We all know we are going to die, but few of us really believe it. We avoid thinking about death because of the fear of what we may encounter in that foreign and unfamiliar territory. As a result, far too many of us make unwise choices and experience unnecessary suffering and distress at the end of our lives.
I know this because I am a doctor whose patients all die. I am a hospice physician; my focus is on the care of the terminally ill. This field is rewarding, fulfilling, frustrating, humbling, and challenging, and its greatest rewards lie in the conversations with and the lessons learned from these people facing the end of their lives, who are figuring out what is essential and real, and who have nothing to lose by being honest. The greatest wisdom I have received from them is the simplest of lessons, the realization that, just like each of my patients, I will die, and there is nothing I can do to change that fact.
In survey after survey, Americans report that, when the time comes, they want to be able to die at home, surrounded and cared for by those closest to them, relieved of pain and other distressing symptoms, and coherent enough to say good-bye, heal relationships, create a legacy, and find peace. But there is a persistent disconnect between this idyllic image and what so often occurs, death in an intensive care unit, drugged to prevent fighting the tubes, machines, and procedures, and mostly alone. We may say that we want to die on our own terms, but by not considering and establishing what those terms are, we end up clicking the “Accept terms and conditions” button without reading the fine print.
I am convinced that if we honestly face our mortality, we will make wiser decisions, die with less distress, and live the remainder of our lives, whether days or decades, more fully and with less anxiety. If our society adopted a similar, more mindful outlook, we would make wiser and more just policy decisions, and debate the issues with a bit less hubris. This is why I wrote my book, Dying with Ease: A Compassionate Guide to Making Wiser End of Life Decisions, and it is the foundational thesis for my blog and future projects.
My writing is informed and inspired by what I have learned and experienced in caring for the dying, and by insights provided by millennia of human thought and creativity: myth, philosophy, sacred texts, literature, arts, and popular culture. These often reveal that the misinformation and mistakes of the present are largely the result of collective forgetting of what our forbearers knew; I enjoy finding out that my latest revelation isn’t really that new, after all, and then bringing those thoughts to my readers.
I have been doing the work of care for seriously and terminally ill for over three decades now, first as an oncologist, then transitioning to hospice medicine. I have been honored by the trust placed in me by my patients and their families, and by the recognition of peers and colleagues. I was particularly humbled when, in 2016, the American Academy of Hospice and Palliative Medicine named me the 12th annual recipient of the Josephina B. Magno Distinguished Hospice Physician Award. And in January 2019 I fulfilled a lifelong dream of appearing on JEOPARDY! (I came in 2nd). Of course, all of these pale beside my real roles in life, that of son, husband, father, and grandfather. I look forward to you joining me in this exploration and conversation.
Books by Jeff Spiess
Rowman & Littlefield