Introduction
Many people live in dismay of the natural, inevitable death. Ira Byock, a prominent palliative, and hospice care expert, articulates the enhancement of care at the near end of life. In his book, Dying Well of 1998, he recounts passages of his previous patients to emphasize the need for hospice care and emotional peace for the dying. The several case studies he explains bear a very emotional effect on the reader. Through the several chapters, he elaborates on handling the terminally ill’ emotional and physical pain and emphasizes the gravity of our time before the uncertainty embraces us. Throughout the context of the book, Byock sets out the idea that no one is requisite for a painful, lonely death. As the book pictures us the stories of love and reconciliation, we discern that much emotional advancement at the near embracement with death can make life more refined and meaningful for a happy ending. In each story, the message cut across the board is the same, that death is a natural part of life that does not have to be physically and emotionally strenuous for anyone. Despite the fear of uncertainty in dying, death should not be painful physically or emotionally, nor should it be a lonely process.
Contents of the Book
As a prominent hospice director and a palliative care physician, Byock uses real-life stories of patients and families that he has covered in his years of palliative care. Death, however, can bring different emotions depending on how a person copes with the loss. Byock documents several stories of patients in his hospice program. He starts with the story of his father, Seymour Byock, who has pancreatic cancer during his medical training. He teaches us about living and the final inevitable death through the first story of this father. He further narrates the stories of his palliative care patients in a compassionate way. These individual stories convey different lessons to us. Anne- Marrie Wilson’s story gives the steps toward a peaceful death. Although our thoughts about death suck and the actual death suck, the culminating stories of Douglas Kearny and Wallace Burke enlighten us on how to find dignity despite suffering in death.
Among the most excruciating stories is that of an eight-year-old Michael Merseal under the palliative care of a single father and a dedicated hospice team. The story has also been featured in a documentary, Letting Go: A Hospice Journey (Beresford & Connor, 2020). However, I do not underestimate the emotional load tagged with each story and the essential lessons that Boyck intended them to have. The chapters that follow on facing unbearable pain and letting go, growing on, carry very moving stories and lessons. Boyck wraps up these experiences with a topic on the social-cultural dimensions in considering an okay death. Additionally, the appendix in the book’s final part involves the reader through the Question and Answer section. The contents of this book clearly state the purpose of the book.
Purpose of the Book
Ira Byock has a mission to ensure that his patients do not die a lonely, painful death. Through the stories of the different families in his book, he sought to give us general advice and the different experiences that may accompany those last moments. Dying is not fun, and none of us wants to taste it. Even a single brush with the gut-wrenching death scares the hell out of some of us. The everyday fear of dying makes the topic of death and people nearing it to be shunned probably at the moment they need us the most. However, Byock’s book assures us that death can be a reasonably good, calm, and memorable natural experience for all of us. For example, one case study advises that when choking to death is of concern to a patient, a feeding tube or eased malnutrition can be the convalescent way to a less painful ending. This book sets precedence for us who want a peaceful death for our loved ones and ourselves.
Themes
Byock’s chief idea is how to make a better, less painful exit in this world. Throughout the moving stories of the patients, he describes to us that a long life is not necessary for exchange for suffering in pain. Physical pain is much easier and possible to relieve through medical appeals. Emotional pain is much more complex and has diverse reactions depending on how resilient we are to ordeals (Neenan, 2017). Modern technology medicine can ease the physical pain of a terminally ill patient. Hence, he slams the thoughts of some doctors that they cannot do anything more to assist a terminally ill patient. Something can always be done to ease the patient’s suffering. Family relationships are also of much gravity in relieving the emotional pain of the dying person. The family’s decisions concerning the patient should always be in the premier interest of the comfort and peace of the loved one. Since the family is a pillar to everyone, a good death must enable reconciliation and forgiveness between the convalescent and the family. Our personhood, character, and attitude are equally important to a family. We should mend our ways to live ethically with others instead of waiting until we are incapacitated to bond.
