Author Archives: James Desiderati

Moments of Forever

Listening closely to the RN’s hushed request, I glanced down at my uniform to see it was clean, crisp and fresh. Like somehow, that would matter. The room appeared darkened, with all curtains drawn. What, behind this door would be the level of intensity, now all too familiar, even for my brief nursing experience? Calmly opening the door, my senses absorbed the scene within.

She sat on the edge of his bed, rocking in slow rhythmic circles to inaudible cadence. Long dried of tears, briefly looking up at me, her silent eyes screamed beneath her tussled hair. Traces of faint daylight squeezed through draped edges of the windows. In two steps I sat a few feet from her on the day bed. Quietly breathing, occasional routines muffled through closed doors, filtered into our space. We sat, we breathed, and waited.

Slowly, accommodation revealed swaddling white lumpy blankets and tiny tufts of blond. Her arms, trembling from hours of resisting, relaxed in renewed strength. Her encircled embrace, sheltering precious dreams, allowed a free left hand for softly stroking silky hair. Her face, partially hidden by her precious bundle, glowed soft in dim light. She never looked away.

Eventually, my imagination strayed, and quickly jumped into doubt and fear. What right did I have to be here? In sacred rituals of ancient people, only those specialized appointed souls were permitted access to such private encounters. Where would there be a wealth of powerful words and offerings worthy of my presence? How could I administer purposeful delegation of tangible value when there was no preparation? Her shifting of positions awakened me from my dream state. My focus returned with each heartbeat as the gift of humanity began kindly quieting my thoughts.

Together, welcomed only by the passing time, we lived there in this room. What thoughts, memories, hopes, dreams or fantasies had once existed here? Reaching into an abyss of questions, my only answer was to remain present. Despite my racing thoughts, my heart was stilled. My relief at her acceptance of my invasion began to strengthen my ability to act, by doing nothing. It would bring no one comfort now, to announce some benign task requirement. To enlist some formal offering of well intended words, felt grotesque and cruel. Pretending anything but being numbed by this reality, seemed insensitive and calculating.

Mechanical ticking of a clock on the wall pulsed with phony certainty as time ground monstrously past us. Never once weakening, never once, acknowledging our presence upon its inescapable equality. Eventually, it felt like we became as one. As if beings, in electric form, we maintained a balanced energy between us. My heart ached for her as I lived in her grief. Incomprehensible sadness painted each pixel before me. Life vibrated within me in circulating waves of acceptance. Each moment was becoming more vivid in clarity, as I honored them with my silence.

Suddenly, almost as if on secret cue, we simultaneously sighed. Looking deep into my soul, she smiled. I said, “I bet you have to pee?” My words slid from my vocal cords with a shocking unedited ease. She nodded in quick embarrassed relief while looking down at her child. “Let me hold him for you.” Without hesitation, she gently placed her son in my open arms and walked calmly over and opened the door. Tears dripped freely from my face as the RN who had requested my visit, entered the room and thanked me.

I remember you

I haven’t forgotten you.

Despite all the months and years that may have gone by. No matter how many ups and downs there have been. Even with all the life changes, personal celebrations and tragedies that have occurred. I still remember.

Perhaps there is now even a poem or song in your honor. Certainly there is a part of my soul that will always remain with you. You were likely a total stranger to me when we first me. You could have never guessed in a thousand years that one day I would be crossing your doorway carrying that bag slung over my shoulder. The one filled with the tools to help the needs of many.

There are times when something triggers my memory of you. Possibly a winding country road, a certain song, a snow storm, a soft breeze or the quick glimpse of a familiar neighborhood during a drive. I remember. We likely shared laughter, we certainly shared tears.

I cried a lot, but you maybe never knew this. I often would keep myself composed until I left your bedside. But there were times, especially while hooking up a new infusion, I would be unable to hold back. Then the wet glistening eyes, somber nods and quiet whispers were really me wailing inside. Filling up with the emotion of how much love surrounded us. Overwhelmed with the stoic bravery from such an unlikely source.

