I have to admit I always try to steer away from any uncomfortable thoughts about death concerning myself or my loved ones, and I have realized that I have never given a thought, let alone done any of the five things recommended by the coalition Dying Matters to both live and die well. They recommend writing your will, telling loved ones your wishes, recording your funeral wishes, planning your future care and support, and registering as an organ donor. I am perhaps the product of what is in many ways a “death denying society.”
After attending an evening lecture and panel discussion chaired by the BBC Social Affairs Correspondent Alison Holt at the Royal College of Physicians, as part of Dying Matters Awareness Week 2014, I became more persuaded almost to the point of feeling guilty that my bucket list should not only include the things that I see as part of making the most of living well, but also everything else that relates to dying well. In other words, embracing life to the full does not have to exclude planning our final moments. I heard in the panel discussion that not planning for death could be counter productive and could subsequently end up causing even more distress for relatives.
I was particularly keen to hear from Kate Granger in person. Kate Granger is a doctor who has been specialising in elderly medicine in Northern England. She was diagnosed with a rare and aggressive form of sarcoma about three years ago. Through social media, particularly Twitter, she has opened an unprecedented and prolific debate about death and dying which has garnished attention and admiration from all around the world. The impact of this movement has been such that according to Philip Pearson, a consultant respiratory physician in Plymouth who was one of the panellists, she’s about to become the first ever trainee in the almost 500 year old history of the Royal College of Physicians to become a fellow, a distinction that until now was restricted to doctors who have been fully fledged specialists for at least three years.
Fiona Hicks, a consultant in Palliative Medicine at the Leeds Teaching Hospitals, and another of the panellists, said that it is shocking that something that should be a common courtesy such as introducing yourself to a patient had to become a campaign ((#hellomynameis—previously covered in another BMJ blog) to generate impact. We seem to have lost the personal touch in medicine. Nevertheless, I enjoyed hearing from Kate, in a short film that was projected, that the prospect of a short life expectancy has made her compile an extensive bucket list and try to live life to the full, as well as gain appreciation for the small things in life, like seeing cherry blossom, spending time with friends and family, or watching her nephews grow up. But I felt uncomfortable learning that she plans to tweet from her deathbed (using hashtag #deathbedlive) which reflects her incredibly open and honest approach to dying that also incorporates humour.
Finally, I had no idea that we are apparently already entitled to a digital life after death, through what is known as a “digital legacy service.” Mayur Lakhani, the chairman of the National Council for Palliative Care and Dying Matters Coalition said that there are companies that send messages to selected people on our behalf after our death. Having realized that I have used the “d” word so many times on this blog, I’d like to finish off on a lighter note and attempt to steal a smile from you by sharing a little joke I learned at the lecture. So, what do you call getting sick at an airport? The answer is: terminal illness.
Tiago Villanueva is the editorial registrar, The BMJ.