Straight talk about death...

March 9, 2010

No, this is not one of those dreams of mine. One has to be a bit serious once in a while, you see. So, let me give it straight but in small doses so you can stop yourself from feeling overwhelmed.

I often ask people young and not so young what kind of death they would like to die and almost everyone blurts out something like this: “I want to die in my sleep”; “I want to die a natural death at 80”, “I want a peaceful death without any illness or disability.”  Sounds good, right? Just one look around and we know that this hope for a ‘good death’ is many a times reduced to wishful thinking, that’s all. Well, there is nothing wrong in aspiring for a great ending.  However, given the harsh reality of today, there is wisdom in hoping for the best but also in being prepared for the worst. 

So, how does one prepare for the worst case scenario, you may wonder. It can be done and it is too darn important. Many things in life are uncertain and we do not know what lies ahead but one thing is certain and that is death. Everyone who is born has to die whether we like it or not. In our attempts to blindly ape the western way of life, we are not too far from becoming an ‘age-defying, death-denying culture.’ We conveniently use terms like ‘passed away’ and ‘expired’ when we refer to someone’s death. It is about time we learnt say the ‘D’ word without hesitation. 

As a child I was too afraid of death of loved ones as well as my own death. I didn’t quite like attending funeral services, because I remember crying and wailing made me very uncomfortable. As years rolled by, I discovered I’m much more at ease talking about death than most of my counterparts. Today, due to my engagement with hospice work, I can confidently think about my own funeral (like I did in my last posting) without any qualms. Part of my job is to assist people in having a good death despite their debilitating illness or other painful realities.  

Fear of death and death anxiety are common seen in people of all ages. They are more intense in patients who have been given a death sentence- Yes, that’s what it is. It was not too long ago that folks used to dread using the ‘C’ word and even when someone did have cancer, they hushed it up -‘shhh, don’t even say it lest you’ll catch the bug”  Times are different now, for, there isn’t a family that is not affected by Cancer either directly or indirectly. I am not immune from this dreaded disease either. I now know that not all cancers are preventable and most cancers attack you when you least expect them. I guess that’s why they are called ‘silent killers.’  

What makes it worse is that in India, due to ignorance and lack of awareness most cancers are detected in the advanced stages when treatment is not an option. Some cancers can be detected early due to the symptoms they manifest no doubt, but in most cases however, the person is completely oblivious to the minute changes that occur in the body until they become malignant or reach the point of no return. 

Diagnosis of Cancer is often done after much prying and prodding. Then they cut and discard that which is not needed and finally radiate and pump chemicals into the body to kill the unwanted demons.  Just when the family has been drained psychologically, spiritually and financially, comes the final verdict like a bolt of thunder- “Sorry, we’ve tried everything medically possible and there’s nothing else we can do.” At this point the patient and the family feel all alone- ‘we have to fight our own battle now.’ 

“I will never see my son graduate from college” or “I will not be able to hold my grand-child in my arms” are some painful facts people have to reckon with after they receive the death-sentence.  “Why me?”, “What have I done to deserve this?” are questions which cannot easily be answered. People diagnosed with this dreaded disease as well as their families go through shock- ‘May be it is a mistake’, ‘I cannot have cancer’, ‘may be the biopsy results are wrong’; or denial- ‘My mother is such a wonderful human being, this is not fair’. Folks take their own time to transition from the state of shock, anger and denial to acceptance and when they do, they are at peace- with themselves, their creator and their loved-ones. They admit “I am going to die.”; “I have something for which there is no cure”, “I have to get ready to say good bye to my family.” Assisting them to get to this juncture is what a hospice or palliative care team does on a daily basis. 

We hear motivational speakers and spiritual gurus talk about living well or living one’s life to the fullest.  Believe me, there’s nothing wrong in it. My philosophy is that if you prepare people for dying well, they will invariably start living well too. A good death is therefore closely related to a good life.

By the way, have you ever written your own eulogy? That would be a good exercise to do if you’re afraid of death. Write your own epitaph or the newspaper announcement of your own death and before you know it, you will be a pro on thenatology (i.e., the art and science of death and dying, in simple words). 

Having been a witness to all the commotion that takes place after death in the line of work I am in, I tell you, it is not too late to start planning if you have not already done so. A lot of misunderstandings, fights and arguments can be prevented if you make your wishes known in advance. Advance Directives are a set of instructions you leave to the family or your caretakers to help them make decisions about your life when you are not in a position to make those decisions yourself. For example, if you are in an accident and are brain dead and do not want to be hooked to a bunch of machines and tubes that perform all the vital tasks like breathing for you, put it in writing! You will save your loved-ones unnecessary burden of guilt and heart aches.  

