May 21, 2014

“All stories, if continued far enough, end in death, and he is no true-story teller who would keep that from you.” ~ Ernest Hemingway, Death in the Afternoon.

Death and dying are difficult, sensitive subjects and yet this isn’t the first time I’ve written about candor and its relevance here. I’m not morbid (I don’t believe), but I do believe habits of candor make us more comfortable in conversations about uncomfortable things.

CBS Sunday Morning recently did a segment called “Documenting a ‘Good Death.’ ” It was the story of how photographer Joshua Bright captured the final months of 78-year-old John Hawkins’ life. Hawkins, a New York psychotherapist, had decided to forego treatment for the lung disease that would claim his life, and was under hospice care. The photos were featured in the New York Times and show Hawkins at home, surrounded by flowers, friends, and sunlight, and seemingly at peace. His passing is described by those closest to him as a “good death” – the kind of death more than 70% of Americans say they want, and yet, only 1 in 4 actually experience. It’s hard to understand how something this important can fall so drastically short of expectations.

As part of the segment, CBS’ Susan Spencer interviewed Dr. Jessica Zitter of the Highland Hospital in Oakland, CA. It seems a great piece of the puzzle in dying a good death is about doctors “being candid with patients,” Zitter says, “Giving them the information they need to make the hard decisions.” Zitter goes on to admit she hasn’t always been candid with her patients, acknowledging this is something she believes many doctors struggle with, “not wanting to be the bearer of bad news – I regret it”.

Zitter and other doctors struggle with candor (in a way that many of us do) at moments of high stress and emotion, with a lot at stake, and with really dire outcomes on the line. Can you hardly blame them? Many of us have a hard time being candid with our family members about just taking the trash out.

And yet, we have to expect and require more, especially in these conversations about the end of our time on earth. It is truly a matter of life and death, spending the remainder of one’s life in ways that are the most fulfilling for the dying and those that surround them. Could there be any other path than one of complete candor?