A time to be born, and a time to die-what books teach us about dying

There is a time for everything,
    and a season for every activity under the heavens:

    a time to be born and a time to die,

Ecclesiastes 3, NIV

Holy Bible, New International Version®, NIV® Copyright ©1973, 1978, 1984, 2011 by Biblica, Inc.® Used by permission. All rights reserved worldwide.

Birth and death are the only medical events that all humans share. We can anticipate and celebrate the births of other people but not our own.

However we all can anticipate our own death although most of the time we don’t want to.  Unless we deal with a chronic life threatening disease or  are  diagnosed with a terminal illness, or thrust into a life-threatening situation such as combat or a natural disaster,  most of us don’t consider  about how or when we will die. But in truth we all will die.

I have reviewed several books about death here . Not because I  wanted to write about death but because several good books deal with death sensitively and thoughtfully.

Books about death are sometimes written by a person who is facing death. Relatives write after a loved one dies- a child ,a spouse ,a parent. The motivation for writing these books varies as does the motivation for reading them.

I reviewed these books  because by understanding how other people and their families have faced death it may relieve our dread, anxiety, or fear  about dying and death. Often it is not death itself that we  fear but the dying process -the pain , disability, dependence, isolation, unfulfilled dreams.

In an essay  for JAMA, Dr. Zachary Sager, a geriatric and palliative care physician in Boston Massachusetts, described his response to  working with dying patients-

“I witnessed how people could be simultaneously resilient and fragile. I was moved by the connectedness between individuals.

I accept that death offers not only the expected reflection on life and mourning but an opportunity for a unique form of growth and healing. ”

The books I reviewed share  common themes, and events yet are each unique as are the people in them who demonstrate both resilience and fragility.

I am posting excerpts from my reviews with a link to the entire piece. I welcome and encourage your comments about these books as well as any about how you  have navigated death in your family.

A 90 year old woman says “yes” to life

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Driving Miss Norma - a book cover

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel  trailer they parked in campgrounds and  Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

Driving Miss Norma- a book review

A young mother who chose life

A few months after their baby Indiana’s birth, Joey  faced the recurrence of cervical cancer diagnosed and treated years before. Despite more surgery, radiation and chemo the cancer persisted until further treatments were futile and and likely to cause more suffering. Joey decided to leave their Nashville farm,her horses, chickens and gardens, to move home to Indiana to spend her remaining time with her extended family.

To Joey, With Love

Faced with the persistence of the cancer

“Joey decided to come home-not to die, but to live.”

To Joey, With Love- a movie review

A physician who faces his own mortality

Dr. Paul Kalanithi was a 36-year-old resident physician who had, as he wrote, “reached the mountaintop” of anticipating a promising career as a neurosurgeon and neuroscientist. He had a loving wife, a supportive family and professors who respected his knowledge and skill. He seemed destined to be sought after, well paid, productive, successful, and  famous.

WHEN BREATH BECOMES AIR- a book

(note: a neurosurgeon treats  brain, spinal cord and nerve  diseases such as brain tumors that can be cured or improved with surgery,)

Unfortunately, “the culmination of decades of striving evaporated” when he was diagnosed with an aggressive form of lung cancer for which the prognosis was bleak, even with treatment. He was admitted to the very hospital where he trained as a neurosurgery resident, now  to learn what it is like to be a patient with a potentially terminal illness.

When Breath Becomes Air- reflections from Dr. Lucy Kalanithi

Thank you for joining me to remember and honor Norma, Joey, and Paul. I appreciate their families’ generosity in sharing their stories and the HEART of health.

Dr. Aletha stethoscope with a heart

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“Tis the season, again

This is one of my favorite posts, probably because I had fun writing it. There’s no serious medical information in it, but I hope you will find inspiration to stop and think about the “reason for the season”.

