On Death

I was asked the other day if being diagnosed with cancer had changed how I felt about death. And the answer is no. I do wonder what life will be like for my family and friends, but those thoughts have been with me for longer than I knew I had cancer. I can’t answer for everyone, but death is something I think about rarely. I’m comfortable with believing that death isn’t an ending but a beginning, and I know I have lots of living to do yet.  So I’m not ready to leave this world any time soon. Of course, I probably won’t have any control over when I die.

When I was first diagnosed, I was told that lung cancer isn’t curable just manageable. At that point I was certain this cancer would kill me, and I thought Stage 4 lung cancer was always fatal; the question is just when and how long I could keep it under control. I have since learned that it is possible to have no evidence of disease (NED) after treatment. And I know of some who have been NED for years. But there are also those whose treatment doesn’t work and who die early on with the disease. Part of the problem with lung cancer is it often isn’t diagnosed until the late stages when it has already metastasized. And the traditional treatments don’t always work, or they work for a little while then the cancer becomes resistant. There are some exciting new treatments out there that harness the  power of the body’s own immune system and others that target a particular DNA mutation switch – all fascinating. And options for clinical trials that may not have been available when I was diagnosed, which was just in October of last year.

I remember reading “On Death and Dying” by Elisabeth Kubler-Ross as an assigned book for one of my nursing school classes. Of course back then I had no sense of my own mortality. I saw patients die and I saw patients get well and leave the hospital. I cried with the bereaved families and rejoiced with new parents and the families of those who went home. And the five stages of grief stayed with me from all those years ago. Now I find myself going through those same stages – because those stages don’t just occur after someone dies; they can also be a response to a diagnosis such as cancer.

The five stages are denial, anger, bargaining, depression and acceptance. They do not happen in a linear fashion, so people don’t necessarily go from denial to anger then bargaining etc. The stages can occur in any order, and people can even sometimes skip a stage altogether. Some never reach acceptance. I seem to vacillate between anger and depression with a little acceptance thrown in there every once in a while. But mostly I’m fighting and convinced I can beat this, at least for a while, and determined to live my life the way I want to live it – not the life this cancer wants me to live. I never did just ‘go with the flow’; I was always the one fighting the status quo – and I still am.

14 thoughts on “On Death

  1. 3headedtoad says:

    We should all live that way. Like we know we will die one day, but not today!

  2. This is such a well-written, beautiful, courageous post, Ruth. I seem not to be able to comment any further without sharing that it was the one and only thing that my brother (Gary) and I never talked about in all of the months I was his primary care-giver. Even when he was hospitalized, even when he was in ICU, I could never bring myself to ask him his feelings about death. It has haunted me ever since that in all of those hours of sitting by his hospital bed, I never gave him the opportunity to talk about it. I would have been open to the conversation, but I never wanted to even consider the possibility that he would die. I have often wondered how lonely that may have made him feel, and to this day, I wish I had been brave enough to ask him that question. It still makes me weep to think about it. I think that everyone who faces a terminal – or serious – illness, ought to have the opportunity and safe place/person with whom to have this discussion. You continue to bless us with your courage, and your willingness to share all of these facets of your journey. I’m honored to continue to be on this road with you.

    And as long as we both continue to wake up in the morning to a new day, I continue to celebrate with you the awesome gift of life…living is for now.

  3. Did Gary ever bring it up? Maybe he wasn’t ready or didn’t want to talk about it. My experience in nursing was that until patients accepted that they were dying, it wasn’t something they wanted to talk about. No amount of asking can make that happen. And as I said in the post, some never reach the acceptance stage even though they may seem resigned to the fact that they are dying. Acceptance and resignation are two different things. But that’s a whole different blog post. At least take comfort in the fact that you were there for him.

  4. Thank you, Ruth. I take comfort in knowing that it’s long gone and I allow myself to trust that he’s happy where he is…I can’t go back and change a thing anyway so it’s more important to move on and learn from it. And what I’ve learned from that experience is to be more present and open for others who are struggling with feelings that not everyone is comfortable talking about.

    I don’t know if you intend this or not, but in sharing your journey, you help so much…not just others who are going through similar situations, but those of us who didn’t even know we needed to learn what’s being learned along this way. I’m grateful. And continue to carry you in heart and prayer. xoxoxoxox

  5. 3headedtoad says:

    I didnt discuss it at all until I had kids. Then Maria and I talked about what we would do, how we can prepare and plan for it, etc. I talked to dad about it alot. He knew he was dying, and I think at the end, he was more scared for us than of dying. But, just knkwing that somehow made it easier for me. Not that his dying was easy at all, but knowing he wasnt afraid to die, and him knowing he was dying, made it not so hard.

    I think talking about death takes some of the mystery and fear out of it. Like bringing that shadowy object in the closet out into the light of day. You find out its just a moldy bagel and an old toy guillotine. …

  6. camp2go says:

    Dear Ruth, what an honest and personal answer to the question about cancer and death. Since you were a nurse, you were always confronted with it, … but I know it’s different when you are the one concerned. My father was a doctor and an atheist. But as a patient, he made a roundabout turn in his beliefs. It was magical and beautiful. And it was his comfort.
    I can honestly say after caring for my mother and accompanying her in her old age till death, I have a completely new view on it. My mother taught me so much, and one of the most valuable lessons she passed on to me was her view on death. She had lived to the fullest, and when that wasn’t possible anymore, she accepted it, but felt confined.
    As the years passed, she often said she’s really curious about death, and is ready to go, just to satisfy her curiosity. Haha. That was my Mom. Her positive and almost joyous acceptance of death, as a part of life, has taken all MY prior fears away.
    I believe if I were terminally ill, I would want to talk about death, but in a positive joyous way. While my mother was in the Senior Home, several volunteer ladies came by to talk to her. But they were all so solemn. They were depressing. I hope, when my day comes, I find someone positive and optimistic to help me prepare for the beginning of that new journey.
    I think one needs to choose who to talk about it to. Sharon, maybe your brother sensed that it was too difficult for you to talk to him about it. I know I could not talk to my husband or my sons. They would pull me down. I would want someone like my Mom to accompany me. I truly wish that for everyone.
    And the fact that you don’t feel you need to talk about it,..well Ruth, I would say that confirms your conviction that you WILL beat this! I believe you will too! HUGS!

  7. Thank you, Angelika. I must say that part of what I love about my oncologist’s staff is that they are always upbeat. The nurses in the infusion room are always cracking jokes with patients and with each other. Yes, cancer and dying are serious, but that doesn’t mean we can’t still celebrate life. I think being around solemn people with long faces would bring anyone’s mood down. And yes, I’m curious about death, too, and wonder what I will choose for my next life.

  8. camp2go says:

    That’s what I love and miss about America. It’s that upbeat positive attitude, which the Germans need to learn in such situations.

  9. Thank you, Josh. I’m doing my best. I truly believe that attitude plays a large part in beating it. That and a worldwide network of people who are encouraging me and praying for me.

Ruth passed away from cancer. Please remove from list

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