What Dying People Want (David Kuhl)
OVERVIEW
David Kuhl wanted to know about the physical, psychological, and spiritual aspects of living with a terminal illness. He wondered: what is it like knowing you’re going to die? Not dying in some distant, abstract future… but dying here, and now. As a palliative care physician and professor, he began his research, talking to terminally ill patients and their families. This book is a collection of the knowledge gained from those conversations. This book is for mortals.
Time – When you’re dying, your perception of time changes. Most importantly, terminal illness has a way of clarifying what is and isn’t worth your time. You may wonder what important projects will be left undone, with no future to entrust their completion to. While most of us take for granted the future time we assume we’ll have, dying people have no such guarantee. Dying also causes you to reflect on the life you have lived, no longer assured of the future. It’s common to wonder: Have I lived the life I wanted? If you can’t answer positively, you may feel a great deal of anxiety.
Anxiety – There are so many ways dying creates anxiety, as does any situation of uncertainty. There’s the fear of the pain you may experience, and fear of the pain and grief you will cause your loved ones. Who will take care of them, and who will take care of you? You may have regrets or worry that you didn’t live authentically – that you didn’t take enough chances, didn’t spend enough time with loved ones, didn’t experience everything you wanted to. There may also be a more generalized sense of dread, the anxiety of annihilation, of nothingness. Kierkegaard distinguished fear from dread… dread being the fear of “no thing” rather than the fear of something you can name. Dying brings both fear and dread for many.
Touch and Belonging – Dying people can feel isolated and alone in their experience… crave physical and emotional connection. You may feel a sense of estrangement, of being out of touch and untouchable… a loss of intimacy or a sense of abandonment. You can feel out of touch with yourself too, or out of touch spiritually. Dying will also heighten your longing to belong, one of our most basic human needs. You’ll probably spend some time wondering who and what you belong to, where you fit. Nowhere is it more obvious that dying people are still living, still in need of connection, communication, togetherness, and love.
Truth – But intimacy doesn’t exist without clear and honest communication. Near the end of life, you may be ready to divulge secrets, to be authentic and truthful about the things you regret and the things you fear. James Hollis called these the three R’s: recognition, recompense, and release. All this ladders up to being whole. You are your whole life, whether you’re proud or ashamed or guilty… full of ‘I’m glad’s or ‘I wish I had’s. Dying is a time of honest communication, forgiving yourself and others, and asking for forgiveness. Dying is the time that you will face the truth of who you are.
Life Review – This integration often involves the life review, which is more than remembrance or reminiscence. It’s a process of storytelling and of sense-making… of finding meaning. What dying people realize, what you will realize, is that meaning is not something that lives in the future… meaning is not potential… meaning is what we create from the material of our life story. The richest source of meaning is one you already possess: the life you have lived. When we worry about meaninglessness, it’s usually the worry that there might not be enough time left to do the things that matter. But your whole life has been filled with mattering, with accomplishments and love and projects and careers and family and things of value. When you want to craft a meaningful story, look to your source material. It sounds so obvious, but it bears repeating: the meaning of your life is always in the life you have lived, not in the future you haven’t.
Spirituality –Atheists might not believe in a higher power, but that’s not the only spirituality or transcendence available to us. What Kuhl found during his research was that those people who turned toward spiritual experience… toward profound love and acceptance, those who sought truth and forgiveness, those who journeyed inward to find wholeness and their authentic self… those people diminished or eliminated their fear of death. One agnostic Kuhl talked to described how being in nature, being part of life, had always been more than enough for her. Atheists and agnostics should look not up, but around – around to this beautiful planet we’ve had the good fortune to live on, to the people we’ve had the good fortune to love. If spirituality is inner peace, this is a spirituality available to everyone.
WHAT NOW? (actions for mortal atheists)
Accept death, embrace life
Only by confronting the inevitability and uncertainty of death can we truly embrace living. That’s the take home message. We don’t have to wait until we’re dying to accept our mortality, to let it imbue our lives with vividness and urgency. We don’t have to wait until we’re dying to reflect on meaning, to forgive, to find our authenticity, to stop wasting all this precious time. Letting finitude into our hearts now can only serve to make life more splendid, more beautiful, less prone to regret. We don’t have to wait until we’re dying to start living.
IN SUM:
Is this book entirely secular? No.
If I had to describe the book in one sentence? What dying people want (I love a perfectly titled book)
Who should read this book? Everyone who will die.