance to another.”

Families should revisit the will every few years because as time passes, one asset can gain value a lot while another loses.

Les Kotzer, a Toronto attorney, takes preparations for the family even further in his book: “The Family Fight: Planning to Avoid It.”

During years of working with wills, Kotzer noted that many grown children end up in feuds because parents failed to talk with their children about wills while still alive. Conversations can suggest better ways of dividing possessions. One problem Kotzer noted was that one grown child might have memories of playing a piano in the family home, while the child who is to be given the piano in a will might have a spouse that doesn’t want the instrument cluttering their house.

Complete Article HERE!

10 Myths about Palliative Care

By: CVH Team

Palliative-Care2

Palliative care is still widely misunderstood by many Canadians. Here are 10 common myths we often encounter. Help dispel these myths by sharing the facts with family members and friends, colleagues, patients and client.

1.  Myth: Palliative care hastens death.
Fact: Palliative care does not hasten death. It provides comfort and the best quality of life from diagnosis of an advanced illness until end of life.
See also: Palliative Care: Dispel the myth of hastening death

2.  Myth: Palliative care is only for people dying of cancer.
Fact: Palliative care can benefit patients and their families from the time of diagnosis of any illness that may shorten life.
See also: How do you know when someone is ready for palliative care?

3.  Myth: People in palliative care who stop eating die of starvation.
Fact: People with advanced illnesses don’t experience hunger or thirst as healthy people do. People who stop eating die of their illness, not starvation.
See also: Can you provide some guidance about oral nutrition at the end of life?

4.  Myth: Palliative care is only provided in a hospital.
Fact: Palliative care can be provided wherever the patient lives – home, long-term care facility, hospice or hospital.
See also: What is Palliative Care?

5.  Myth: We need to protect children from being exposed to death and dying.
Fact: Allowing children to talk about death and dying can help them develop healthy attitudes that can benefit them as adults. Like adults, children also need time to say goodbye to people who are important to them.
See also:  Don’t Use the ‘D’ Word: Exploring Myths about Children and Death

6.  Myth: Pain is a part of dying.
Fact: Pain is not always a part of dying. If pain is experienced near end of life, there are many ways it can be alleviated.
See also: Pain

7.  Myth: Taking pain medications in palliative care leads to addiction.
Fact: Keeping people comfortable often requires increased doses of pain medication. This is a result of tolerance to medication as the body adjusts, not addiction.
See also: Pain medication myths: Addiction and hastened death

8.  Myth: Morphine is administered to hasten death.
Fact: Appropriate doses of morphine keep patients comfortable but do not hasten death.
See also: Does morphine make death come sooner?

9.  Myth: Palliative care means my doctor has given up and there is no hope for me.
Fact: Palliative care ensures the best quality of life for those who have been diagnosed with an advanced illness. Hope becomes less about cure and more about living life as fully as possible.
See also: Health Care Decisions: An Approach to Decision Making and Advance Care Planning

10. Myth: I’ve let my family member down because he/she didn’t die at home.
Fact: Sometimes the needs of the patient exceed what can be provided at home despite best efforts. Ensuring that the best care is delivered, regardless of setting, is not a failure.

Complete Article HERE!

Preparing for end-of-life

Everyone should ask themselves, “How do I want to die?”

Preparing for end-of-life

BY MARK FOURRE

As doctors, we are trained to solve problems.

If an arm is broken, we set it. If a heart valve is leaking, we replace it. If infection strikes, we do our best to cure it. There is real satisfaction when, as physicians, we make an accurate diagnosis and deploy an effective treatment.

Perhaps that’s why, when there is no problem to be solved, we don’t always do our best work. Death, after all, is not a solvable problem. All our patients will die. We can’t fix that. And too often, as a result, we don’t do all we should, or could to help our patients accept the inevitable.

Physicians are not alone, of course. Our society generally does a poor job of seeing death as a natural outcome of life. Many of us maintain the myth of our own invincibility long past our 20s. And where death was once something that typically happened at home in the presence of family and friends, it more often happens today in a hospital or nursing home.