You will never be forgotten. I still remember you. I remember your smile, I remember your pain. I remember the look of concern in everyone’s eyes. Oh I know, I may not remember when, or possibly, may not even remember your name. But I remember the gift of time we shared.

No, I haven’t forgotten you. And, I never will.

The Mess of Doing Nothing

“I’ve noticed that it’s become easy to do nothing lately.”

These words took effect this afternoon while Cindy and I were driving back from the pizza shop with our Saturday “cheat.”

For months, possibly even years, it has been an awareness I only paid half attention too. As far back as maybe a decade ago, I had become aware that occasionally I would relish the idea of actually “doing nothing” as if that alone were an accomplishment. I would contemplate the options of “maybe tomorrow I will do absolutely nothing?”

Tomorrows come and todays go and before too long what started out as an unavoidable down time, crisis only option (due to illness or injury) shifted to willful decision. I would stay home, watch a movie, play a video game, or scroll randomly through vintage footage of concerts, history documentaries, or scientific extrapolations on what, why, when, how, where, and who. To some, this is “doing something.” In regard to an end result or specific goal of actually accomplishing something – the highest score or fleeting knowledge of trivia – my “doing nothing” produces the same.

Let me define my understanding of “doing nothing.” To me, doing nothing means that in place of doing something that can, should, or needs to be done, one simply does anything but.

To the bold-faced seeker of meaning, the reality of doing the things described above, may in fact be “somethings” each and every one. Granted, doing nothing itself is actually doing something right?

Do not discount the benefit of mindless distraction or enjoyable relaxation. One recipe of good heath is rest, exercise, and eating healthy. Volumes of data, debate, and proclamation stand ready to service your needs in these areas. But here is the problem with all this.

Doing nothing in the sense of leaving unattended a wider and larger portion of life’s responsibilities soon becomes more than just chill time. It leads to crisis.

Objects degrade, function declines, or conditions adapt to unsustainable proportions of endurance and stamina to perform basic tasks of life. Now things have become a mess. Just recently I used that phrase to describe the discovery of how to do something new with ease, “That was as easy as making a mess.” It stands to reason that the 2^nd easiest thing to do, besides nothing, is make a mess.

When weighing the outcomes of a given situation using the choice of doing nothing, compared to doing something with effort, hard work and attention, well, it is pretty obvious where the more positive resolution will exist. What healthy adult does not want a positive solution? Just look at the world today; look at the potential all around you for positive outcomes. Generalized in the world I bet there are millions of people going to bed every night hoping for just such a change. Yet how many are doing nothing?

I once went to see a speaker with very well established charitable efforts already existing in the treatment of the sick and poor. He had founded a free hospital and named it Gesundheit. His question to the group of attendees was “What are you doing?” There is always something that can be done to help others.

During one of my afternoon web scrolling marathons, I came upon an interview with Suzanne O’Brien RN who had started a group of End of Life Doulas. She was discussing the growing interest for more personalized control over the outcome of how we are coping and preparing for mortality. She teaches hope of peaceful surroundings and thoughtful arrangements for the often overlooked tasks of caring for a dependent loved one while their journey ends here with us. In addition to the professional guidance of a hospice, palliative medicine team, specialist, or family practitioner, trained Doulas educate, demonstrate and advocate for the care of patients, family and caregivers. Special lighting, music, and chosen items arranged in almost sacred tenderness, aid possible relief of symptoms that may occur. Suzanne’s doulagivers.com™ have become a worldwide network of loving hearts, “doing something.”

The basics of care for your loved one, friend, or client are detailed and offered for free. After reviewing the material Doulagivers™ provide, I eagerly joined and have become certified as a Level 3 Doula. Originally I had found this group by a desire to advance my own skills as an RN with end of life symptom management.

Now I wish to share this knowledge in hopes of helping those who do not wish to allow the “mess” that “doing nothing” can create.

In addition to our Elephant in the Room conversation guide elephant-inthe-room.org caringchoices.org Caring Choices offers experience and compassion within the complexities of dealing with death. Don’t let “nothing” stand in your way. Hope for the best, prepare for the worst. Just think about it. Knowing you’re safe and accepted for your wishes can lessen anxiety and stress. Knowing everyone around you is prepared brings peace of mind and comfort. Appreciation of the love makes the loss more palpable and even visceral, but is life at its fullest when facing the unknown absence of it? We comfort each other our whole lives.

