Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
The Dying Process: A Celebration of Life
Carey Chisholm, MD and Nicole Pelly, MD
with contributions from
Robin, Kelsey & Tyler Chisholm
This photoessay was created to tell the story of dying from different points of view. Carey (retired Emergency Medicine physician who was diagnosed unexpectedly with terminal lung cancer) chose photographs from his portfolio to represent how he felt at different stages of dying and interpreted them with words to describe his journey. Nicole (Palliative Care physician and trainee under Carey during internship) describes observations gathered from other dying patients combined with her personal feelings of caring for Carey as his physician. Robin provides a family perspective as a wife who walked alongside Carey through it all. Their two daughters, Kelsey and Tyler contribute their wisdom and unique perspectives. We are hoping you add comments to make the story even more complete.
Becoming a Patient
Entering the world of medicine as a patient with a terminal illness is filled with anxiety, fear of the unknown, and a confusing schedule of “hurry up and wait” intertwined with tough decisions coupled with quick deadlines. Assessing one’s trust in facilities and new providers also becomes a source of anxiety. As one learns more about their disease, it is ever important to share your treatment expectations and goals with your providers, and to seek other providers if you don’t develop the trust that you need.
The Most Challenging Part of the Early Journey: Telling Others
Perhaps the first major task - and source of anxiety - comes about when deciding how to tell others about your terminal illness. The conversations are always tough. Hopefully they will lead to opportunities for open and honest conversations as the journey proceeds.
Addressing Guilt
Guilt is a normal reaction for the person with disease, and for their loved ones. For the ill, it focuses on leaving others behind. For both groups in includes worrying about their future without you, and leaving things unsaid or undone.
Bridging the Distance
Communication plan and visits throughout the journey as well as thoughts about how to stay connected with distant friends and family.
Do You Really Fight or Battle Cancer?
This really depends upon where your journey begins. It will be different for a parent of young children than it will be for a retiree who is financially secure. However, the extortions of others to “be strong”, “fight” or “battle on”, while well-intentioned, miss the point of the individual journey. With a terminal illness, the outcome is already written. The battles really are with the side effects of the treatment protocols as well as the normal disease progression. Again, having clear goals assists decisions about which pathways to choose on the journey.
Living in the Moment
Even in the worst moments, we can find joy in a hug, or petting the dog, or feeling the wind, or the warmth of the sun.
Good Life - Good Death?
Judgement of a good life or good death looks different to the person experiencing it themselves or the people watching from afar.
The Journey Can Keep Growing Exciting
I’ve had an opportunity to introspectively ponder each step along the journey. These have provided learning opportunities and more importantly an expansion of empathy (in my opinion the most important human attribute and critical leadership characteristic).
Setting Final Things in Order
Open discussions and assuring that final wishes as well as practical matters are addressed removes multiple layers of effort and anxiety for those left behind.
For Every Tear, a Hundred Smiles
Because of the stigma associated with death, many of us are sorely unprepared to think about that grieving process until it unexpectedly confronts us.
Legacy
As one nears the end of their life, they are forced to think about what their time on Earth meant. Did you make a positive impact on others? Or were you a taker and not a giver? In reality, one’s legacy is “written” and lived” by those with whom you interacted . Others write your legacy.
Last Hugs and Saying Goodbye
We always hope there will be time for another hug or another word together. Life is uncertain - leave nothing unsaid and nothing undone.
