Dying well: How to face death with faith and not fear
Retired intensive care doctor Professor John Wyatt shares his unique perspective on what it means to die well
Dying isn’t exactly an easy topic, and when you saw the subject of this article you may have been tempted to turn the page and find something less, well, morbid. But I want to persuade you that thinking about dying does not need to be all doom and gloom. In fact, dying can bring wonderful and unexpected opportunities; it can be a time for joy as well as tears, even a strange adventure, a once-in-a-lifetime voyage of discovery.
If you ask people how they would like to die, the most common answer is: “I want to die in my bed while I am asleep. I don’t want any warning; I don’t want any premonition or any awareness. I just want to go out suddenly, like a light...” The strange thing about this is that if you were to go back 500 years and ask people the same question, you would generally find a consensus that sudden, unexpected death was the worst possible way to die. To be catapulted into eternity with no chance to prepare yourself, no chance of saying goodbye, no chance to ask forgiveness from those you have wronged, to ensure your loved ones are provided for, no chance to prepare yourself to meet your maker...what a terrible way to die.
A medical approach
Death and dying used to take place in the home. At the beginning of the 20th Century, fewer than 15 per cent of all deaths occurred in an institution, such as a hospital or nursing home. But now more than 50 per cent of people in the UK die in a NHS hospital, and it’s actually very unusual for people to die without warning in their sleep.
Death has become medicalised. When we become seriously ill, we expect to be admitted to hospital. It’s the medical team who tell us what treatments are available for our condition, and the natural assumption is that we will just accept whatever therapies are offered. The battle continues until the medics decide that further treatment is hopeless. And then we die. Death has become defined by what doctors can and cannot do.
Modern medicine can offer us the idea that death can be kept at bay indefinitely. Of course, we know that death cannot be held back forever, but we prefer to focus on the positive. Death is an enemy to be fought, and we will keep on fighting to the end.
Author Rob Moll quotes a funeral director in Wheaton, Illinois, who said that the most common Bible verse that families put on funeral announcements or read at services is: “I have fought the good fight” (2 Timothy 4:7).“Except they are not talking about spiritual things,” says Moll. “They mean this person tried every medical option to stay alive.”
This medicalised view of death has only been around for the last few decades. At the beginning of life we are learning that intervention isn’t always the best way to go. There is now an increasing movement away from the medicalisation of childbirth and towards a more natural approach. But when it comes to dying, the medics are still very much in control.
I think we have a lot to learn from Christians of previous generations. Back in the 14th and 15th Centuries there were a series of documents which were circulating among Christian people called ‘The Art of Dying’ (Ars Moriendi in Latin). They were self-help manuals for ordinary people. A modern equivalent title would be Dying for Dummies! The great fear for many Christians of this era was that they might face death without the presence of a priest to guide them through the process. So these documents helped ordinary people prepare for death, with vivid woodcut images of a dying person on a bed, surrounded by angels and demons who were involved in protecting or attacking them.
It’s interesting that Christians of this era saw preparing for death as an important part of Christian living. As Christian physician John Dunlop put it: “One thing I have learned is that dying well is rarely a coincidence. Rather it results from choices made throughout life. After all, dying well is nothing more than living well right up till the end.”
As an intensive care doctor, I have had the privilege of supporting people through the process of dying and bereavement for more than 30 years, and I have been able to see at first-hand the extraordinary opportunities of dying well. Here are some of the possibilities and opportunities:
An opportunity for finding forgiveness
An older woman, whom I shall call Mary, was diagnosed with a very advanced and rapidly progressing form of cancer. She’d had a difficult life and her daughter described her as “an intensely angry person” with a sharp and destructive tongue. Mary had always rejected and rebuffed any attempt to talk about God.
But then came the sudden news that she had advanced cancer and only weeks to live. Sitting in the radiotherapy outpatient department, she turned to her daughter: “I’ve got three questions for you: How can I forgive?
How can I be forgiven?
What is heaven like?”
For the first time Mary talked about her hidden secret of being abused as a child, and the shame, hurt and anger that had dominated her life. Mary’s daughter gently shared about Jesus and the forgiveness he offered. From that moment in the outpatient department, Mary’s life changed. “My mum was remade two weeks before she died,” said her daughter. “I’ve never seen anything more radical in my life.”
Mary was admitted to a local nursing home for terminal care. In the place of previous bitterness and resentment there was thankfulness. Sitting with her grandchildren, she was weeping: “You’ve got no idea what it feels like to pray for the first time.” Mary died barely two weeks from that conversation in the outpatient department, with her daughter holding her hand and singing hymns to her.
Afterwards, the nurses gathered in her room. “This was an amazing lady...She was so grateful for everything, so kind, so gentle. She had no fear about dying...We’ve never seen anyone die like this.” And her daughter was able to share with them something of the grace and forgiveness that her mother had discovered in those precious last days of her life.