Don’t  we celebrate more special events and holidays the last six weeks of the year than the rest of the year combined? It feels that way to me.  We have these three major holidays-

Thanksgiving, Christmas, New Year’s Day

Christmas Eve and New Year’s Eve have become mini holidays too.

And when Christmas and New Year’s Day fall on the weekend, Friday or Monday will be a holiday for many people.

First we had Black Friday. Then they added Cyber Monday. Now we also have Giving Tuesday, which I think is the only one that really counts.

beautiful large Christmas tree

Christmas at the Chicago Museum of  Science and Industry

Some people observe the special celebrations of Hanukkah and Kwanzaa.

In the United States, we observe December 7 as Pearl Harbor Remembrance Day, the day in 1941 the United States entered World War II.  That event changed our country forever, and created my generation, the post-war  Baby Boomers.

The USS Arizona Memorial

Pearl Harbor Memorial to the USS Arizona

On December 17 , 1903, Orville and Wilbur Wright made their  famous flight at Kitty Hawk, North Carolina, ushering in the age of air travel, another historical turning point.

aircraft airplane antique classic

Photo by Inge Wallumrød on Pexels.com

The shortest day of the year occurs on December 21, the winter solstice and first day of winter in the northern hemisphere.

light snow on trees and ground

And  there are other special holidays and events observed too.

Besides holidays, other matters demand our time and attention during this season also.

College students face the end of a semester by studying for finals and finishing term papers and projects.

Renewal notices for subscriptions, licenses, and memberships show up in our mailboxes or inboxes.

Charities offer us one final opportunity to make  tax-deductible donations.

Patients call their doctor’s, dentist’s or optometrist’s office for that last chance to use medical insurance before the new (and probably higher) deductible kicks in or use medical spending accounts.

red gift boxes

Christmas birthdays can be messy too.

And in the middle of all this, I celebrate my birthday.

Having a  birthday close to Christmas makes both occasions rather messy for you and your family. As my friend ,whose birthday is on New Year’s Day, wrote, “You feel like you get cheated on your Christmas/birthday gifts.”  But  there are perks.

Your neighbors remind you your birthday is coming by hanging lights on their houses and turning them on every evening. (My husband claims that’s not the real reason. He doesn’t believe in Santa Claus either.)

You can go to a holiday party and pretend it’s for you.

You can listen to Christmas music on your birthday without seeming weird.

Your husband may hire a limousine to drive you around town looking at holiday lights displays. (No joke.)

boy and woman with birthday cakes

Celebrating a long ago birthday with my son. I don’t know why I had two birthday cakes.

Thank goodness, so far, no one else in my immediate family has chosen to be born or married this month. (Although I was delighted to learn  recently that two  distant cousins also have December birthdays.)

But the best part of any birthday, no matter when you observe it, is reflecting on your life, both the successes and failures, the joys and sorrows, and remembering and reflecting on the people and events that brought you to where you are now.

Birth and death comprise this journey  we call Life. Long ago I recognized that we physicians do not ultimately “save lives” or “prevent death”, but we can sometimes impact the time and circumstances.

A Bible book,  Ecclesiastes chapter 3 addresses the extremes of life in this passage which is often read at funerals or memorials-

For everything there is a season, and a time for

every matter under heaven:

a time to be born, and a time to die;
a time to plant, and a time to pluck up what is planted;
a time to kill, and a time to heal;
a time to break down, and a time to build up;
a time to weep, and a time to laugh;
a time to mourn, and a time to dance;
a time to cast away stones, and a time to gather stones together;
a time to embrace, and a time to refrain from embracing;
a time to seek, and a time to lose;
a time to keep, and a time to cast away;
a time to tear, and a time to sew;
a time to keep silence, and a time to speak;
a time to love, and a time to hate;
a time for war, and a time for peace.

The Holy Bible, English Standard Version. ESV® Text Edition: 2016. Copyright © 2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

This year I have  celebrated with friends who welcomed new babies into their families. I watched a friend face a disabling illness and death with the same faith, courage, enthusiasm, dignity and humor that he had lived life. I have mourned with his family and others who have lost loved ones this year.

