I do not know exactly what death is for each of the readers. For me, death is both an ideal enemy and a best friend.
Enemy — because I, as a surgeon, must hourly fight against death, not allow it to prematurely take my patients. In addition, we must try not to become the “hand of death” ourselves (it is known that each surgeon has his own small cemetery).
And a friend — because in moments of painful reflection, uncertainty and sadness, I personally always turn to the thought of death, because it is completely guaranteed to me, unlike many other things (for example, happiness, health, well-being). When I think that my journey will end, I invariably calm down: after all, what do I have to lose if I already lose everything?
Doctors know how difficult it is to tell the patient about the coming end: sometimes it becomes a stumbling block for relatives. Indeed, what is it like to state before a still living person the absence of any hope?
Each of us has a legal, psychological and spiritual right to receive sufficient information about the duration of his life. This is especially important for people suffering from slowly progressive incurable diseases. But how to inform a person about death? This question remains open for doctors, philosophers, priests.
After some time, the patient’s son called and said that her mother had died, she had been buried the day before. He thanked me for my frankness
In my practice, there was a case when I had to talk to a patient with multiple metastases about her future. In her situation, the median survival did not exceed three months. A socially active business woman, 48 years old, honestly said that she needed to give instructions to her son, deal with a loan, and complete the transfer of rights to the company.
She really needed to know when she was going to die, it was not only a philosophical question, but also a practical one. I took responsibility and described in detail to the patient what awaits her and how much she has left.
Two and a half months later, the patient called me from the hospice and told me that she had time to make all the dying orders. Some time later, her son called and said that her mother had died, she had been buried the day before.
He thanked me for my frankness. I remember that this dialogue left me with mixed, but still bright feelings.
Numerous ethical, social, medical aspects of death become important only on condition that the dying person knows that he is dying, and the one who sees him off knows that he is seeing him off. Those who have dealt with death spoke about it at the symposium “Death and Dying in Contemporary Russia: How to Start Talking About the Important?” (2016, Moscow).
A serious responsibility falls on the shoulders of the doctor: to authoritatively inform the actors about their sad «roles». Can someone replace the doctor as the moderator of this difficult dialogue? I think it’s impossible.