Epiphany

Epiphany: Merriam-Webster 3a (1) : a usually sudden manifestation or perception of the essential nature or meaning of something (2) : an intuitive grasp of reality through something (such as an event) usually simple and striking (3) : an illuminating discovery, realization, or disclosure b : a revealing scene or moment.

Sometimes I think my synaptic junctions are widening to basically affect a 20 year delayed response to stimuli. Recently I was re-recording a song I had written back in 1998 called Love You Forever. The lyrics were intended for a young couple anticipating the birth of their first child. Unfortunately, the soon to be Dad I had offered to write the song for was transferred out of the area and we lost touch before I could deliver it to him. So basically the song sat in my studio storage box ever since.

Recently, a friend I had met through my End of Life Doula group (Doulagivers.com), had posted a request for music CDs for use at an inpatient Hospice. I wanted to send her some of the instrumental songs I had written over the years and thought I would throw in a few with vocal tracks also. She had said both types, and any style was welcome. As I was sifting through hundreds of old cassettes and CDs of songs I had written over the past 40 years, I came upon this particular one, (mentioned earlier), that was written with the lyrical content designed to be as if it were the parents singing to their newborn. Simple, assuring, warm.
I cued up the CD. As I listened I was struck with an overwhelming epiphany. Although intended for birth, this song, when applied to a Hospice setting at end of life, was so emotionally powerful I repeated out loud “Oh My God”, over and over as I listened. It hit me in the pit of my stomach like a wave of healing calm, soothing a weary soul. Life at the point where Hospice is required is every bit as precious as birth. And the reality of this had never been so brilliantly clear to me before. My eyes welled up with tears of literal relief as if I could see the circle of life completing itself. These words, written for the beginning, were just as meaningful and important at the end. Maybe these words are even more important for this time. They represent the continuation of love and joy for life at its fullest. A time that is just as scary, bright, cold, loud, and painful as birth itself.

This is not a time for avoidance and fear. Our life is lived right up to the very moment of our last breath….and even beyond. Are not gifts of time and love we have shared with each other, the emotions and rewards of a lifetime much greater at this end then at any other point in our life? The volume of such exchange in many cases is incomprehensible. To task one with the counting of every deed, moment of joy, laugh, shared triumph, healed sorrow and broken or fulfilled dream is astronomical to even comprehend. Although I know some memories are lost and forgotten, others are honored, and span generation after generation throughout human history.

So why is it then that we shy from death as if it were an enemy? It seems like the relationship between life and death, are one in the same. Balance: as left is to right, as up to down, and as sadness is to joy. Are we so greedily selfish that we only love what is new and living? We only celebrate the win? Not the daily sacrifice, work, effort, strain and dedicated loyalty of life. This is just taken for granted? Struggle is nothing to worry about? Expected? Living is just the business of survival right?

Well my friends. Death is not losing as if life were some game. It is the next level of reality. It is so strong of an event that it generates billions of books, movies, and internet hits. Millions of dollars of speculation, prediction, evaluation, commentary and research have been poured into death, or the afterlife, or whatever belief one fancies. But the truth remains equal for all. No one can buy their way, beg their way, or cheat their way out of it. What I believe we can do, is to enrich it with the same genuine love and attention we give to a birth. What can change is that the same generous level of resources for care, comfort and quality can be just as welcome and available as you are helplessly taking your last breath as they were when you helplessly took your first. After a lifetime of living in this hard world, no matter how long that is, it is the least compassionate act of love we can do for one another.

Love You Forever

Thank you, you’ve touched our world. Listen, Have you heard

We are the ones who will, love you forever

Rest here, by my side. Sleep now, close your eyes

We are the ones who will, love you forever

JMD 7-1-1998

The Grass is always Greener

The Grass is always Greener….

This phrase is one of many old adages expressing how the reality of something is really quite different than what you may have initially expected. A list of examples is unnecessary in this case as I am sure most everyone can come up with quite a few on their own.

