palliative care – watercress words by Dr Aletha

This is at least the fouth book about death I have reviewed. I didn’t plan to, but it just happened. Maybe because of what Dr. Atul Gawande wrote in his book Being Mortal, another book I reviewed.

Death may be the enemy, but it is also the natural order of things.
Atul Gawande, M.D.

In this instance, I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. The book links in this post are affiliate links which may help support this blog financially.

Dying with Ease by Jeff Spiess, M.D.

A Compassionate Guide for Making Wiser End-of-Life Decisions

In the introduction, author Dr. Jeff Spiess explains his purpose for writing this book.

my primary hope is for you, dear reader, to become more informed and at peace regarding your own dying.
Jeff Spiess, M.D.

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

His book reviews the challenges of the dying process, and guides us in making choices that make it smoother and with ease.

Let’s review the titles of each chapter with a brief description of what each contains.

1. Dying in America

Here he proposes a definition for what is a “good death”; it’s one that matches the wishes of the dying person and their family.

2. I’m Going to Die? What Can I Do?

In this chapter he explains Advance Care Planning

Advanced Directives
Durable power of attorney for healthcare
Do Not Resuscitate-DNR
Physician Orders for Life Sustaining Treatment
Artificial Nutrition and Hydration

3. Hospice

In this chapter he reviews the history of hospice care care and explains the basics of palliative (rather than curative) care

4. Suffering

Most dying persons want to minimize suffering so Dr. Spiess lists ways to do so, some of which are controversial and even illegal in some states.

Palliative sedation
Voluntary stopping eating / drinking
medical aid in dying
voluntary euthanasia

5. It’s My Life, Isn’t It?

Here he discussed autonomy , bioethics, and the legal system using past high profile cases as illustrations, those being

Karen Ann Quinlan
Brittnany Maynard
Theresa Schiavo

"To every thing there is a season" Bible verse with fall color leaves — from Ecclesiastes 3

the time of peril, what St. John of the Cross called the “dark night of the soul,” … both tests the validity of one’s faith and initiates that essential process of incarnation
page 109

6. What’s God Got to Do With It?

Here he talks about “Religion, Spirituality, and the End of Life. He finds many people turn to religion when faced with death and sometimes that is not an altogether positive experience. However, he denies being anti-religion saying,

many find religious traditions to be sources of profound comfort and meaning. …it has been so for many friends, relatives, and patients, and also because it is true for me.
page 109

He finds it essential to differentiate religion as primarily a matter of intellectual assent to doctrines and beliefs, or whether the essense of a person’s faith has become understood and embodied in their being.

7. What Does It Feel Like to Die?

In this chapter he invites the reader to do a guided exercise to encounter the inner experience of dying. Putting pen to paper you will answer a series of questions about your life. Then you review it as you finish reading the chapter. I did the exercise and found it enlightening and sobering.

8. Envisioning Your Own Death

Here he expands on the idea of Advanced Care Planning introduced in chapter 2. He adds such steps as

Know the rules (insurance coverage)
Disposition of your body
Disposition of “stuff”, making a will

woman sitting in a cemetery — photo from the Lightstock.com collection, an affiliate link

9. What’s It All About, Anyway?

Dr. Spiess concludes with a true story about a wife’s journey to finding meaning after her young husband’s unexpected death.

living well increases the likelihood of dying well
page 161

Conclusion

After the obligatory Acknowledgments this book has

Discussion Questions which seem most appropriate for personal reflection . There is one question based on each chapter.
Notes, which are chapter specific
An extensive Bibliography
An Index
Brief Author bio

Jeff Spiess, M.D.

Dr. Spiess started in medicine as an oncologist, cancer specialist, then transitioned into palliative and end-of-life care as director of a hospice. His website, https://drjeffspiess.com/, offers a complete bio, audio interviews, his blog posts, social media links, and form to join his email list.

exploring the HEART of life and death

Dr. Aletha

Lightstock-quality photos and graphics site- here.

(This is an affiliate link)

by B.J. Miller, M.D. and Shoshana Berger

This book’s tag line sums up the content of this book perfectly. I have reviewed other books about death on this blog; they were more biographical, philosophical, and spiritual and touched less on the practical. This book is on the other end of the spectrum; more practical, but also philosophical ,and spiritual. ( And I mean spiritual in a broad sense, not necessarily religious.)

The book begins with a brief biographical section where each author shares their reason for writing a book about death. Dr. Miller, a palliative care physician, had a life-threatening injury. He writes,

I got close enough to see something of death and come back from the ledge, only to realize that it’s in and around us all the time.

Ms. Berger, an editorial director, took care of her dying father. She wrote,

I remember those years as being full of anxiety and grief but also as a time of drawing closer.

How the book unfolds

The book consists of 5 sections that mimic the progression from life to illness to death. Even as a physician, I was surprised at the claim that only 10% to 20% of us will die without warning. The rest of us will know we have something that will likely take our life. And even if we don’t, we all know we will die eventually, although we tend to think and act as if it’s a well kept secret, and maybe it is.

The sections are as follows

PLANNING AHEAD
DEALING WITH ILLNESS
HELP ALONG THE WAY
WHEN DEATH IS CLOSE
AFTER

Although you could read the book straight through, you might want to skip to sections you need at whatever stage you are in. Chapter titles clearly tell you what to expect from their content. Here are some examples-

Yes, There’s Paperwork.
Can I Afford to Die?
I’m Sick
Love, Sex, and Relationships
Hospital Hacks
Care for the Caregiver
It’s Your Body and Your Funeral
Grief
How to write a Eulogy and an Obituary
Celebrating a Life

There are no photographs, charts, graphs, or info graphics, but scattered throughout are illustrative sketches that convey helpful information in a non threatening way. I have used some screenshots of a few of them to illustrate this post.

The authors conclude the book with Last Words, Acknowledgments, Resources (an extensive list), Notes, and Index.

Read this book

As much as I hope you don’t need it right now, unfortunately you do need it right now. So whatever stage of living, or dying, you or a loved one may be in, you will find something helpful here.

Find the book at your local library like I did, or get it from one of these book sellers; this would be a good book to keep on hand. (These affiliate links pay a commission to support this blog, while you pay nothing extra. )

Dr. Miller’s TED talk on WHAT REALLY MATTERS AT THE END OF LIFE

Here is another post from this blog about the dying experience

What books teach us about dying

an excerpt-

I reviewed these books because understanding how other people and their families have faced death 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.