September 19, 2019

Why Is It So Hard to Talk About Death?

“Standing under the canopy, hiding from the scorching sun, I listened to stories of my grandfather. Meanwhile, my grandmother stared aimlessly ahead, her dementia shielding her from her husband’s body — neatly tucked inside a wooden box. I had met my family in San Diego to mourn my grandfather’s death, but confronted with my grandmother’s foggy-eyed gaze, I found myself wondering what the end of her life would look like.

As a family medicine doctor, I knew what conversation was needed. I also knew the challenges of initiating such conversations. The week before, I had seen a 95-year-old gentleman have his ribs crushed and crumpled like papier-mâché during CPR because there was no documentation indicating he wanted anything differently. I remember sitting anxiously the month prior with a family trying to decide whether to “pull the plug” on their comatose father/husband, uncertain of his wishes, having never had that conversation.

These conversations are hard, but they are immensely important. Regardless of how healthfully we live or how much medical care we receive, we will all die. Yet, understanding this intellectually is vastly different from truly feeling it; raw confrontation with our own mortality is frightening. Many of us live in denial about death — shying away from discussing it — and many medical professionals act as if death is a problem to be solved, rather than a process to be lived. Consequently, while 92% of people believe talking with their loved ones about end-of-life care is important, only 32% of people do so. Similarly, while 97% of people say it’s important to put their wishes in writing, only 37% of people have such written documentation.”

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