While I was in hospital one of the nurses mentioned a patient in the mens’ ward who was 94 and had just undergone an operation very similar to mine.

It got me thinking.  This is not an insubstantial operation and, honestly, the recovery part is a bit pants.  Graft care, swallowing, washing, eating, mouth care, halitosis; general recovery from a serious dose of anaesthetic. Frankly, it’s not for the faint hearted.  So I am intrigued by why anyone who has had a good innings in life – and 94 is good innings – wants to put themselves through this for diminishing returns.  I’m not saying we should not operate on those well enough and keen enough to endure the effects.  But when does life at any cost supercede a dignified death?

Craig and I have first hand experience of this dilemma.  My father was diagnosed, at the age of 57, of non-hodgekinsons lymphoma.   He refused all treatment and marched towards death with his arms wide open and a large smile on his face.  For the last 9 months of his life we put our differences to one side and learned, for the first time, how to be father and daughter.  It was a privilege to be sitting with him throughout his final night, listening to the death rattle, watching his last breath escape from his body, knowing this was what he wanted.  He was better at death than he ever was at life.

By contrast Craig’s father suffered a huge stroke caused by a bleed at the bottom of his brain stem, when he was 82.  Overnight, he went from being a fiercely independent, fit, capable man to being a shell, initially in a hospital bed and latterly at home, where he relies on others to wash him, dress him, take him to the bathroom and attend to all his needs.  He lost his dignity when that stroke took him down, but his will to live, or will to not die, beats very strongly.

And our third personal example is my Papa, who was in his late 80’s when my Nana died.  They were inseparable and I would initially have laid bets that Papa would not be far behind.  Much to my surprise, and his chagrin, he continued to function for the next 4 years.  He cooked and cleaned for himself, and I would often find him in the kitchen trying to recreate his favourite treats from her old cookbook.  But he was lonely and he could not wait to die.  Once he confessed that he would wake in the morning and be disappointed that he was still breathing.  For him, it was not the fear of dying, he was just fed up of living.

And these examples, from the 94-year-old patient to my Papa, cause me to think about the art of dying and how I want to prepare for its eventuality.  Back in Victorian times this was a common conversation to have over tea; but somehow, with advances in medical science and our incredible National Health Service, we may have come to expect a long life as a matter of fact.  I watch my father-in-law and hear stories of older people being kept alive no matter what and I wonder at what cost to our dignity and self-respect?

Given a choice, I would like an elegant death and at broad principle level, I’d rather a shorter life and a dignified death than a longer life requiring medical intervention or care.

Why are we not more accepting of dying as much as we are of the art of breathing?