Tell your family about your final wishes- Tell them if you want to be cremated or buried; let them know if you wish to donate your organs after death. Truly, we don’t need any of those after we die. If someone can see through your eyes, why not give them the gift?  Won’t it be cool to be the light of someone’s eyes? Consent from loved ones is also needed (in India) if you plan on donating your body or other organs after death. Talk to the family and convince them before you put it in writing, it is the family or the legal guardian who has to fulfill your final wishes after you’re gone!

Planning for your end does not make death come sooner; it only means you’re well prepared when it does happen. So, start thinking about your own mortality, make plans and jot them down with all the intricate details. This will give your loved-ones enough time to dwell on all the fond memories they have of you instead of running around (like a headless chicken) making arrangements! Why rob them of quality time they can spend reminiscing about the deceased loved one? 

Dr Lavina Noronha - Archives :  

by Dr. Lavina Noronha
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Comment on this article

  • Shahina , Lakhani

    Sat, Oct 08 2011

    A wonderful article Dr Noronah. It is true that when we prepare for a good death we automatically begin living a more empowered life. There is a great need for helping people in this direction with compassion. There is also a dire need to train palliative care and hospice healthcare professionals so they can help clients live a meaningful life and as a result experience a peaceful death. Shahina

  • Julie, Mundkur/Doha Qatar

    Wed, Jun 30 2010

    Very nice comment Antony. Keep it up.

  • adshenoy, mangluru

    Sat, Mar 13 2010

    Mr Siddiq, its a mistery.

    Mr. Rasquinha, do we need elaborate preparations for forhtcoming death? Or its the American way? just curious.
    "Suicide Tourism" it boggles my mind. Is swissin death tourism business?

  • John Borgiba, Pernal

    Sat, Mar 13 2010

    Reading the article and the comments i am urged to write as to why god has been mentioned here. why not the devil. it is always gods call even if the person prior to death was leading a life not in agreement with societal norms or what we told " sinners". death is end of life and to say there is life after death is in my opinion to achieve mental self satisfaction , just as we do with prayers.

  • Siddiq, Sharjah

    Fri, Mar 12 2010

    We all believe God has created us, he send us to this world and then call us back to him. Why is he doing it. What is the purpose of sending to this world for a limited period and calling back again. What does he wants us to do in this world. Is it that what we all doing ie. educating ourself for wisdom or to earn living, marrying, producing new generation and then passing the time nearing the death if it does not come premature or is there something he really wants us to do????

  • Max E Rasquinha, Mangalore/Houston, Tx

    Fri, Mar 12 2010

    Thank you, Dr. Lavina, for your timely and thoughtful talk on death. This is a topic that need be tabled at every possible opportunity particularly in a family circle so that the topic not only makes us feel humbled but also allows us to remain united and well prepared, because each of us have to say "good bye" sooner or later. The very thought of a death encourages you to prepare your Will well in advance, so that all the future plans are clean and in tact, and well documented.

    Nowadays Switzerland encourages you to visit their country as a "suicide tourism" so that people in their terminal illness can travel to Switzerland legally and their own day and time to bid farewell to the world in the presence of their family members.  I have even prepared a suitable spot to be buried in "Mungalooru" so that my wife and my family can have a glympse at my grave from one of the seven balconies of my home nearby thru the help of a binocular. I have even selected the music to be played at my funeral and I have even taped a message of my own to be read after the funeral eulogy.

    These are all plans worth documenting well before hand so that when times come nearer to our destiny no one has to decide for you but you yourself with a bold voice to say "I am ready, my Lord, there is nothing else that I want in this world. I have paid all my dues and have fulfilled my mission - please let me enter into your Kingdom". Amen.

  • j dsouza,

    Fri, Mar 12 2010

    Most people are living dead. man without education is all most is like animal. and educated man with out enlightenment is all most dead. jesus , buddha and lots of people achieved enlightenment. lets all achieve it and not be dead.

  • shravana, Mulki

    Fri, Mar 12 2010

    Dear Lavina,X'cellent article.I liked it.Since your a hospice,have you ever given a thought to" after death.".what..if people knew..would not fear to die.Death is not an end but a new are a right person to put it across.Need some info,see for your self,
    All the Best,

  • Uday Kulal, Mangalore

    Fri, Mar 12 2010

    Good article. I would want to donate my organs when I die.