The point, however, is expressly different.

Imagine what you think your death will be like. Will it be at home? Will you be surrounded by loving family, friends and cherished memories of your long and prosperous life? Will you be at peace with yourself? Will you be warm and comfortable in a soft cozy bed? Will there be the sweet fragrant aroma of incense permeating the air and tranquil melodies floating between hushed whispers of thanks and gratitude? Will you feel a growing excitement at joining the billions of other souls who have made this unique journey to a better place?

What wonderful ideas, right?

The reality of death is not quite so pretty for many people. Far from the above descriptions of how things could be are the actual ways many people face their last moments on earth.

My life experience including 10 plus years working Hospice (23 total years in nursing) have led me to this place today. A place where I am trying to help everyone understand that the above desires for end-of-life experiences are only possible with conscientious effort, planning and above all else CONVERSATIONS with others.

Too many people suffer needlessly at the hands of a system designed to keep people alive “no matter what.” Mechanical interventions replace natural processes. Legal checklists become substitutes for conversations and making real choices. Heathcare algorithm “clickfests” take the place of tender touch and genuine human interaction. These “interventions” are manipulating dying and death into becoming situations of cold, sterile, expensive states of suspended animation in order to wring every last breath out of a body long overdue for its final “resting place.”

Does this sound too harsh? Maybe an acronym to lessen the intensity of suffering? What could we call a system focused on longevity and not quality of life? What could be appropriate in our acronym-infested healthcare system? I know! Let’s call it,

S-ervices, A-gainst, D-eath … and what it really is: SAD!

Do not misinterpret my compassion for minimizing suffering as a fatalistic wish to end all happiness by “killing” everyone before their time. Such an assumption could possibly give strength to what pushes death even further into the abyss of denial.

There are wonders of technology and dedicated people everywhere that can save lives. The resources are almost limitless in both material effort and will when saving lives. When there is an opportunity, we almost all rush to the aide of anyone in distress.

But isn’t dying simply just life at its most amplified state? Isn’t everyone’s emotional, mental, physical, and spiritual culmination of lifetime energy at its most powerful when people are dying? Why is it that the one moment in life – that we get no other chance at repeating – is stripped of resources when they are most needed?

What I support is a preservation of that kindness and love we seek. While still capable and healthy, there is still time to offer a greater acceptance of dying and recognize it as the catalyst from which all appreciation of life began. When we can accept our limited existence, it intensifies each moment and delivers the “spirit” of living as no other act can. We can then set aside our fears and embrace the loss of a loved one with a renewed understanding of how important this end time is.

We have tossed death into the cold, damp corner of our minds where we hope we will never need to go again. We label our relief at not having been struck by lightning as good luck or the Grace of God, and some say we have “survivor’s guilt.” We feel even more relief to be alive.

Hourglass of Life and Death

We can learn to die better in this world. There are exceptions, for sure: trauma, sudden onset of disease, and the hateful violence of some people. But for the majority of human existence, there is a natural compassion and concern to help one another. Consider the shape of our life to look more like an hour glass instead of a funnel. Instead of narrowing options and resources as we circle nearer the tapered end there is an acceptance and an expansion of personal options once we pass through that point where quality of life reigns over quantity of days. We are embraced and comforted approaching the natural end of our life. Please have meaningful conversations with your family friends and loved ones about how you would want to die. Do not look across the fence of death and think that the grass will be any greener, less complicated or less problematic than the reality you live in here.

Dinner Date

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

Woke up here this morning my dream’s message, still quite clear
Not all full of worry, in denial’s hopeless fear
Melody still in my head of word’s so soft and kind
Our end of lives in comfort, safe with peace of mind

The dream had special meaning of the beauty of this life
And the need to represent it as with marching drum and fife
Let me tell the story of waking from this dream
Singing “you’re all going to die”, in crescendo to a scream

I was….

