Opinion Today: What does it mean to be ‘ready’ to die?

This is how one physician thinks about her patients' acceptance of death.

View in browser|nytimes.com Continue reading the main story April 1, 2023 Death is never neat. A good death should be defined by how well and honestly we care for the dying, not by their performance on our behalf. Joshua Bright By Sunita Puri It's been almost a decade since I finished my medical residency and became a "real doctor." After training ended, I faced one final hurdle: passing a grueling eight-hour-long internal medicine board exam. Back then, it seemed as though there was nothing more important than knowing the right answers. What I didn't know was that when practicing palliative care, it's really about asking the right questions. As a resident, I would have never let myself consider only the most obvious diagnosis for a patient's illness. But when it came to my patients' personal lives, I too easily assumed the simplest narratives: Amid a health crisis, previously divided families would surely rally around their loved one. A person dying at the age of 90 must have lived a long and fulfilling life. Agreeing to hospice care meant that a patient had accepted that they were dying. Back then, I didn't question what "accepting" death really meant, or whether it was something I could expect from my patients. I struggled to ask about their suffering unless they seemed ready to embrace their fate, fearful that I might inadvertently worsen it. But as I write in my guest essay this week, I've learned that awaiting specific imaginings of acceptance only justified avoiding having necessary conversations with patients and loved ones about what they fear and need as death nears. Several days ago, I sat in the corner of a hospital room with the daughter of a patient suffering from incurable cancer. She was a nurse, and told me that she was worried that her mother hadn't come to terms with the end of her life. I know the stages of grief, she said, and I think she is in denial, but maybe you could help her understand she needs to accept what is coming. Ten years ago, I would have nodded, confident that I might help her mother, earnest in my naïveté. I still feel the initial rush of my inclination toward rescue. I knew the answer she wanted, but instead I asked a question. "I'm happy to speak with your mother and understand how she is making sense of what she is going through. But is this conversation also a way to help you to find peace?" She considered my question. Then she met my gaze, her eyes brimming with emotion, whispering, only, "Yes." READ SUNITA'S FULL ESSAY HERE GUEST ESSAY As a Doctor, I Know Being Ready to Die Is an Illusion It is easier to search for readiness than to process what its absence means. By Sunita Puri Continue reading the main story ADVERTISEMENT THE WEEK IN BIG IDEAS Alexander Skarsgard Explains the Answer to Everything. (It Involves Doing Some Math.) It's time to completely rethink how we measure economic success. By Nathan Grossman, Tom Mustill and Cecilia Nessen Rose Wong Build Your Own College Rankings The values that you care about most should inform your top college choices. By Quoctrung Bui and Jessia Ma Sophie Barbasch for The New York Times GUEST ESSAY I Am Going Blind, and I Now Find It Strangely Exhilarating Now that I signal my disability with a white cane, I find that I have tapped a well of visible kindness. By Edward Hirsch Niklas Wesner GUEST ESSAY Affirmative Action Is in Peril and 'Model Minority' Stories Don't Help Asian Americans are being exploited by white activists with an agenda. By Serena Puang Continue reading the main story ADVERTISEMENT Subscribe Today New York Times Opinion curates a wide range of views, inviting rich discussion and debate that help readers analyze the world. This work is made possible with the support of subscribers. Please consider subscribing to The Times with this special offer. Games Here are today's Mini Crossword, Wordle and Spelling Bee. If you're in the mood to play more, find all our games here. Forward this newsletter to friends to share ideas and perspectives that will help inform their lives. They can sign up here. Do you have feedback? Email us at opiniontoday@nytimes.com. Continue reading the main story ADVERTISEMENT If you have questions about your Times account, delivery problems or other issues, visit our Help Page or contact The Times. Continue reading the main story Need help? Review our newsletter help page or contact us for assistance. You received this email because you signed up for the Opinion Today newsletter from The New York Times. To stop receiving Opinion Today, unsubscribe. To opt out of other promotional emails from The Times, manage your email preferences. Subscribe to The TimesGet The New York Times app Connect with us on: Change Your EmailPrivacy PolicyContact UsCalifornia Notices The New York Times Company. 620 Eighth Avenue New York, NY 10018

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