I read this book for two reasons. First, I am working my way through the lesser-known works of EKR's oeuvre in preparation for a class I am co-teaching on death in the Eastern Orthodox tradition at the Orthodox School of Theology (Toronto). Second, my father-in-law is currently in the middle of a long battle with cancer that doesn't have a good prognosis. I was looking for a practical book that would help me navigate communication, and after attempts with less-than-stellar books, I finally just went back to EKR. It's been half a century since she began pioneering a new way through death and dying and her works are still some of the best and most perceptive out there. I will now be recommending this book as a must-read to my friends with aging parents.
It initiates readers into the topic of death / communication strategies through narrative rather than exposition. I could locate myself in the stories, patients, and families that were described; I both related to and learned from their experiences. While many of the chapters deal explicitly with terminally ill children, the core ideas are applicable to a variety of situations involving caregiving, aging, and mortality in the general medical context.
Here are the main lessons I'll be taking with me, to apply to both my father-in-law and my course:
- Let your loved one talk about their sense of mortality in their own time or in their own way. Don't ask how they feel about dying, just ask how they're feeling (or why they seem sad/ upset) and give them the opportunity to bring up what they want to talk about if they want to talk about it.
- If they do bring up a fear of death, or other difficult thoughts, stay on their level. Let them say what they need to say. Don't make things lighter or more serious than your loved one is expressing.
- Anger (at God, death, nurses, you, etc.) can be a good thing. It is, among other things, a sign that your loved one is moving beyond denial, beginning to recognize the seriousness of his/her reality.
- The difference between acceptance (positive/ healthy) and resignation (not such a good sign). And some warning signs.
- The value of symbolic language. Maybe your loved one isn't talking about death explicitly, like you'd like them to. Maybe instead they are talking about a nightmare they had about being left alone, or a memory of a butterfly they once saw emerge from a cacoon. Don't dismiss such "random" comments abut try to be in that symbolic world with them for a moment. Be curious, ask questions, share in their emotional response to the symbol they've brought up. Death is a mystery and symbols are often the only way people can find to make sense of what they are going through. (And the symbols may be allowing them to work through things on a subconscious level as well, which is just as important as anything else.)
Here's to hoping these tidbits will come in handy in the weeks or months ahead.
But already, the book did what is hard for a work on this topic to do: it left me with hope and a greater sense of awe for the human condition of living, dying, and loving those around us in between. If you know someone who is dying--slowly or rapidly--or you are a living, breathing human being who has ever been preoccupied by the topic of death (which is ALL of us), read it.