Understanding Death

A friend of mine recently asked me, as a lung cancer patient, if I had any insight into the process of dying. This seemed reasonable to me -- in the United States alone, lung cancer claims an estimated average of 433 lives each day, though this is ever-so-slightly down from a decade or so earlier. This disease kills more people than the next three major cancer killers combined and has shown increasingly less reliance on known risk factors. It turns out that the biggest risk factor involved with getting lung cancer is, well, having lungs. And if you are one of the more than 220,000 or so Americans who gets diagnosed each year, you learn to live with the thought of death in the back of your head quite quickly.

In the US alone, it averages out to a death about every 3.3 minutes. That is well over 150,000 annual deaths, and of those, we expect about 72,000 to be women (as compared to just over 40,000 due to breast cancer).

Living beyond fear

That does not mean lung cancer patients have to live in fear. Quite the contrary, actually; the more that is understood about lung cancer treatment, the more opportunities are visible on the horizon. People are getting diagnosed earlier, more treatments are becoming available, and there is more hope for patients than ever before. In many cases, oncologists are beginning to treat lung cancer as a chronic condition rather than a terminal one.

Still, death is a personal issue and one that most lung cancer patients consider whether they are ready to or not. Because of the well-known and quite dire outlook, it is difficult not to be reminded of our individual mortality when receiving the initial diagnosis. It is an open door to depression, anxiety, and even fear. Whether we choose to keep that door open and stare into it, or choose that entrance to begin our journey through treatment, or to seek out another door entirely is all up to the individual (perhaps with a little help from the doctor, family, and a social worker or counselor).

Repriotizing my time

I chose not to live in fear of death, though I understand it is entirely possible my years will be cut short by this disease. Rather, my focus has been on trying to get my living in order; priorities that had slipped aside are being put back in place, time with my child is bumped up ahead of less important obligations, but busy work and organizational things that I might have put completely aside in the past have taken on a new relevance because, when it is my time to go, I don't want loose ends getting in the way of celebrating the life I had. And every few years, as I have been fortunate enough to add them in, I find that I must also take some satisfaction in revising the mundane legal documents that will make life a bit easier for my family when I am gone.

Embracing death as part of life

Two years after my own diagnosis, I met an eight-year cancer patient online who was then in his final months of treatment. He had lived optimistically as long as he could, far outliving his initial prognosis, but fully aware that he had run out of treatment options and it was simply a matter of time. We talked at length about his legacy -- he organized a charity for disadvantaged children, though he had none of his own -- and what he felt most important among the gifts he would leave behind was his example of embracing the inevitability of his own death without fear or regret.

Our culture has a uniquely difficult time with death, hushing it up and keeping it out of sight. But death is just as natural a part of life as birth and something that should be spoken of more openly. By being aware of it and allowing it to be commonplace, the associated anxiety, fear, and depression we often experience will be minimized. Coping with the final days of loved ones or ourselves becomes easier when we can openly and honestly discuss the process.

Preparing for death while remembering to live

After all, there are practical considerations to be addressed. Whether the patient will die at home or in a care facility, how pain will be managed, which treatments or for how long might intervention be used to prolong life, are all legitimate issues that can be worked out well in advance so that the family or friends can focus on simply being there with the patient at the end.

As for the actual process of dying, I suspect that it is unique for everyone. The few deaths I have been close to had little in common, except for the end result. The thing I hope for is a peaceful resolution to a satisfying life experience. Personally, I work for that by being as open as I can be about what I am going through and trying to be there for others as much as possible. Death is going to happen, but the moment of now is still about living. And it will be until it's not.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.