Sitting in a restaurant, the evening crisp and cool,
Gentleman all laughing, at the bar no empty stool
Ladies all so lovely, faces bright and flush
Their picking at their salads, sipping on their blush

I overhear the comments, and preparation’s planned
To spend the lifetime gathering, more valuables and land
It suddenly tears into me, like hot iron through my brain
Is assuming that there’s time enough, all we can attain

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

Living in each moment, like it’s precious, pure and dear
Don’t be caught in prisons, made of- denial’s fear
Live your every minute, like its precious, dear, and pure
Hoping for the future, and what may be in store

Please don’t turn your head down, and quickly look away
You’re all going to die, someday…

Uncomfortable

I consider conversation between people to be one of the most rewarding and exciting aspects of life. Recordings of the written word comes in second in my humble opinion due to the fact that what is written is subject to misinterpretation depending on many factors. Not to negate the misunderstanding caused by language barrier and incoherent speech patterns, but generally when you hear something it is pretty much just “what you heard.”

At no other time in history have I been more aware that there is such a massive amount of uncomfortable conversations occurring. Sadly, much of the most offensive exchange we are currently exposed to is not verbal but texted, posted, printed, or pre-recorded. The convenience of these methods of information exchange is undeniable. The quality is questionable.

The volume of discourse over the current political landscape is beyond comprehension, not only in America, but across the globe. The shifting sands of opinion and time will eventually settle, and new dialogue will resurface about whatever balance human existence regains.

Having witnessed these tumultuous events, and recognizing the multitude of newly vehement revelers of political opinion which had never, before now, given the topic much consideration, I began to wonder: Why? Why now? Have there not been millions of debatable issues over the past 40 years that failed to become more than a C-Spanned, red-eyed, remote flip of boredom? Certainly we have all been affected by this shuffling of interests in world affairs both public and private. But in the past many of those personally involved were understandably limited to the professions directly designed to be appropriating the need. This political slugfest seems to have engaged everyone, from every perspective and every varied opinion into an extremely uncomfortable national discourse.

Yet when attempts are made to encourage everyone to become involved with their own end of life issues, the resistance is equally universal. Very few people seem to want to begin discussions with a loved one; that is until an acute trauma or terminal diagnosis is ripping the lives of their family, friends, and acquaintances apart. As is common within proper social etiquette, there is a general outpouring of prayer, shared grief, and unified offers of support.

What will it take to make this “uncomfortable” conversation as popular as the raging debates around the world today over truth, rights, and political control? It is every bit an undeniable fact that we have a new President as it is that everyone will eventually die. Life goes on, and ends; the disproportionate lack of acknowledgement of death will not change the fact that it will occur for all of us.

What can help make conversations about death more comfortable? I believe it is honest, compassionate examination and understanding of the emotional, physical, and psychological needs of each other coupled with genuine, meaningful communication before a medical crisis occurs. Enough can never be said to help each other with what is often the most frightening, “uncomfortable” event we all will ever (and must) face.

The outcome of these “uncomfortable” discussions may even be peace of mind, increased knowledge of legal and financial responsibility, understanding of desired preferences for services and care due to changed independence, emotional release, insight into unanswered concerns, repaired personal conflicts and family dynamics, expression of personal choice, acceptance of everyone’s opinion, etc. You will never know if you don’t ask.
Just start talking!

“You can’t take it with ya.”

Earlier this week, as I lay iced up on the therapy table after my session, I overheard a light-hearted laugh and discussion about plans for something that involved what I imagined to be a pretty hefty amount of cash. Having only caught the last exchange of the entire conversation due to unintentional proximity, I was struck by the gist of the ending phrase as the parties were walking past my doorway and continuing on about their day. All that I could hear being said was “… might as well, you can’t take it with ya.” Now it’s not that I have never heard this saying before. In fact, very likely I have heard it hundreds, if not thousands, of times. But that day, it registered in my mind with a completely different reaction as any other time. Maybe it was the light-hearted giggle and soft tones, or maybe it was the representative acceptance of what I now imagined the meaning that this common phrase infers.

Having worked as a nurse for over 25 years, I have been exposed to the traumatic effects of the loss of independence and death. I have witnessed the impact of these events on patients, their families, loved ones and friends in a multitude of settings, circumstances and degrees of intensity too broad to include in this forum. In all of this time however, there were very few, if any, references to any material assets which would not be taken “with ya.”

