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How to Enjoy Life When You Know the End Is Near

Here’s what friends with cancer have to say about it

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illustration of woman swinging on clock hand
Jon Krause
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Lately, I've been thinking a lot about death and dying — not in a bad way, but in the scorecard-keeping way of scanning an obituary for the deceased’s age and feeling better if they are much older than me.

I am 73, healthy, and despite my obsession with reading other people’s obits, I swear I am not afraid of death. But I am terrified of the pain, suffering and loss of dignity that all too often accompanies dying. And I do have more than a few friends who are seriously ill. Most have cancer of one kind or another.

The youngest is in her early 40s with two small children, who have never known a time when their mom didn’t go for chemotherapy. The oldest was in his late 70s and still going to work at his law firm every day before his cancer tightened its grip and COVID cautions sealed the deal that he had to stay home. And there’s my still-practicing-until-his-diagnosis dentist, 72, who, upon learning that cancer had riddled his body, told his oncologist he wasn’t all that interested in extending his life if it came at the cost of losing its quality. Instead of debilitating treatments, he grabbed his extended family and their surfboards and went to Costa Rica to catch some more waves.

How do terminally ill people plow past their pain, worry and grief and manage to function like nothing is wrong with them? What degree of compartmentalization is necessary to shelve their illness and not let its trappings color the present moment? How do you enjoy life knowing it’s coming rapidly to an end?

Actually, more people manage it than you would imagine are able to. While fear of death remains a fundamental part of the human experience — and, in the abstract, we dread the idea of suffering and worry that we will face the end alone — a University of North Carolina study shows that those who know their deaths are near don’t actually feel that way.

Researchers “scored” the words used in the writings of terminally ill patients and death row inmates and concluded that the “about to die” used “happier words” the closer they came to their imminent deaths, thus suggesting they had come to peace with their loss of life.

The findings, published in the June 2017 issue of Psychological Science, found that the final blog posts of their subjects were filled with “love, social connection and meaning.”

As my late husband’s caregiver for two years, I understand the value of coming to peace with the inevitable. I just don’t know how people do it. Having seen what death looks like, I can attest that it, and what precedes it, is messy, soul-sucking and riddled with pain and loss of dignity.

And yet I see people who, on a day-to-day basis, manage to still enjoy life despite having a terminal illness. They take pleasure in the small stuff, celebrate what many take for granted, and have figured out that when your time is limited you don’t waste a whole lot of it on the unimportant. Alison Aten Rash, who credits her medical team and God with the fact that she is still alive, is my version of Wonder Woman. She paints and sells her artwork — donating the money to those who need it. She is writing a book about staying grounded while you are told your cancer has returned and spread, again and again. She drives for hours across several states to take her place in what she calls her “chemo chair,” and then schedules family trips to begin the very nanosecond her port is unhooked. Her goal is to stay alive long enough to raise her children and make sure they have good memories. This is a woman who plans and stages birthday parties concurrent with chemo infusions. Rash says that sometimes she walks past a mirror and sees a cancer patient looking back at her. Her response is to just keep on walking.

My friend the lawyer, who was entering hospice as I wrote this, told me that he didn’t actually fear death — and that helped him maintain his balance for the past few years of cancer treatments. He had always been someone who enjoyed the pleasures of life fully, whether they were traveling with his wife, a bottle of fine wine or the joy of a good conversation with one of his many friends.

While cancer ultimately claimed his life, he managed to keep doing the things he loved to do for as long as he could do them. No point in dying before you are dead, he told me.

And my dentist? Geoffrey Bell calls himself the CEO of his health. He maintains a skepticism that doctors have all the answers, and very shortly after his aggressive cancer made itself known, he drew the line about what he was willing to sacrifice just to stay alive. The ability to do the things he loves was not negotiable.

Bell reflected with gratitude on a long and happy life, ticking off the boxes of marrying his sweetheart 50 years ago, loving his patients and dental practice, raising two great kids, surfing and skiing with friends collected across the globe.

Besides, “shouldn’t we all be living as if we were going to die soon? After all, no one gets out of life alive,” he says. “If I simply am able to encourage you to live your life to its fullest potential, then I will have contributed to you.”

Consider it done, Dr. Bell. Consider it done.

I am reminded of my late Aunt Sophie, who lived to be 93 years old, all of it with her dancing shoes on and a handsome man on her arm. When faced with a terminal cancer diagnosis, she made a list of all the books she wanted to read and reread, and asked her doctor if she would have enough time. He told her it depended on how fast a reader she was.

Do you agree with the above? How would you enjoy life if you knew the end is near? Let us know in the comments below.

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