Then there is pain—perhaps the most important factor in the current debate. We all fear the end, because of the agony it might entail. No one should have to suffer unduly, and public sympathy is clearly opposed to prolonging a person’s anguish. How often have we told ourselves that our society condones putting dogs, cats, horses, our loved animals, to sleep rather than have them suffer? Our compassion says it’s “the right thing to do.” Indeed, it was because of the unrelenting suffering of several people, notably Sue Rodriguez and Lee Carter, that we have the legislation on medical assistance in dying. It was their pain that propelled their cases all the way to the Supreme Court of Canada.
While many people approach their end with relatively little discomfort, those who suffer will tell you of how it distorts everything. This we fear more than anything else: the lingering torture of a vicious cancer, as it eases its way through vital organs, the bone-on-bone grinding of degenerative arthritis, the mental anguish of seeing your body become more and more immobilized, while your mind is still vital and awake, the desperate grasping for every breath as one slowly suffocates, the loss of bodily functions. Everyone can imagine the horrors of a painful ending. And we fear it.
It is to alleviate this pain that we now have medical assistance in dying. And while some palliative care pain clinics offer solace and the promise of relief,7 many Canadians outside major urban centers have no access to such services. And those who suffer unrelenting pain will tell you that it is life-altering. It racks the body, but takes over the mind and soul as well. It clouds everything. As Betty told me, “Pain can cloud your mind so much that it fills your mind with a ‘pain fog.’”8
And aside from our fear of nonbeing and the pain associated with dying, there is yet another aspect of death that keeps us awake at night: the solitary nature of dying. It is as disturbing as the pain we might suffer. There is no way around it. I must enter into my end on my own. No matter how much I am loved, and how many companions I have made along this pilgrimage, death is a one-person show. And the singularity of dying haunts me. If my chief anxiety during life is the desire to be part of a community, to be accepted and included, then to be totally alone is a very frightening prospect. And this fact about dying retrojects back into our living a serious doubt over our ultimate meaning and purpose. What if I don’t really matter? If there is no grand finale to my life,9 is it possible I am nothing more than a haphazard, a basically pointless being? What if there is no heaven-sent plan, no providential plot giving shape and purpose to my life? Could I be meaningless? Is it possible that, in the end, I am not important at all, not part of anything majestic or grand, but just a singular, randomly contingent animal? The prospect of dying raises these troubling questions.
Dying, while it often follows a predictable pattern, is, nonetheless, a complex event, as our biological self interacts with our spiritual and emotional desires.10 Yet it comes to all, despite our will or ability as a species. It’s built right into the cycle of creation. The day we are born, we start the march toward our grave. And while advances in medical science and technological prowess have meant that human beings can manipulate greater and greater aspects of their living, there is no antidote to dying, no elixir of eternal life. As the song lyric puts it: “If ever I leave this world alive.”11 There’s no way out of this finite world except through death.
And it is, therefore, surprising that we have a reticence to talk about death openly. It’s the monster in the closet, the boogeyman under the bed. We don’t spend much time preparing for or thinking about it until it’s often too late. As the dark secret we all keep, it also holds a fascination for the modern mind as entertainment. So, even though death holds our imaginations, it does not invite casual conversation or reveal itself easily. So, we have to organize special gatherings and coffee encounters.12 Radio programmes invite listeners to tell their stories of grief.13 All this work to unmask the devil we call death.
Death Is Not the Enemy
From the beginning of my conversations with those who have worked through the process of medical assistance in dying, I was told a simple fact: death is not the enemy we imagine. During a conversation with Ethel Campbell, I heard how her daughter, Julia, who was assisted in her death on July 20, 2016, greeted death as a friend. Julia was living with ALS and had suffered much. The family was on a 24/7 watch. Julia went through the incredible pain of a disintegrated shoulder and other physical agony because of her disease. In the end, she could only communicate by blinking her eyes. However, with conviction, she telegraphed her desires, and through the dedication of her family, she was able to end her life with dignity. She dictated a letter to her sister, who read it on the day of her dying . . . family and friends gathered on the back deck and people could say good-bye and offer gratitude for Julia’s life while she was still able to hear them. Ethel told me that Julia’s death was a healing moment. Though painful and heart-wrenching, it was also a “gift of life back to us,” for it freed the family from the constant vigilance and care and sense of helplessness, as they watched their loved one decline.14 For Julia and her family, death was not the enemy but a welcome step on the journey of living.
It was from Ethel and many others that I began to understand that dying, an essential part of living, might also be a healing moment. And that fact raised many pastoral questions that became the guiding ideas of my research and writing. They are: If dying is neither an exceptional event nor the enemy of living but a part of life, how can we shape our encounter with death so that it becomes a welcome, meaningful end? Since death is clearly part of what it means to be human, shall we not apply as much calm intentionality to dying as we do to living? Is it not possible to walk through our dying in such a way that we have been healed?
In the end, the guiding thesis of this text became a simple affirmation. We can place the words “healing” and “death” together in the same sentence, for it is possible that, in our ending, we can experience a wholeness and completion which is quite restorative.
It may seem like a contradiction to talk of dying as a healing process. On the surface, they seem to be opposites. Isn’t death a defeat? It is the triumph of the shadows that threaten us: the victory of “that good night.”15 The light is snuffed out by the grave and the downfall of all efforts for curing the diseases that take away our life. How can there be healing in death? This book will explore the many ways in which our manner of dying can be a road to healing.
A simple example at this point will suffice to illustrate how we will explore death as a form of healing. How often have I stood at the graveside, saying good-bye to a beloved father or mother, and there in the circle of mourners is a space where the youngest son or the oldest daughter should be standing. They weren’t welcome. No one wants to talk about it, for fear of “upsetting” the ceremony, but there’s an open wound that needs addressing. And while it is not within my ability to heal it during the funeral itself, it is a pity that, in the time leading up to a parent’s death, we lacked the rituals or traditions which might have allowed for the reconciliation of this broken relationship. We don’t have the tradition or the means of acknowledging and forgiving our missteps and mistakes! Surely, at our end, this is one of our chief desires and tasks. Death wins, when we allow it to rob us of the chance to be reunited with the very precious, but broken, bits and pieces of our life.
In the past, the possibility of finding healing in our dying was confounded by the uncertainty surrounding the event. No one knows when it will happen, at least not with anything like precision. So, we let it slide. The young son will come home eventually. No need to push it or presume. That older daughter will come when “it’s time.” And planning a healthy, wholesome ending to our life feels either like capitulation to fatalism or a macabre self-absorption. Those who are dying don’t want to call attention to themselves, and those who are in the dying person’s circle don’t want to plan anything, lest they look like they are prematurely pushing the dying person into their grave.
Besides, dying is, by its nature, a confusing and conflicting time. Any bent or broken emotions we have carried during our life get crazier as we close in on the end. There are only a few noble examples of clarity in our dying: Socrates drinking hemlock with his friends around about his bed or Jesus speaking with his disciples in the upper room.16 But such examples appear to be exceptions—quite exotic