Category Archives: Death – Essays of the Dying

Essays of the Dying: More From Oliver Sacks

I have written previously about the impending death of the great  neurologist and author Oliver Sacks. Recently he published another moving piece in the New York Times. In it Sacks writes of a most profound experience when “…  far from the lights of the city, I saw the entire sky “powdered with stars” … My sense of the heavens’ beauty, of eternity, was inseparably mixed for me with a sense of transience — and death.”

And while he has been soothed by hundreds of letters from well-wishers,  none comforted him as much as seeing those stars. Sacks attributes this to the comfort he has always found in the non-human. As a little boy, numbers were his friends, and later the periodic table became a source of good cheer. I have never read anyone who wrote about the periodic table with such affinity.

And now, at this juncture, when death is no longer an abstract concept, but a presence — an all-too-close, not-to-be-denied presence — I am again surrounding myself, as I did when I was a boy, with metals and minerals, little emblems of eternity. At one end of my writing table, I have element 81 in a charming box, sent to me by element-friends in England: It says, “Happy Thallium Birthday,”a souvenir of my 81st birthday last July; then, a realm devoted to lead, element 82, for my just celebrated 82nd birthday earlier this month. Here, too, is a little lead casket, containing element 90, thorium, crystalline thorium, as beautiful as diamonds, and, of course, radioactive — hence the lead casket …

NEXT to the circle of lead on my table is the land of bismuth: naturally occurring bismuth from Australia; little limousine-shaped ingots of bismuth from a mine in Bolivia; bismuth slowly cooled from a melt to form beautiful iridescent crystals terraced like a Hopi village; and, in a nod to Euclid and the beauty of geometry, a cylinder and a sphere made of bismuth.

Bismuth is element 83. I do not think I will see my 83rd birthday, but I feel there is something hopeful, something encouraging, about having “83” around. Moreover, I have a soft spot for bismuth, a modest gray metal, often unregarded, ignored, even by metal lovers. My feeling as a doctor for the mistreated or marginalized extends into the inorganic world and finds a parallel in my feeling for bismuth.

I almost certainly will not see my polonium (84th) birthday, nor would I want any polonium around, with its intense, murderous radioactivity. But then, at the other end of my table — my periodic table — I have a beautifully machined piece of beryllium (element 4) to remind me of my childhood, and of how long ago my soon-to-end life began.

For Sacks molecules transcends our ephemeral lives—for him molecules are Platonic forms. Sacks has found solace in something real but eternal, in the very elements of our universe. This is a great insight.

I only hope that I can face death with such equanimity.

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[Books by Oliver Sacks]

On the Move: A Life

The Mind’s Eye

The Man Who Mistook His Wife For A Hat: And Other Clinical Tales

A Leg to Stand On

Hallucinations

Oaxaca Journal

Awakenings

Musicophilia: Tales of Music and the Brain, Revised and Expanded Edition

Essays of the Dying: Laurie Becklund

The former LA Times staff writer Laurie Becklund died on February 8 in Hollywood, CA of breast cancer. Before she died she penned a moving essay about death and dying. (In the past few days I have discussed a number of “essays of the dying.” They can be found here, here, and here.) She also gave a beautiful speech about her experience of dying of cancer in the video below.) She begins her essay:

I am dying, literally, at my home in Hollywood, of metastatic breast cancer, the only kind of breast cancer that kills. For six years I’ve known I was going to die. I just didn’t know when.

Then, a couple of weeks before Christmas, a new, deadly diagnosis gave me a deadline. No doctor would promise me I’d make it to 2015.

Promise me, I told my friends and family, that you’ll never say that I died after “fighting a courageous battle with breast cancer.” This tired, trite line dishonors the dead and the dying by suggesting that we, the victims, are responsible for our deaths or that the fight we were in was ever fair.

Promise me you’ll never wear a pink ribbon in my name or drop a dollar into a bucket that goes to breast cancer “awareness” for “early detection for a cure,” the mantra of fund-raising juggernaut Susan G. Komen, which has propagated a distorted message about breast cancer and how to “cure” it.

I’m proof that early detection doesn’t cure cancer. I had more than 20 mammograms, and none of them caught my disease. In fact, we now have significant studies showing that routine mammogram screening, which may result in misdiagnoses, unnecessary treatment and radiation overexposure, can harm more people than it helps.

I don’t know enough about breast cancer to know if these latter claims are true, but I do know that this essay differs in tone from the other essays of the dying I have recently read. Her tone in defiant, and her defiant plea falls on my receptive ears. After all, I consider death to be a great evil, and I have argued that death should be optional.

Her tone resonates with the spirit of Philip Appleman, a contemporary poet about whom I have written. Appleman says: “Our anger at death is precious, testifying to the value of life; our sorrow for family and friends testifies to our devotion.” Her tone also reminds me of the immortal lines of Dylan Thomas: “Do not go gentle into that good night. Rage, rage against the dying of the light.” Here is Thomas reciting his famous poem:

Becklund says that dying of the disease has been like “playing Chutes and Ladders, a childhood board game whose outcome is based on rolls of the dice. As for a cure, she says poignantly: “It will come too late for me. But it is possible to end the game: Patients shouldn’t have to climb up ladders and fall down chutes.”

