By MICHAEL HEBB
The train sped along from Seattle to Portland on a spectacular summer morning, following the track along the waterways of the lower Puget Sound. One of my daughters lived in Portland at the time, so I found myself on the train frequently. Like most of us, I don’t seek out conversations with strangers while traveling, which is unfortunate, as I have had transformative moments when I decide to engage and treat fellow passengers as fellow humans.
That day the train was crowded, and I didn’t have the option of keeping my distance. I found myself at a table with two women—both physicians and both of whom had left the conventional healthcare system because the chaos had disgusted and beaten them down. They didn’t know one another before that crowded train ride but weren’t surprised when they’d so quickly found common ground.
I asked them what piece of our healthcare system was most broken? They both immediately answered, speaking at the same time: “How we die. End of Life.” This was in 2012, and how we die in America was not front-page news. (Atul Gawande’s Being
Mortal wasn’t published until two years later.) I was taken aback and asked for more information. I quickly learned two devastating statistics: that end-of-life care is the number-one factor in American bankruptcies and that although 80 percent of Americans want to die at home, only 20 percent do.
I asked them if they agreed that how we end our lives is one of the most important—and costly—conversations Americans aren’t having. They did.
Then I asked: If I created a national campaign called Let’s Have Dinner and Talk About Death, did they think I would find support from physicians, insurance companies, patients—essentially everyone? “Definitely,” they said. “This has to happen.” The three of us clasped hands in a quasi-kumbaya moment, and a fellowship was born, even though I haven’t seen those two doctors again since.
I tell this story because it represents the heart of the Death Over Dinner experience, and it inspired this prompt. When we think—really think—about how we want to die, and when we talk with others about it, we have much more of a chance of making it happen. I don’t use this prompt in every death dinner, but it’s possibly the most important. If you only had thirty days left to live, how would you spend it? What would your last day look like? Who is around you?
Of the many things these questions evoke, perhaps the most important sentiment is that you only die once. We carefully consider and plan our weddings and our children’s births, and we recognize these moments as major transitions. To deny our end of life the same level of consideration denies a tremendous part of us, perhaps the most important part: that we are in fact mortal. We might not be able to control how our final days or hours look or what they feel like, but we can do our best to make sure our wishes are communicated and honored.
Some people say they want to die alone, which is what I used to say. I thought I’d like to wander off into the woods when my time came and pass away quietly without being a burden to anyone, as cats are known to do. But the first time I answered this question out loud, at a death dinner, what came out of my mouth wasn’t the noble loner narrative. It was clear to me that I wanted my two daughters—and no one else—to be with me. I could see that it wouldn’t be a burden to them but a gift to all three of us. That realization changed the way I parent from that moment forward. I realized I had kept my children at a “safe” distance from many of my emotions and experiences, and because of this, they didn’t feel emotionally safe in my presence. There are certain things we don’t share with our children, but our emotions, our depth of feeling, is not something to take off the table.
Thinking about what we want for our last days and moments illuminates, then, what we love and value about life.
Michael Hebb is the founder of Death Over Dinner. He lives in Seattle, Washington. Visit DeathOverDinner.org for more information. You can also buy the book using this link: Let’s Talk about Death (over Dinner): An Invitation and Guide to Life’s Most Important Conversation.
Excerpted from Let’s Talk About Death (Over Dinner): An Invitation and Guide to Life’s Most Important Conversation by Michael Hebb. Copyright ©2018. Available on October 2, 2018 from Da Capo Lifelong Books, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc
Just cited this over at my KHIT.org blog.
Dying is surely going to be different from what we expect. Therefore to discuss it will be a spurious conversation.