There are, unfortunately, innumerous examples I can remember that involved the inability and unpreparedness to accept the new reality that had now been forced upon the present.

But when we say the phrase “you can’t take it with ya,” it seems there is an undeniable acceptance of death or changed realities already so well in hand that that it can be so casually joked about. Why, then, is the reaction so intense for the grief stricken who are seemingly left helpless at this change in condition when it becomes a reality? Why is the reality of “can’t take it with ya” such an unimportant consideration until death becomes impossible to avoid?

The answer for myself is that I never want to imagine the “with” part of that statement. I personally have filled out my Will and Five Wishes forms. I write these blogs hoping to get others to address the possibilities of “with” before it becomes “now.” I still don’t feel very casual about the “with.”

But this fact has not stopped me from recognizing the importance of planning for the time when I have lost my independence and have left this world and my family and friends to remain and deal with my departure in however they best can. (One glimpse of this inevitability came just last month when I underwent a right posterior total hip repair.) No one gets to choose how they die. Very few know when. Even fewer look forward to it sincerely. But there is nothing in this world stopping anyone from discussing how they may wish to be cared for in the event of a loss of independence, on any level, or how they would like to be treated and have their physical body and material things handled when that “with” finally becomes “now”.

Please, by all means with every breath of your life, hope for the best. But my friends, please also strive for happiness, love, and compassion in the world around you. Perhaps more importantly, be prepared for the worst. Discuss your wishes, feelings, and beliefs with your family, friends, and loved ones. Get as much in writing and scanned into medical records backed up by legal consents and authorizations in the hope to lessen the tragic impact of inevitable changes on you and those you love. Don’t let the burden of “with” become someone else’s problem “now.”

Pain

Pain is not something I have ever been a fan of. Actually, I have always been afraid of it in lethal doses as with torture, cancer, trauma, or acute disease (myocardial infarction) or the myriad exacerbation possibilities of chronic diseases. I have made a career of trying to eradicate pain from the lives of all patients, but especially hospice patients. With the help of my wife in promoting end of life conversations, we have tried to lessen and soften the emotional, mental and spiritual pain of inevitable changes we ALL will face.

As a nurse for over 24 years, I have witnessed the devastating effects of chronic conditions and diseases. Too long to name here, the lengthy list of aliments that have the ability to affect our quality of life is known to many people. Most everyone knows someone who is living with an awful disease. Some may often be preventable, and many are treatable. Certainly there are always behaviors we can eliminate and choices we can make that may promote the general wellbeing of our future health. Many of us hope to grow old, with dignity and good health. Many wish for a peaceful end for our lives which, despite all hope, often does not go as we expect. Hope for the best, prepare for the worst I like to say.

Personally, and I say this very seriously … I did not expect my fate would be to fall prey to, of all things, something as common as Arthritis! More pointedly, “end-stage arthritis” as the orthopedic doc I saw this week phrased it. It never occurred to me that arthritis could be the source of such mind numbing, relentless, severe pain as I have been experiencing with growing intensity for the past 5 years. Although arthritis, in and of itself, is not really fatal, the death of my independence and function as it once was, occurred none-the-less. And there are millions who experience this around the world every day.

I always thought arthritis was an “old person’s” disease. I never would have dreamed in a million lifetimes that this is what would finally break my armor and take me down.

I once believed in the “no pain, no gain” slogan often spouting from the competitive nature many have within the rigors of physical achievement in sports and general athletics. This mantra of Spartan-like stoicism in the face of brutal resistance even spills into academia, politics, and religious worlds of all who believe that they will achieve their goals “no matter what” the costs. Just ask any nursing student who has worked full time throughout their entire nursing education. Or ask any Evangelist who builds wells in Africa in the midst of civil war and political coup. We all fight our fights, pick our battles, and slay our demons as we struggle toward our personal (or unified) goals.

So, yes, in the majority of the circumstances I agree with the “No pain, No Gain” philosophy. Just my own experiences with backpacking the Grand Canyon for many days at a time ring true in this sense.

