Nov. 9, 2021

9: What is a Good Death?

9: What is a Good Death?

We often refer to the idea of a "good death" without really digging in to what that means for us. But being clear about it is critical when it comes to completing an Advance Care Directive.

We often refer to the idea of a "good death" without really digging in to what that means for us. But being clear about it is critical when it comes to completing an Advance Care Directive.



I don't know if you can hear it in the background. But that's a whole lot of rain outside.



Before I dive in today, I just want to acknowledge something that's come up when I've talked with different people who have listened to past episodes. – Which, by the way, thank you for listening to past episodes, I really, really appreciate it. And I super appreciate hearing back from people about what occurred to them, and what questions they have and all that. So thank you, it's really awesome. – A few people have talked to me about the fact that they get overwhelmed while they're listening to this, or that, it just feels like wow, I'm sharing so much information in, like, a single episode, which is true. It's– often there's a lot. But some of the episodes are still pretty short. And it still feels like a lot. And after thinking about it, I realized that this may be coming up, because it's naturally pretty emotional, to think about your own death, especially to think about the impact that your death will have on the people that you love, all around you. And I'm asking you to think about really hard things that are generally pretty emotional. And maybe hearing me talk about this also makes you think about people you've loved who have died. And then you start thinking about them, and I'm still talking in your ears. But now you haven't actually heard what I've said for a little while. And then you come back in and you're like, "Aah, that was so much!" That might be happening. I wouldn't be surprised. Maybe it's happening now, even as I'm talking about it. 



And I just want to remind you that this is a podcast. You can pause it. You can stop it. You can decide to save certain episodes, to listen to later, when you're ready, or maybe when you have enough time to think about it. And also, you can go back and re-listen to episodes, you can go back and hear what you might have missed. Even more than that, you probably want to go back and listen to other episodes. And you might hear something different in it, you know, when you listen back. And you'll probably hear different things also because your life changes. And you've learned things in between or maybe you've had some experiences that now inform your understanding of the kinds of topics that I'm talking about. I mean, heck, I'm even hearing different things when I go back and listen to interviews that I did a year or two ago. You know, those things are really hitting me differently now. And it's not just because those were interviews from before the pandemic, and now the world looks different. (Although it really does.) But also, it's just I've learned things. And so now I can understand some things better. Or I hear something and oh, I now I have different questions about it than I did the first time I heard it when it was just new. So I find the topic of death in general to be extremely rich. And that I can learn so much about myself and other people and about relationships and about how to live and about so much of all the things that we do while we're here on this earth. All of it can be affected by what we know and how we think about our own deaths and the deaths of the people around us. So if you're starting to experience some emotional stuff, listening to this show? Cool. I mean, seriously. Cool. I welcome that. And I hope that you do too. And I will take no offense, if you need to pause it. I won't even know that you did it. Just take care of yourself. Because that's really, really important. 



And I'm saying all of this, because today I actually want to get into a topic that may be quite emotional for some people. I'm going to be talking about the concept of a "good death." So I just want to tell you that up front. And you'll make decisions for yourself about what that means for you and when you want to hear this. Or how you want to hear it. Or how many times you want to hear it. Alright. Enough preamble. Here comes the sting. 





Hello, and welcome to Dying Kindness, the podcast for people who are going to die someday. I'm Cianna Stewart, and I'm going to die someday. You will too. So let's all learn what we need to do and make some key decisions before we die in order to be kinder to those will leave behind. I believe we should write these decisions down and collect them into one place, what I call a Death Binder, you can get a template for your own Death Binder and more at my website, On behalf of the people who love you, I thank you for taking care of them by thinking ahead. And now on with the show.


[music ends]



Today's episode is going to be a little different, because I'm just going to talk off the top of my head about this concept, the concept of a "good death." It's something that we say a lot, and we hear a lot. "Oh, this person had a good death." Or, "I want to die a good death." A lot of the things that are underlying whatever it is you have in your mind as a good death are going to come up for you when you start filling out your advanced care directive, and you start having conversations with your family. Or maybe you're already having these conversations with your family. But maybe you're not really fully explaining what you mean by a good death. Or maybe you haven't really asked them what they mean, or what they think they heard about what you said. So many times we toss around phrases, and think that the other person understands. And this is one that I think is very important for you to get curious about, to get detailed about. Because it's going to mean a lot and a lot of decisions hinge on what everyone's assumption is about what a good death is. So in service of high quality conversations, and well crafted Advance Care Directives, I'm going to be posing a bunch of questions. They may bring up some stuff for you. You may want to pause and think about it from time to time. Or you may just want to let these things all in and then sit down and journal about them afterwards. Or maybe you've already thought about what a good death is. You know, I'm not going to push to say that you're going to feel something emotional on this. You may or may not. I'm not going to make any assumptions there. But I just want you to be aware, because I know that it can be hard. 



So often, when people use the phrase, "a good death," they're thinking about dying when they're old. They say that they want their death to be peaceful, at home, maybe die in their sleep. A lot of times we also talk about having our loved ones around us as we pass. You know, certainly I've heard many people talk about that amazing moment of experiencing somebody crossing over. One moment, they're with you, and you know that they're alive. And then you're there in the moment when they actually die. That can be a profound moment. And it's one that will not be experienced by anybody if you die in your sleep. You know, that's– that's just you alone, having that experience. And maybe it's you not even experienceing– we don't know. You know, we don't know what it's like to die in your sleep. Maybe you're not even aware that that's happening. That might be a good death to you. But it also probably means that you're not experiencing the love of the people around you. You know, you went to sleep. Maybe it was you go into sleep like any other night. 



