We’re All Terminal


Surgeon Atul Gawande writes about care for the dying and choices faced by terminal patients and their families in an article titled “Letting Go.”

Contrasting hospice with hospital care, he reports:

“Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But researchers followed patients with terminal illnesses and found no difference in survival time between hospice and non-hospice patients.  Curiously hospice care seemed to extend survival for some patients”

He noted “the lesson seems almost Zen-like: you live longer only when you stop trying to live longer.”

Shunryu Suzuki Roshi, author of, Zen Mind, Beginner’s Mind, often admonished his students to have “no gaining idea” when practicing meditation. The patients who chose to forgo hospital treatment were rejecting a gaining idea: the idea that life should be prolonged at any cost.

I’m not surprised and think there’s an unmentioned piece missing from the discussion: knowing that one has a terminal illness is one thing.  Accepting death — sooner rather than later — is quite another.

I wonder if this “acceptance” is like others, allowing us to relax emotionally, throw away the To-Do list and answer the only question:  what — if anything —  do I need to do right now? In this moment?

How would I say “good bye” on my own terms? Is there any sense of relief to be found in the minimal and highly personal list of ‘musts?’ It might even be fun and therapeutic to make a list of things I don’t ever have to do again.


I never again have to:

  • pick up after the neighbor’s dog
  • attend a cocktail party
  • vote for the least bad choice
  • get the car inspected
  • go to the dentist
  • sort the recyclables and take out the trash
  • apply sunscreen

You get the idea.

What would you lose from your To Do list? And, why not lose it now?


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