Last week I talked about a hospice patient who, on the surface at least, seemed to be nowhere near “terminal” status.  Although she had several organ systems that had failed and could relapse at any time, she remained upbeat and even told me that she had hopes of getting well.

I was surprised.  Most hospice patients are in a great deal of misery.  Of course they’d all jump if a painless cure were offered to them, but at their stage of illness they know everything feasible has been tried.  I had never seen a hospice patient speak to me with so much optimism.

For a couple of reasons this concerned me.  In the past I’ve treated people who tell me that they want to die, yet when I start a lengthy conversation with them I’ve found out that the reason they have chosen death is that they’re concerned that they have become a physical and financial burden to their loved ones.  At this point their sense of duty leads them to believe that they should let go, not to relieve their own suffering but to be considerate of their families.  I always watch out for these cases, and I try to make sure that they’re making a reasonable decision.

I’ve also seen many people who are overwhelmed enough by an acute episode to lose objectivity.  Even if I feel that it’s unlikely that the serious disease will return, and I tell them so, the fear of another long stay on the disabled list drives them to ask for deliverance by death.

After giving it some thought I decided that neither of these situations applied here.  I remained a bit confused over the case until I shared last week’s blog with a High School friend that I recently reconnected with.  She’s a very spiritual person and understands human nature well.

“Of course she wants to get well,” she said.  “We all want to get well.  We want another chance; maybe we didn’t do everything we wanted to…”

She went on to describe in beautiful prose what suddenly hit me after I read her first sentence.  Life is very hard; even for someone who was raised in a loving family and who had the best education available, I must acknowledge that it hasn’t been easy for me.  Now think of someone who’s had to struggle since birth; then think of all the times a cruel twist of Fate made matters much more difficult.  The husband’s illness that maybe could have been diagnosed sooner; the child who made a wrong turn and was crippled in an accident; so many things that could have turned out different if only we had made a decision we postponed…

Of course we want another chance!

As we get older the reality of death looms larger.  The need to be able to part with our bucket list close to empty can be distracting; even overwhelming.  Many people develop vague symptoms, maybe as a way to coax or lead the doctor into finding that condition that could end their lives before they’re done with it.

How can we come to terms with our mortality?  Is there such a thing as a good death?

I think it’s important to be honest with ourselves.  We cannot possibly get everything done.  I could not take every class that I was interested in when I was in college, nor have I been able to master all of medicine.  I know there have been gaps in my performance as a father, and I’m sure my wife has many times wondered why in the world she picked me as a partner.

I’ve come to terms with the fact that I’ll never be able to say: “All is well.”  I try very hard to serve; I do everything possible to be in touch with beautiful things and righteous people.  Every once in a while I still find myself yearning and longing for whatever happens to assault the “wanna” part of my brain.  At those moments I take a deep breath, think about all that has been done, and I flash a resigned smile at the awesomeness and futility of the human condition. 

It’s the best we can do.