‘Most people under 60 have never seen a person die and have become fearful of death’

WITH 30 YEARS of experience as an oncology nurse and counsellor of cancer patients facing a terminal diagnosis, I believe many of us, including health professionals, have become detached and fearful of death. It used to be part of life. Not so many years ago, people would die at home with their families around them. Now, during the pandemic, thousands have passed away while their loved ones are forced to whisper parting words into a smartphone.

While some deaths are sudden and traumatic, most are normal and manageable. My book – Radical Acts Of Love – contains 20 conversations with dying patients and friends – all of them on the journey from fear to acceptance.

The greatest gift we can loved ones is to be prepared, accepting when our time comes.

Preparing for death is a radical act of love for ourselves and for those close to us. It is one of the most important and least discussed experiences of our lives.

The first person I saw die was my grandmother. I was 19 years old and she was 81.

She was my father’s mother and lived with our family just outside Glasgow for the last couple of years of her life.

She died of oesophageal cancer, more common in those days because of heavy cigarette smoking combined with her daily tipples of whisky. I wanted to help my mother care for Gran but I felt frozen, unsure what to do, even though I had worked in hospitals for two summers by then.

I don’t remember being afraid of death, rather just curious. She coughed a lot and didn’t talk much. Mum didn’t seem afraid either, just busy.

There were no long heartfelt conversations at Gran’s bedside, nor long bucket lists of activities to be accomplished. There was just the work of dying – for my gran, the patient, and for my mum, the caregiver.

I learned then that most deaths are natural. Not easy, but not necessarily scary; nor traumatic or over-medicalised; not romantic or glorified.

In those days, before hospital or hospice admission was commonplace for the last days or weeks of life, the majority of people died at home. But most people now under 60 have never seen a person die and have become deeply fearful about death.

They have had no role models to show them how to care for a dying person and no confidence in being able to do so. I hope my book will help remove some of the fear and mystery of death.

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♦ give open our and

DANIEL stood in the doorway of my counselling room with his seven-year-old daughter, Emily. “Sorry for the surprise, Janie,” he said, glancing towards his daughter. “Can Em entertain herself in the waiting room while I talk to you?” He looked at me from inside dark circles of fatigue. “My girls don’t

know how sick I am,” Daniel told me on the phone the week before. He’d decided not to tell them the latest news: his cancer had come back with a vengeance and he had only a few months to live.

Being the father of two daughters aged seven and nine was Daniel’s proudest accomplishment.Two days later he knocked on my door, Emily in tow.

She exuded self-confidence, a sign of resilience, a character trait that makes all the difference in the aftermath of a tragedy. She pulled a colouring book and a zip-lock bag of crayons out of her backpack.

“If you need us, just knock on this door, okay?” I pointed to the door of my counselling room. “Your daddy and I will be in there talking.”

A large maple tree against a backdrop of blue sky filled my office window. The tree steadied me for conversations that were not often easy. “My wife and her parents are relying on me to get better. When I talk about dying, they tell me to stop being so negative. They don’t want to talk about death and believe that talking about it will make it happen,” explained Daniel.

When someone directly asks if they are dying, there are choices to make. Slip beneath the words, shift my eyes away from their gaze, succumb to the instinct to protect, to avoid the pain, to say something else, anything else: You can beat this cancer. You’re too young to die. Miracles happen.

You want to echo a family’s plea that death is conquerable, that the sick person just has to find the strength. But in the end, you have to be honest.

Death was already present on the couch beside Daniel and he needed me to respect his capacity to handle the truth. Without respect, there is no dignity.

I exhaled slowly: “It’s not looking you’re going to make it, Daniel.”

The dawning reality that death cannot be like avoided has its own rhythm, its own season, and fruitful conversations about dying happen in their right time.

IUSED TO think it was my duty to guide people towards the fact that death was approaching, even without an invitation. However, over time, I’ve learned my hurry to open up a conversation can frighten a person who isn’t ready. Sometimes the mind never catches up and I have had to learn to accept that, too.

But I knew Daniel was ready to talk from the urgency in his voice and the way he leaned forward. “Is it okay for the kids to see me dying? Would it traumatise them?” he asked.

“It depends on whether the process is an easeful one or not,” I told him. “Most times the palliative care team can settle your