Some people dread birthdays, but I believe  they are  a blessing; I am grateful for another year of life and hope to use whatever time I have left productively.  I agree with Oliver Wendell Holmes

“To be seventy years young is sometimes far more cheerful and hopeful than to be forty years old.”

Buzz Aldrin, one of the Apollo 11 astronauts and second human to step on the moon’s surface , trekked to the South Pole-at 86 years old.

A woman celebrating  her 103rd birthday made the news.  As always, she spent the day at a senior citizen center- as a volunteer!

In January, our country observes the birthday of Dr. Martin Luther King, Jr. I doubt my birthday will ever be named a holiday, but I hope something I do in life will leave this world a little better.

A birthday creates a new beginning  and so does a new year.  Perhaps we can all use the New Year’s Day holiday  to remember, reflect, renew and recharge our hearts and minds for another season  of life.

Yes, ’tis the season-Merry Christmas, Happy New Year-

and happy birthday, whenever yours may be.

Dr. Aletha

dessert with a lit candle in the middle

I hope your favorite restaurant gives you a complimentary dessert on your birthday.

COURAGE for the UNKNOWN SEASON- a review

 

COURAGE for the UNKNOWN SEASON

Navigating What’s Next with Confidence and Hope

By Jan Silvious

Even though Jan Silvious titled her book, Courage for the Unknown Season, we know what that season is-the season of aging and its inevitable, relentless progression toward death.

We’ve seen it, some of us are already in it, and it can be a scary place, with many unknowns other than the end. Jan refuses to let aging intimidate her, and wrote this book to help others take on our fear of aging, loss, illness, disability, and death with confidence and hope.

She starts the book with a chapter titled “Resilience”, followed soon by “Fight Fear”. She advises us “Don’t Forget to Laugh”, and to “Clean Up after Yourself”- that is, deal with our personal possessions so our family doesn’t have to when we are gone.

 

 

I like that she offers practical tips on staying healthy that she learned from a physician friend. In the chapter “Head Toward Ninety” she lists several steps to maintain wellness-exercise, get adequate sleep, eat health promoting foods ,  and pursue a healthy mind and spirit.  She writes,

“Read, stay curious, forgive, drop the bitterness, and pursue peace.”

 

She points us to Psalm 92 from the Bible, and suggests meditating on it to gain a “wealth of spiritual health.”

“It is good to give thanks to the Lord
And to sing praises to Your name, O Most High;
 To declare Your lovingkindness in the morning
And Your faithfulness by night,

For You, O Lord, have made me glad by what You have done,
I will sing for joy at the works of Your hands.”

Psalm 92: 1-4 (NASB)

New American Standard Bible (NASB)

Copyright © 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation

 

Later, she takes us by the hand, without mincing words about the pain we will experience with loss, and walks us through steps to navigate “Grief and Hope”.

Jan uses examples from her life, her family, friends, and colleagues of using our later years to cherish old memories while continuing to make new ones. She doesn’t try to convince us that aging isn’t painful, but encourages us to find new ways to find joy and fulfillment when the old ways are no longer possible.

Written especially for Baby Boomers-those of us born between 1946 and 1964- Courage for the Unknown Season offers sound advice and encouragement to anyone who wants to be prepared for aging. For those younger, it will help you understand and deal with the challenges your parents and grandparents are encountering now; but stow away a copy for 10, 20, 30 or more years when you will appreciate its wisdom for your own life.

I enjoyed reading it since I have or am experiencing much of what she discusses, and her perspective validates my own. For those things I have yet to encounter, I appreciate her suggestions and warnings.

As Jan wrote,

“No matter what season you are in, there are truths that can help you approach the unknown with confidence and hope. Trust that God is the God of our season, no matter what it looks like, no matter how unknown.”