So often we think about having enough time to say goodbye. And that also kind of is predicated on the fact that you know that this is the time that you have left. And so that means in general, that you are living with an awareness of your imminent death. Situations where there's imminent death also generally involve pain, discomfort. The conscious awareness of parts of your body dying. So that would be in conflict with what some other people say they want their deaths to be, which is quick. Or even more that they're painless. You know, dying painless is generally achieved–or can often be achieved–by taking a lot of painkillers that will also generally render you pretty out of it. Like, you're not aware of what's going on around you. And then you just need to balance, well you know even as you're filling out the forms, the Advance Care Directives, and all of those other things, talking to your loved ones, you need to start knowing how to balance and how to express like, just how painless, just how aware, do you want to be around you? How are you going to balance those two things? Like how which, which takes priority, in what moment? 



Also, when people say that, they hope that their death is quick? Well, the quickest deaths are often accidents. And if it's an accident, then you don't have time to say goodbye to people, because you didn't know you were going to die. It was an accident. So how does that go together? You know, do you want to know that you're going to die? Meaning that you're old, and your body's falling apart. Or that you have a terminal diagnosis. That is one way that people know they have X amount of time left to say goodbye. Because they can feel death coming into their bodies in some way. Or they've been told by their doctors, what the statistics are for people who have had their conditions in the past and how long they have to expect to live. But that's not quick. And it's often not painless. 



Sometimes, people say that, you know, when people die doing something that they love, like a sport or die for a cause or something like that, that that's a good death, because they died doing something that they loved. Again, though, that's usually an accident. They probably didn't go out there expecting to die. So they may or may not have said all that they need to do before they went in to do that thing. 



You know it kind of invites the idea that you want to live every day as if you've said all the things that you need to say to the people who you want to hear them. And can you live like that? It'd be pretty awesome if you could. And it's also very difficult to keep that in mind as we go through our day to day. You know, people, people say that they want to die without regrets. Again, that's kind of counting on that you know when you're going to die. Or that you live every day without regrets so that you're prepared. If you ever have an accident, you might still then be able to die without regrets because you live every day in a way that you don't regret. 



Ah, the deepness of thinking about death and how it affects how we think about our life. This is one of the things that's amazing to me about holding death conscious in our minds, is how it affects the decisions that we make about how we live. 



Some people think that a good death is to die heroically, to die in service of some great cause or while you're doing something really heroic. Often, though, that's very far away from dying painlessly. A huge percentage of heroic acts involve doing something that is extremely frightening or extremely painful, putting yourself consciously at risk. So would you rather die heroically or die painlessly? Because you probably can't have both. 



I hear people talk about that they want to have dignity, as they get older as they die, that they want to die with dignity. Feeling a loss of dignity, often comes along with having the body fall apart so that you become more dependent on other people or on equipment to be able to do certain things. Maybe there are things that you used to be able to do when you're younger, that you can't do any more. Are you willing to ask for help? If you're not, or if it feels like accepting help is a loss of dignity, does that mean that it's better for you to die perhaps a little bit on the earlier side than is absolutely necessary in order to preserve your dignity? I don't think there's a wrong answer to that. But I do think there's a high value in thinking about it. 



We also often talk about not wanting to be a burden on others. But then again, it's really hard to live alone, if you're starting to have some issues with your body or your mind. So do you accept help perhaps a little bit earlier so you could get used to those systems? So that you can set up new patterns so that you're not a burden on your friends and family? Would you lose some time with your friends and family, some closeness with them, by doing that? Or would you be sparing them the kinds of things that would actually make it hard for you to stay close with them? I don't know. But it's a question worth asking. What does it mean to be a burden? What is a burden? We're living longer. And our bodies haven't really evolved to support these extended lifetimes. It's great that we're living longer. And also, it's hard that we're living longer. How do we live in the face of these long lives? 



What does it even mean to live? Like, what is a good life? Not just what's a good death? Are you okay with dying, say, after you've achieved a lot or had a great impact on the world? Then again, we've all heard stories of great leaders, and big movers and shakers, who were actually estranged from their families, or were just really distant even if they weren't estranged. They just weren't around, because they were focused on doing the thing that the rest of the world valued and saw having a great impact. But is it more important to you to be a good parent, or to be a good child, to be a good sibling? You know, do you want to have a greater amount of impact on a fewer number of people, or a more distributed impact on a larger number of people? They're both good ways to live. But they don't often go together. Because we're all still limited in time. 



I don't know how many of you are fans of Neil Gaiman but I do think a lot about the character Death from the Sandman comics, and, and Death's response when asked, "How long do I get?" And the answer is, "You get what everyone gets. You get a lifetime." I think it's really important for us to think about how do we want to use that lifetime? And to share our vision for how that lifetime would end. When that lifetime would end. What we are looking like, feeling like, experiencing. How we're thinking at the end of our lives. Who we're surrounded by. What we're doing. How aware are we what we're doing? How do we impact everyone around us? These are important questions. I'm thinking about them. I imagine you are to, you certainly will be when you fill out your advanced care directive. I'm glad you're here to think about them with me right now.





That's it for today. I hope that this episode was helpful. If you find this podcast useful and want to support it, I ask you for two things: Please tell someone about this show. And also send me a question or a comment to let me know what can help you in your process. You can do that and find other ways to support the show at dying kindness, calm. Thanks. The theme music is by Blue Dot sessions. Everything else was done by me. Until next time, I'm Cianna Stewart, and I'm going to die someday. Who knows when or how? It's the greatest mystery there is. 


[music ends]



Today's death reading is from "When Breath Becomes Air" by Paul Kalanithi. 





I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die. But I didn't know when. After the diagnosis. I knew that someday I would die. But I didn't know when. But now I knew it acutely. The problem wasn't really a scientific one. The fact of death is unsettling. Yet there is no other way to live.