Dying well is an opportunity to find forgiveness, to be remade, to become a “new creation”, in the words of the apostle Paul (2 Corinthians 5:17).
An opportunity to be thankful
This may seem rather paradoxical but many people have found that the process of dying can teach them more about being thankful. Often it’s about learning to be thankful for the little things. Being thankful for the tiny gifts and graces of everyday life – a beautiful flower in a vase, a welcome cup of tea, the sound of birdsong, the smile of a friend. Most of the time we just don’t notice these things – our lives are too busy and we’re too preoccupied. But dying is an opportunity to learn.
Here are the words of a younger Christian, Ruth van den Broek, who was facing a life-threatening illness: “When it comes to dying well, gratitude has been one of the most transformative things for me. Gratitude for my body despite its brokenness, for my medical team despite their limits, for the decay of my lungs because it makes me notice and appreciate most of my waking breaths. A while back I started praying before I took medications, the way I do before food: ‘Lord, thank you for these medications and for the people who invented, prescribed and prepared them.’ I began to see them as the blessings they are. Gratitude has changed so much for me, even though I’m still not great at it.”
An opportunity for rebuilding our relationships
In order to die well, we have to be at peace with God and at peace with the most important people in our lives. One of the strange and wonderful things is that a dying person can have a special influence on others – they are able to bless their loved ones by strengthening and, where necessary, healing their most significant relationships.
Dying well can be an opportunity for broken relationships to be healed and restored, even after many years of fracture and hostility. And it’s an opportunity for good relationships to be made stronger, more open and more honest. It’s a chance for sharing from the heart, and for saying sorry and thank you to those who are closest to us.
An opportunity to learn about letting go
Dying well is an opportunity to let goof tasks that will never be completed and to hand over responsibilities that we can no longer maintain. It’s a chance for accepting that God is in control of our lives.
But letting go is not as easy as it sounds. It is very noticeable that many older people find it extremely difficult to let go as they approach the end of life. They have learned to be independent and not to rely on handouts; they’ve worked and struggled to be self-sufficient. They hate the idea of depending on other people, of ‘being a burden’. It’s no wonder that they find it difficult to give things up.
But it seems that it is God’s plan, as we come to the end of our lives, that we should be gradually detached from earthly attachments and responsibilities, so that we can prepare for the next phase of the journey. For now, we are being called to focus on our Lord. It is he who will close our eyes and it is he who will awaken us from sleep.
The biblical view of death
It’s very striking that the New Testament rarely speaks of believers in Christ as “dying”. Time and again the phrase that is used is that believers “fall asleep”. Is this just a gentle phrase intended to shield us from the brutal reality of death? No, I’m convinced there is much more behind those words.
There’s a very real sense in which Christian believers do not really die. That terrible enemy, death, has in a sense already been absorbed and destroyed by Christ. That’s why Jesus could say to Martha: “I am the resurrection and the life. The one who believes in me will live, even though they die; and whoever lives by believing in me will never die. Do you believe this?” (John 11:25-26).
In Christ the sting and power of death has been ultimately weakened and life has triumphed over death. The point about sleep is that however long a period of natural sleep lasts, the person is still there, intact and unharmed. You only have to touch them to know they are still there. But while they are asleep, the sleeping person is inaccessible. They are alive, safe but unreachable.
So when we fall asleep in Christ, in some mysterious way we remain alive. Christ holds our very being, our real self, intact and unharmed. Nothing can harm those “who have fallen asleep in Christ” (1 Corinthians 15:18). We don’t need to grieve hopelessly about those who have fallen asleep because Jesus is going to wake them up again and the person will still be there – they are safe.
But there’s another truth here. It seems that many Christian believers are anxious and fearful about the process of dying. What will it actually feel like to die? It’s easy for an overactive imagination to come up with all manner of horrors and nameless fears. And it has struck me that in his grace and compassion, our heavenly father allows us to practise what it is like to die as a believer and follower of Christ every single night of our lives. You know what it feels like to die in Christ – it is falling asleep. Imagine that feeling of being tired, exhausted and drained after a long and gruelling day, and at long last your head touches that soft pillow. All you have to do is to give way to sleep, because you know you are safe, you are secure, you are protected. Falling asleep is not something strange, alien or terrifying. It’s an experience that our heavenly father gives us in advance so that we need not be fearful.
These are just a few of the opportunities that dying can bring. None of us knows what the future might hold, and the truth is that death may come to any of us out of the blue, or with only hours of warning. So we need to start preparing for the end of our lives now, while we have the chance. Are there things you need to do now to prepare for the strange adventure of dying? Are there conversations to be had, relationships to be healed, preparations to be made?
Yes, death is still an enemy –it’s called the final enemy (see 1 Corinthians 15:26), and it’s one that we will all need to face, unless Christ comes first. But, in the meantime, we need to encourage one another with Paul’s words in 2 Corinthians 4:16-18: “Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day...So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.”