Strengths and Weaknesses of the Book
Though a medical practitioner professionally, Byock excellently interweaves all challenges faced by a patient ranging from medical challenges to interpersonal and intrapersonal challenges. The book vividly brings us different dying experiences and helps us discern expiry more positively. He successfully brings us a different approach to our ultimate exit with a more reconciling heart to other people. Moreover, he drives for positivity in all life viewpoints, no matter the difficulty of the situation. This book is an excellent source of inspiration for those facing the problematic imaginations of their last moments and for the relatives and close friends of terminally ill patients. It opens our eyes to the various roles of hospice programs in our society in enhancing a more comfortable exit in this world.
However, Byock fails to express the need for the spiritual advancement of a patient during those final moments. Spiritual suffering is a significant hurdle toward a peaceful ending. Given that death has a spiritual connection, the person’s spiritual advancement in palliative care should be considered (Shaulov et al., 2019). Moreover, given that this book is more than two decades old, society has since evolved, and thus this book becomes irrelevant in some instances. Improvements in medical technology have since refined our hospitals, hospice, and palliative care to enable patients’ peace of mind. Byock also insufficiently addresses sudden deaths, which are dominant in this world.
Lessons
Through some of the passages of his patients, we see the successful reconciliation efforts between family members at the last moments. We are posed with the question of whether we must wait until the last minute to make peace with family. We should therefore strive to live positively with others through forgiveness and reconciliation. We should also maximize our hospice to those close to us to ensure a high-quality end of life (LeBlanc et al., 2018). Moreover, this book advocates that a good death should be at home, surrounded by family members, which is a consideration for most American citizens (Bhatnagar & Lagnese, 2021). Family members play a senior role in enhancing the peaceful death of their loved ones. The value of cleaning loose ends when adversity is close to us is also of much gravity. Perhaps the most prominent is that we need to be ready to heal emotionally by letting go of our feelings for our departed ones, which can help us live with the fact that death is a natural process and is here to stay with us.
Ethics and Dying Well
The moral principles we are accustomed to in life affect whether death will be a perfect or a bitter experience. Our relationships with others should always be progressive. How Byock criticizes some physicians shows that there is still much refinement needed in the healthcare sector. For instance, Byock illustrates that some practitioners may offer excessive chemotherapy to treat cancer to an untreatable terminal tumor. The healthcare sector needs to be refined to enhance comfort and respect the patient’s needs. Euthanasia does not adhere to ethics. Instead, we should ensure that nature gets its way. All we can offer is give ethical assistance towards a peaceful death.
Conclusion
Dying Well of 1998 is a beautiful book with very moving real-life empathetic stories. Though the thoughts of death are scary to some extent, reading this book helps to overcome the fear of death since death is an individual natural experience. However, though death is a private personal experience that no one can explain better, it does not have to be lonely and painful. The experience can positively affect how we see it through palliative care and hospice service. This book is suitable for everyone to read for a better personal deliberation of a peaceful death when our time to offer or be offered palliative care comes. Through proper assuasive care and hospice assistance, dying well is, in fact, a real option.
References
Neenan, M. (2017). Developing resilience: A cognitive-behavioral approach. Routledge. https://doi.org/10.4324/9781315189178
Bhatnagar, M., & Lagnese, K. R. (2021). Hospice care. StatPearls [Internet].
Beresford, L., & Connor, S. R. (2020). History of the national hospice organization. The hospice heritage: Celebrating our future (pp. 15–31). Routledge.
LeBlanc, T. W., Egan, P. C., & Olszewski, A. J. (2018). Transfusion dependence, hospice services use, and end-of-life care quality in leukemia. Blood, The Journal of the American Society of Hematology, 132(7), 717-726.
Shaulov, A., Baddarni, K., Cherny, N., Shaham, D., Shvartzman, P., Tellem, R., & Clarfield, A. M. (2019). “Death is inevitable–a bad death is not,” an international workshop report.
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