When confronted with the question, “How do you want to die?” many of us might answer “I don’t.” But this question, the kind of death we want for ourselves, lives with us every day of our lives. It is true that extending life is a desirable and legitimate goal of our healthcare system, but the quality of our lives — and of our deaths — have a place as well.

None of us can solve death as if it’s a problem, but we can all have goals for the end of our lives. And it is that change, from problem-solving to goal-setting, which can lead us as physicians to do better by our patients when it comes to end-of-life care.

Of course, better end-of life-care, like better health overall, is not just the doctor’s responsibility. Just as everyone needs to do their part in the work of extending and improving life by not smoking, exercising and eating a healthy diet, so, too, must our patients take an active and informed role in good end-of-life planning.

The rewards can be a bit counter-intuitive. Research shows that among those who are given a terminal diagnosis, having an end-of-life plan that includes goal-directed care like hospice leads to care that is not only less costly, but patients on average are happier and actually live longer than those who exhaust every treatment option.

The good news is members of the medical community are beginning to embrace these changes. Across the MaineHealth system, for instance, events were planned around National Healthcare Decisions Day on April 16, organized to raise awareness of better end-of-life planning. And every day the conversation is growing among doctors, nurses and other practitioners about the need to talk to our patients about the benefits of creating advanced directives for healthcare and thoughtful end-of-life options such as hospice care.

For all this good work, though, the most important lessons I learned about death and dying didn’t come as part of my medical training. They came from my parents.

During my internship year, my dad as a relatively young man in his late 50s, had to struggle with the decision of whether to undergo chemotherapy for advanced lung cancer. He decided that his goal was not to pursue more days alive, but rather, to live the rest of his life meaningfully.

He chose to forgo chemotherapy and identified the goals he wanted to meet before dying. He completed the design of a church he was working on. He deliberately and intimately connected with family and friends. He put his financial affairs in order. He even planned his entire visitation service and funeral, including designing the memorial card handed out at his wake.

Importantly, he didn’t do this alone. He had to talk with a lot of people. Everyone important to him knew the plan. His family, his doctor, his business associates and his close friends all understood what to expect. And we all knew that my dad was living the way he always had, in a thoughtful and loving manner.

And, he spent time conversing with his God. “I don’t have a problem with dying,” he would say. “I’m just not sure I agree with the timing.”

My father was able to have the kind of death he wanted because he thought about it beforehand and took steps to insure that he died the way he had always lived.

Years later, my mother died from Parkinson’s disease. I am grateful to this day for the afternoon she spent with me not long after her diagnosis putting her thoughts down into a medical directive that would guide my family through the end stages of that illness. It was a natural and rewarding conversation in part because we didn’t set out to produce a perfect document, just one that would work for my mom and our family.

As a doctor, I have seen the alternatives to these thoughtful deaths.

I remember the first time I responded to a code in the hospital. I was a young medical student. A “code” or “code blue” is called over the intercom system of a hospital when a patient has had an unexpected cardiac arrest.

Amongst all the commotion, the thing that stood out the most to me was the patient. She was very frail, very old — and lifeless. The whole scene struck me as too much. It felt invasive and out of place.

Despite the apparent futility of the efforts, the “code” continued for what seemed to be a very long time. As is the case with the vast majority of “code blues,” the effort was not successful.

There is a reason why 65 percent of older physicians have an advanced directive, compared to 20 percent of the population generally. We know the limits of modern medicine. As a result, we know how we would like to die.

As physicians we must resolve to build end-of-life conversations into the care of all our patients. The time to start the conversation is long before a terminal diagnosis. And as with smoking cessation, progress will depend not on one conversation but instead on an ongoing dialogue.

If you are a patient and your doctor hasn’t brought up end-of-life care, don’t be shy. Ask. The time to start is now, and it is a conversation that should include not only your doctor, but all those close to you.

As an integral and inevitable part of life, death is not a problem. But our failure to plan for it is. Let’s solve it, together.

Complete Article HERE!