 

Jan Silvious

Jan Silvious is a long-time speaker, professional life coach, wife, mother, and grandmother. She is author of eleven books, including Big Girls Don’t Whine and Fool-Proofing Your Life. Jan and her husband, Charlie, live in Tennessee, and have three grown sons, two daughters-in-love, five charming grandchildren and a very bright rescued pit-bull, Rocky-Buddy.

Jan Silvious, author

Jan Silvious, author

 

 

 

 

 

 

 

Disclosure: I read an advance review copy of this book which I received complimentary from  Tyndale via NetGalley in return for writing a review.

This post contains Amazon affiliate links, which if used by readers, pay a small commission to support this blog.

 

Please share this post and follow Watercress Words for more

 

Weekend Words-

sharing words of faith, hope, and love

FAITH HOPE LOVE in block letters

Faith ,Hope ,and Love

(1 Corinthians 13:13)

Thank you so much.    Dr. Aletha 

Most viewed post #5 -Driving Miss Norma- a book review

The 5th most viewed post this year was a book review. I think I was first attracted to this book by the title; it reminded me of one of my favorite movies, Driving Miss Daisy starring the late Jessica Tandy, Morgan Freeman, and Dan Aykroyd.

The plots are quite different but both stories are about an older woman and illustrated many of the same themes-family, friends, relationships, aging, illness, disability, and death. They both show how people do or don’t live life to the fullest.

Driving Miss Daisy was fiction but Driving Miss Norma is true, and her family keeps her story alive in this book and on social media. I’m glad so many of you  read this post, and are reading it now, and I hope you will  read the book.

Driving Miss Norma

One Family’s Journey Saying “Yes” to Living- a memoir

By Tim Bauerschmidt and Ramie Liddle

Harper Collins, 2017

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book.  I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma - a book cover

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel  trailer they parked in campgrounds and  Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and  their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal  “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

Atul Gawande- Being Mortal-book cover

This book caused Norma’s daughter-in-law Ramie to being thinking about end of life issues in a new way

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

 

 

 

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon

Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding  followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States

Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

You can continue to follow Tim and Ramie on Facebook where they are still

Driving Miss Norma

2 DOCS TALK reflected on Norma’s decision to forgo cancer treatment in this podcast

Do You Want a Long Lifespan? Or a Long Healthspan?

Driving Miss Daisy was  a Pulitzer Prize-winning play brought to television starring DRIVING MISS DAISY DVD

Angela Lansbury and

James Earl Jones .

Now available as a DVD or

watch online.

The Power of Meaning: Crafting a Life That Matters

 by Emily Esfahani Smith

“In a culture obsessed with happiness, this wise, stirring book points the way toward a richer, more satisfying life.”
To explore how we can craft lives of meaning, Emily Esfahani Smith considers an array of sources–from psychologists, sociologists, philosophers, and neuroscientists to figures in literature and history.
Drawing on this research, Smith shows us how cultivating connections to others, identifying and working toward a purpose, telling stories about our place in the world, and seeking out mystery can immeasurably deepen our lives.
She explores how we might begin to build a culture that leaves space for introspection and awe, cultivates a sense of community, and imbues our lives with meaning.Inspiring and story-driven, The Power of Meaning will strike a profound chord in anyone seeking a life that matters.

Support Independent Bookstores - Visit IndieBound.org

About the Author

Emily Esfahani Smith’s  writing has appeared in the Wall Street Journal, New York Times, The Atlantic, TIME, and other publications. She is also an instructor in positive psychology at the University of Pennsylvania, as well as an editor at the Stanford University Hoover Institution, where she manages the Ben Franklin Circles project.

 

 

 

 

 

 

 

 

Drs. Paul and Lucy Kalanithi reflected on their experience facing terminal illness in this review-

When Breath Becomes Air- reflections from Dr. Lucy Kalanithi

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the year’s 4th most viewed post. 

Follow Watercress Words as we explore the HEART of HEALTH.