  • Peter L. Alphonso D Costa, Bondel/Mangalore

    Wed, Mar 10 2010

    Antony t de souza/karkal/qatar, I did read Psalms 139, Yes vs: 13-16 speaks about death conveniencinlgy, nothing to fear about death. Good. Keep sharing always.

  • Naveena Pais, shimogga

    Wed, Mar 10 2010

    Wonderful article. It touched my heart deeply because i lost my loving husband with this incurable disease. It is true a cancer patient and his famil undergo this trauma. But death is not an end it is a new beginning. God says in Isaiah 55, "Come, everyone who thirsts, come to the waters and he who has no money, come, buy and eat! Come, buy wine and milk without money and without price.
    Isa 55:2 Why do you spend your money for that which is not bread, and your labor for that which does not satisfy? Listen diligently to me, and eat what is good, and delight yourselves in rich food.
    Isa 55:3 Incline your ear, and come to me hear, that your soul may live and I will make with you an everlasting covenant, my steadfast, sure love for David.

  • Gregory Castelino, Udyavara/New Zealand

    Wed, Mar 10 2010

    Let us read in the Gospel of John what Jesus spoke about the death.John 5:24 I tell you the truth,whoever hears my word and believes him who sent me has eternal life and will not be condemned he has crossed over from death to life.Hebrews 2:14 goes on to say,Since the children have flesh and blood, he too shared in their humanity so that by his death he might destroy him who holds the power of death-that is,the devil-and free those who all their lives were held in slavery by their fear of death.Rev 1:18 am the Living OnI was dead,and behold I am alive for ever and ever.And I hold the keys of death and Hades.

  • Jawar D'Souza, M'lore/Doha

    Wed, Mar 10 2010

    When one is born he comes with two certificates one is the Birth certificate and the other one is more guaranteed certificate of Death. Donating the organs is not a bad Idea, when it will help someone.

  • R.T.SHETTY, mangalore

    Tue, Mar 09 2010

    Aantony.t.desouza.very true comments.keep it up

  • jane dsouza, kallianpur

    Tue, Mar 09 2010

    Death is a reality n it comes at a destined time thats a known fact, but before we go lets do something better n think about the positive aspects, well written.

  • Antony T. D' Souza, Karkala / Qatar

    Tue, Mar 09 2010

    Birth and death are the two faces of a single coin. Therefore,as birth, naturally one has to talk about death too. It is a reality one has to face sooner or later - Can't shy or run away from it. Incase, if some one has prepared to die any time, any moment, it indicates that he has built a solid philosophy about his own death. He does not fear even while awaiting death due to a fearful long illness like cancer. To achieve this one has to read Psalms 139, thereafter he will be mature enough to face death all days along.

  • adshenoy, mangaluru

    Tue, Mar 09 2010

    DR. Lavina. Doctor death? Just kidding doc.It is said death and taxes are unavoidable, well taxes perhaps.We are all born to die. Death is inevitable part of life.
    Do we really die, perhaps the body but we live on among the known.
    Leave good memories in life. Live a good life and God will take care of death. Dont plan for your death. Its natural and timed by the creator when ones mission is over.Live life only to die. all the fame and game in the world not worth it because one day we got to go.

  • R.T.SHETTY, mangalore

    Tue, Mar 09 2010

    Sister lavina.hats off to u once again for the wonderful article.this is one of my favourite subject.according to shastra life &death is two faces of one leads to another.shastra saying we have never born to die.whatever is visible in the world is maya.our body is always changing.body is created by has to distroy.whatever is mixture has to destroy.only soul will b immortal.

  • Jimmy Noronha, Belloor/Lucknow

    Tue, Mar 09 2010

    I can’t see any better advice one could espouse than the one advocated in this article for all the mortals regarding planning death. It is human nature to shirk from the idea of death and things attending upon it, as very aptly admitted by the writer herself when she sincerely admits, ”I didn’t quite like attending funeral services because I remember crying and wailing made me very uncomfortable.” It does discomfort most, if not all, at least, as I see it through the time slid by.
    So, it’s best that one adheres to what is wisely suggested by the writer by her words of wisdom, as it is bound to do a world of good not only to the one who died but also to those who would follow suit sooner or later. Perhaps one would feel lighter if one peers at what Shakespeare said in Julius Caser way back that : ‘….It seems to me most strange that men should fear/Seeing that death, a necessary end/Will come when it will come.”