But then there are the situations like the one with which I now have come face to face; the ones where no amount of suffering will yield a positive outcome. Fortunately, I can have hip replacements to alleviate my pain and be able to regain some of my independence for a while longer. I won’t die in arthritic pain as some may have in generations before me.

Clearly there is a reason most human beings died before age 60 in the past. There just wasn’t anything to gain from prolonged suffering. There were few options to constant unrelenting pain. With the exception of opium, alcohol, and barbaric, antiquated surgical measures, humans suffered and died long before 50 became the new 30.

And yet even with the modern technological advances in medicine and surgery, there are many who now find themselves in states of mind-numbing pain. Whole disciplines of science have been developed over the recent years to combat pain, cure diseases and even stave off death. But one factor has been sadly overlooked.

There are not enough resources to cover the continually growing numbers of people approaching “older” status. There are too few doctors, nurses, social workers, aides, clinics, hospitals, ancillary staff and even funding to handle the growing populations across the entire planet.

Escape Fire is a documentary (available on Netflix) that exposes this “Achilles’ heel” of our medical profession today. This is not alarmist, fatalistic, or negativism. This is reality. Unless we, as a country, align ourselves with forward-thinking neighbors in other countries, the world is destined to fall into a “Survival of the Fittest” mentality. But unfortunately there may be no relief from pain for anyone unless you are affiliated with the “winner.” To me, this is a frightful prospect to ponder.

As humans, we possess the capacity for the most beautiful artistic creations, marvels of scientific advancement in space travel and DNA modification, architectural designs, agricultural success and compassionate empathetic behavior worthy of sainthood. Yet we focus much of our resources on defensive posturing and aggressive superiority in matters of future concerns. My hope is that we may all join together in the united effort worldwide to alleviate fear, hate and pain for everyone. We were all given free will, but some do not wield this compassionately.

“The value of life. That people have to be kind to each other…” Helga Weiss- an interview with a holocaust survivor.

So where do you stand?

Birth________ Death:

Like a book, what is in between is what matters most.

When reading a book, was it the cover that attracted us to it? More likely the impact of its content is where appreciation and fulfillment lie.

Why would we suddenly then be afraid of that last page or back cover? Certainly the better the book, the more likely we would feel varying emotions as it draws near. There is also the option to stop reading the book by stopping somewhere along the way. Some believe that once started the book must be finished no matter what. This is a choice as well. And for some, reading is never a possibility. There may be too many obstacles to overcome. I have also heard “Never judge a book by its cover.” Often people are anxious and excited to reach the end of the story. Now apply this to life.

Why would we suddenly be afraid of what we all know is the inevitable outcome: The end of the book. Why would we care more for the beginning of the book than the end? Depending on the content, the comprehension of the reader and the expectations, the stage is set. The pages of our lives are turning each day. To a degree we often have the ability to do some editing. Others may be helpless to do anything. But we all will finish this life book someday.

In our excitement to improve and lengthen life, we have unknowingly vilified death, or the end of the book. Long ago, we cared for our loved ones in stoic acceptance as they died in our homes. We honored and comforted them. Loving, laughing, crying, grieving and sharing in their care as they died.

Today, everything is an emergent crisis which we must repair! Death has become unacceptable. And in many cases, the trauma, disease or advancing natural decline is so severe that no amount of medication, procedures or diagnostic testing can reverse the process. And there is often unnecessary suffering endured in place of honest communication. Afterwards, when all the possibilities have been exhausted, we warehouse these poor souls and give the buildings softer names to offset the harsh realities within their walls.

Quantity of time has become preferable to quality of life in hope of miracles, cures, new science and luck.

I have been a nurse since 1993; and 11 years in Hospice. Each day passes with a new chance to lessen the stress for those around me. I have seen the acceptance of our mortality, and at times, together with faith, replace the fear of death, with appreciation and anticipation of what the next book may be. If even one person has a softer path from this life, to that final page and the back cover because of something we have done or said, then we are sincerely thankful.

Caring Choices is committed to this mission.