Thinking about dying?

Tomlin Paul, 50 and living better

Weeks after the thanksgiving service and all had settled, one of my patients called to convey appreciation for advising a few weeks back that her mother was dying and that we had reached the limits with medical treatment and so the inevitable was near....

Facing reality

Do you ever think about your own passing? The reality is that having lived through those earlier adult years, you have now entered a phase where, on average, the chances of surviving to your next birthday will decrease with each passing year. Well, it doesn't mean you are going to die. OK, let me try that again! It doesn't mean you are going to die next year. But with each passing year, that reality gets closer and closer, despite no one knowing the "appointed time". And I am not speaking with any great medical insight or crystal ball; it's just a bit of life's statistics.

Death denial

I can count on one hand patients who have come to me and said, "Doc, I know I am going to die soon," thereby opening the door for a very delicate discussion. The few who have done so were not suicidal but were older persons with serious illnesses who had accepted that their passing seemed really close and that it might be a good idea to talk about and plan for it. Ernest Becker, in his book The Denial of Death, says that one of our greatest needs is to be free of the anxiety of death. Doctors can often blanket that anxiety and can leave you with a kind of feel-good effect as we reassure and even at times sidestep the topic.

Natural fear and anxiety

There is indeed a natural fear of death which all of us experience to varying degrees particularly when confronted with a major illness or threat. In the absence of a threat, if it becomes a daily obsession, having a chat with your doctor should be a priority. But there is always that simple awareness and concern that this life must end one day. This is called 'existential death anxiety' and it's not a disease, just something we all experience. Psychologists suggest that our quest for love and closeness in relationships tied with a bit of healthy denial help to buffer this kind of anxiety and keep us going.

Living longer and better

So, amid all of the challenges in the fifties and beyond, I encourage you to take time to reflect on the tremendous potential and opportunity of this journey called life. Until that day comes, you still have a lot of life to live and you should go use it to the best of your ability without getting too anxious. Healthy lifestyles, the latest technology, new drugs and the research of today can all help you with living longer and better. As far as 'living forever' goes, well, that's worth some more thought before you get to the end of the journey.

Dr Tomlin Paul is a family physician at Health Plus Associates in Kingston; email: yourhealth@gleanerjm.com.