Essays of the Dying: Emily Debrayda Phillips

Emily Debrayda Phillips, 69, died on March 25, 2015 of pancreatic cancer. She wrote her own obituary within a few days of her February 24 diagnosis. It begins:

It pains me to admit it, but apparently, I have passed away. Everyone told me it would happen one day but that’s simply not something I wanted to hear, much less experience. Once again I didn’t get things my way! That’s been the story of my life all my life. And while on that subject (the story of my life)…on February 9, 1946 my parents and older sister celebrated my birth and I was introduced to all as Emily DeBrayda Fisher, the daughter of Clyde and Mary Fisher from Hazelwood. I can’t believe that happened in the first half of the last century but there are records on file in the Court House which can corroborate this claim.

I admire people who are brave and funny at the same time. Humor is a wonderful way to deal with the tragedy of death. Emily continues by describing small details from her life. Elementary school teachers who inspired her to become a teacher, playing with her sisters, getting married and having two loving children, and the joy she has had in being “Nana” to her grandchildren. She apologizes for her shortcomings, but displays a proper self-love too. I’ll let her speak for herself:

I’ve been a devoted daughter, an energetic teenager, a WCU graduate (summa cum laude), a loving wife, a comforting mother, a dedicated teacher, a true and loyal friend, and a spoiling grandmother. And if you don’t believe it, just ask me. Oh wait, I’m afraid it’s too late for questions. Sorry.
So…I was born; I blinked; and it was over. No buildings named after me; no monuments erected in my honor.
But I DID have the chance to know and love each and every friend as well as all my family members. How much more blessed can a person be?
So in the end, remember…do your best, follow your arrow, and make something amazing out of your life. Oh, and never stop smiling.
If you want to, you can look for me in the evening sunset or with the earliest spring daffodils or amongst the flitting and fluttering butterflies. You know I’ll be there in one form or another. Of course that will probably comfort some while antagonizing others, but you know me…it’s what I do.
I’ll leave you with this…please don’t cry because I’m gone; instead be happy that I was here. (Or maybe you can cry a little bit. After all, I have passed away).
Today I am happy and I am dancing. Probably naked.
Love you forever.
Emily

Essays of the Dying: Grief Therapist David Malham

The New York Times recently published a moving essay by the grief therapist David Malham. The seventy-three year old Malham has been recently diagnosed with ALS. He begins his essay:

I would not have chosen A.L.S. at the Pick Your Disease store, but there are worse things that can happen and worse ways for a life to end. The very fact that it was happening to me and not to my family was itself a relief. Navigating one’s own pain or fear is much easier than navigating a loved one’s.

Malham says he turned his back on saying “no” and asking “why me?” Instead, he asked “what now?” He found himself comforted by the fact that he had a good life, and a loving family. He doesn’t want to die, he said, but it isn’t fair for a man to cry foul when he has had such a good life. What most worried Malham was that his wife would be alone. A worry he conveys with humor:

I became preoccupied with how she would manage a post-David existence. True, she’s always been the one who handled the bills, balanced the checkbook, managed the investments, addressed maintenance issues (her father introduced her to the mysteries of things mechanical and electrical), kept the house organized (parties and special occasions are planned with the attention to detail Rommel displayed in his desert campaign), and all the while prepared terrific meals. Yet I couldn’t help thinking that not since biblical times has woman had so laudable a husband.

Concerned about his wife, Malham began a “strategy of pre-emptive therapy.” He told his wife stories of widows who thrived. But soon she began to resent the stories, telling her husband, “Stop it. If you die before me, I will grieve and I will survive. If I die before you, you will grieve and you will survive.” This brought about a revelation to Malham: “That’s when I finally accepted that trying to protect her was not only wrong, it was impossible. Grief, after all, is the price we pay for love.”

He now knew that his wife would grieve no matter what, but she would survive because she was resilient. “That’s not to say it’s a quick and easy task. It’s not that grieving suddenly ends and the person forgets and moves on. No, what happens is that a weight that initially feels unbearable becomes, in time, manageable. The grief becomes compact enough, with the hard edges removed, to be gently placed in one’s heart.”

You can read the entire essay here.

Essays of the Dying: Neurosurgeon Paul Kalanithi

The thirty-seven year old Stanford neurosurgeon Paul Kalanithi died from cancer a few weeks ago, but not before he made the beautiful video above and penned a moving essay to his infant daughter. (Here is his obituary from the Stanford Medicine news center.)

What I found most moving was Dr. Kalanithi’s beautiful description about the inexorable passage of time. Its fleeting, ephemeral nature. No wonder the Buddhists think of change as one of the 3 marks of existence. There is something about one’s impending death that reveals something essential about a person’s nature. (I have written about this previously regarding the last words of Roger Ebert and Oliver Sacks and David Hume.) And the video and essay reveal Dr. Kalanithi to have been a thoughtful, loving, and courageous man.