When Death Is Inevitable, Treat It with Kindness

Whatever is born must end. Death is the conclusion of our lives and the final gate of life that none of us can escape. When faced with the threat of death, treating death with kindness is, after all, a wise choice.

Once I went to Shanghai and made a house call on a patient. She told me that the reason she wanted my treatment was that, when handling the funerals of my own mother and father-in-law, I had acted humanely—unreasonably prolonging their dying moments by futile rescue attempts, thereby adding to their suffering.

She told me she did not expect me to cure her, but she hoped that, at the end, she could leave this world as decently and peacefully as possible, without enduring too much pain.

This patient is very rational. Over the last half year she has given up almost all treatment, taking only some pain-control regimens, maintaining a relatively high quality of life until now, quietly waiting for death to approach. Honestly, even if she had pursued every active treatment, the outcome would not necessarily be better than now. So I deeply admire this patient's reason.

Before my mother died, she already understood that the situation was irreversible. She arranged for the family to prepare her burial clothes and coffin, and calmly accepted death's arrival. She treated her own dying as a grand ceremony like a wedding, carefully choosing what to wear at death and where to lie afterward, with a trace of joyful release. Her mood as she left was like the four characters left by Master Hongyi before he died: Sorrow and joy intertwined.

Before my mother died, though my heart was in agony, I did not insert a single tube into her body, nor did I give her a single infusion of albumin. I knew that had I taken those measures she might have lived a while longer, but that final while would have been extremely painful for her.

She died in my arms. Before she left, mother and son wept a final farewell; the heart-wrenching pain left me wishing I were dead. After she was gone I fainted twice, and I grieved fully for nearly four years before slowly coming out of it. This tremendous blow did not rob me of basic reason, driving me madly to make her suffer more just to save her.

If time could turn back to before my mother's death, I would make the same choice again; I would never prolong her days by adding physical and mental suffering. That she could still go out and play cards a couple of days before dying is the thing that comforts me most.

Before my father-in-law died, I rushed home to be at his side. Before I arrived, a gastric tube and oxygen tube had already been inserted, which made him wretched. At the end, he desperately tried to pull out the tubes but could not.

Seeing this, I myself removed the tubes, using only moxibustion to make him a little more comfortable. Finally he left peacefully. At his death, my father-in-law used the last smile of his life to express his satisfaction with his own dying.

As a physician who treats cancer, patients often leave this world in my hands. Not long ago I went to Bama to treat two elderly patients of mine; they had left the Grade-A tertiary hospitals of Beijing and come to the beautiful, green mountains and waters of Bama.

Medical conditions here are poor; if something goes wrong, there is no time for emergency rescue. But both patients and families have accepted it calmly; if death truly comes, they are ready to accept it quietly. I also admire the choice of such patients and families.

When some patients are about to leave this world, my current attitude is generally not to encourage rescue treatment for them or their families, but to comfort them, help them adjust their mindset, and accept death.

Sometimes a patient is choked by a globus of phlegm; sometimes a patient enters a hepatic-encephalopathy state, raving. Families desperately want to relieve the patient's suffering.

From my experience I tell them that the chance of rescue is negligible; a person leaves the world through just such a choked phlegm or hepatic-coma state. At this moment, preparing a farewell ceremony according to the family's cultural or religious traditions is far more valuable than pumping all kinds of fluids into the patient.

Death is a very important part of our lives. I do not advocate that anyone, before a foreseeable death, be kept in the dark about their coming departure, only to die in haste and panic.

Treating death with kindness is also a necessary part of respecting life. One should die as calmly as possible and as comfortably as possible. If one believes that struggling to block death is the way to love one's family, in the end it may bring one's kin more suffering.

In natural selection there is a cruel fact: some people simply do not reach the average life expectancy and meet death at some stage of life. Facing this, we should strive on the one hand and accept the fact on the other, making some preparations for the coming death.

Meeting death calmly is hard, but a death with preparation is far easier to bear than one without.

Buddhism says people have eight sufferings: birth, aging, illness, death, parting from the beloved, meeting the hateful, not getting what one seeks, and the flourishing of the five skandhas. When death arrives, these eight sufferings interweave and disrupt the whole family's life. At such a time, a rational person in charge should lead the family through dying.

Accepting death and treating it with kindness can ease this suffering and let the dying leave more peacefully. If death is inevitable, do not wage a useless struggle against it; if you must die, then die a little more lightly, and a little more freely!