  • Rohan Noronha, Udupi

    Tue, Mar 09 2010

    Nice article...stop thinking about death and think about the positive aspects of life.

  • Antony Crasta, Mangalore/Sydney, Australia

    Tue, Mar 09 2010

    Dr. Laveena : You seems to be obsessed with death and death related subjects. I know death is inevitable and it is a dreadful thought for anyone even to think of the possibility of facing it, yet being a Medical Doctor, the subject of death should be least in your mind, as you should be striving and directing all your efforts and resources to cure your patients and veer them away from the face of death.

    Relax, Doctor, I was just joking, for everyone knows that even Doctors can do very little when someone is diagnosed with a disease like malignant cancer. By the way, you have been down to earth in expressing your views on the subject, though it is a unpleasant one, and also the advice given for planning for one`s death is quite valuable and should be seriously considered.

  • Swathi, Mangalore

    Tue, Mar 09 2010

    Dr.Lavina, this is the essence of spirituality. Contemplation on death makes us be aware that life is short and thus we can live it sweet and meaningful too. Well written and simply superb! Thank You

  • Nithyananda Beskoor, Udupi,Dubai

    Tue, Mar 09 2010

    Death Be Not Proud - a poem by John Donne
    Death be not proud, though some have called thee
    Mighty and dreadfull, for, thou art not soe,
    For, those, whom thou think'st, thou dost overthrow,
    Die not, poore death, nor yet canst thou kill mee.
    From rest and sleepe, which but thy pictures bee,
    Much pleasure, then from thee, much more must flow,
    And soonest our best men with thee doe goe,
    Rest of their bones, and soules deliverie.
    Thou art slave to Fate, Chance, kings, and desperate men,
    And dost with poyson, warre, and sicknesse dwell,
    And poppie, or charmes can make us sleepe as well,
    And better then thy stroake why swell'st thou then?
    One short sleepe past, wee wake eternally,
    And death shall be no more death, thou shalt die.

  • R.T.SHETTY, mangalore

    Tue, Mar 09 2010

    Dear lavina.what a fantastic article.hats off to u.yaksha(yama)asked dharmaraya what is surprise ?in this world.dharmaraya told him everday people have seen many death in front of them,even though every single person thinking i will not wii not come to me)

  • Charles D'Mello, Pangala

    Mon, Mar 08 2010

    Good article Dr. Laveena. Most of us fear death. At young ages although it is less, as the age progresses fear of death is more. One day everybody has to die whether we have completed our responsibilities or not. As the author said informing the family about after death wishes is a good thing. When the life insurance is made, keeping a set of claim documents is ready also a good, particularly when our responsibilities are completed to our satisfaction.

  • JOILET LEWIS, Katpadi/ Dubai

    Mon, Mar 08 2010

    Dr. Lavina, nice article, yes death is man's greatest enemey, when our loved one dies it is very difficult to cope up. Almighty God Jehovah assures us in the Holy Scripture very soon he will remove death forever. Even Gods son, Jesus Christ while he was on this earth said in Gospel John (chapter 5 verses 28 & 29) people who are in memorial tombs will rise up, and he showed this resurrecting few people during his time. In future Jesus will do this in a larger scale when he comes into kingdom power in Paradise earth (God will transform this very earth into a paradise ) which will come very soon. When we see around the world, all these terrible world conditions gives us indication that we are living in the last days, and very soon Almighty God is going to destroy all the wicked ones, and only one who does Gods will/follow his & Jesus teachings (which is recorded in the holy scriptures) in our day today life will get saved and inherit this beautiful paradise earth. (John 17:3 & Rev 21:3-5 ) So If anyone wants to live forever in Paradise earth without seeing death, now is the time to take necessary steps.

  • sathu/karkala,

    Mon, Mar 08 2010

    Great thoughts, simply written. Pinch of satire/humour missing, unlike the last article?

  • stevan, Loreto/UAE

    Mon, Mar 08 2010

    The aticle is superb. Its good to prepare for Death and after death donating our organs is giving a rebirth to someone. I vehemenetly appreciate your efforts to host it. All the best Dr Lavina noronha

  • Lydith Pinto, Mangalore

    Mon, Mar 08 2010

    Lavina, this article is really good and it is time people have a positive outlook to life and death. I also would like to add that people should remember that frivolous expenditure on a funeral should be stopped and people should not only donate their organs to give quality life to others, but also the money they would spend on a funeral to better the lives of the living. I think this way they will be remembered better
    Lydith Pinto

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