Skyline Happenings

I first met Peter when we introduced ourselves at a musical event in my retirement community. After a bit of conversation, I asked him why he might be considering selling his home and moving to this high-rise in downtown Seattle. That’s when I found out his wife died only a year and a half ago. He mentioned he was exploring death and dying (perhaps as a way of dealing with grief and loss) and had started a Death Café in his home.

I had heard of these meetup gatherings which are posted on the internet bringing relative strangers together in a small venue for conversation. It seemed that Peter was trying something a bit different. He lives in an area of about 450 homes which has its own community center connecting them socially. So, he posted his interest there thus starting his version of a death café in his home—no specific agenda, start at 6:30 PM and end at 8:00 PM. New guests welcome. As the group has grown to about 15 attendees, new friendships have sprouted and some pickleball players have found each other.

Peter read my book, Facing Death, and recommended the group read it. Most did. They’d never had a session as a book club but decided to invite me last week. I arrived at Peter’s lovely home (yes, I’m still driving at almost age 88) and found a lively group, mostly women, but three or four guys. It was 6:30 PM and time to start, but how should we do this?

I told Peter that I’d really like to know what brought people there. So, each person was given “a minute” to say why. As you might imagine there had been loss and grief (even an Oncologist was there), but more often they expressed curiosity about death and all the medical and cultural and unknowns surrounding it. As one said, “It only happens once so I need to know more.”

After those introductions, we discussed aspects of my book and my experiences with patients as they faced end of life decisions. There was concern expressed by many about our health care system, lack of personalization and whether a doctor would really listen to them. We even got into practical matters of what happens to the body in the last few days of life, about who signs a death certificate, etc. Then we touched on voluntary stopping eating and drinking (VSED) and medical aid in dying (MAID) and the POLST form. We talked about advance directives and making our wishes known. At one point I mentioned a statement one patient gave to me to enter into her medical records—and offered to read it aloud.

After affirmation I read: “I have a firm belief that there is a natural cycle of life, that death is inevitable, and that dying should be peaceful, comfortable, at home if possible, and without tubes, artificial nutrition or ventilator support. If I cannot carry out self-care, do not have my usual mental faculties, or have an incurable disease or intractable pain, please treat me with the best care for comfort but not invasive life support care. It is quite acceptable to not offer me fluid and nutrition (unless I request them) and treat me with a morphine drip or sedative as I near death, letting nature take its course. Only in an acute and reversible situation (e.g. trauma) would I want attempts to try to get me back to my present state of health (however, no CPR or ventilators or tube feeding). I do not wish to be a burden to my loved ones, or to spend resources and energy on heroic efforts to prolong my life when my life is at end. My worst nightmare is spending my days with a feeding tube in a vegetative state. Quality, not quantity, of earthly life is most important to me.”

I’ve given many of talks and interviews about our choices at life’s end but have never been with a group like Peter’s “death café” gathering. It was interactive, introspective, serious yet allowing humor, questioning and curious. Peter polled the group and they decided to meet again next week. I was so delighted to meet so many people willing to “stare at the sun.”

It got me thinking. There are a lot of community groups. But how often to we talk about, let alone think about death? Can we be like Peter’s group and bring more of us together. I think it’s important to face death as part of life’s natural cycle. Author and psychiatrist Irwin Yalom stated: “A denial of death at any level is a denial of one’s basic nature and begets an increasingly pervasive restriction of awareness and experience. The integration of the idea of death saves us; rather than sentence us to existences of terror or bleak pessimism, it acts as a catalyst to plunge us into more authentic life modes, and it enhances our pleasure in the living of life.”