Helpful Encounters with Death

My Grandfather's Last Words
Sooner or later, everyone faces death, but you do not have to wait until the end of your life to come to terms with it. Any encounter with death that engages and affects us deeply offers a significant opportunity for spiritual growth.

I was twenty-seven when my grandfather said, "See you in four years". These were the last words he spoke to me. He had cancer, and died in the hospital later that evening. I had planned to visit next day, and thought him confused to say such a thing, but could not later avoid the idea that he had given me some strange foreknowledge of my death.

I hung on to the fact that he was smiling broadly when he said those fateful words, holding high his right hand for me to see, four fingers extended. He waved cheerfully as I left the ward. Had he given me four years in which to sort out my life and establish my true values and priorities? "If I am going to die", I asked myself repeatedly, "What are the most important things to say to people and do within that short space of time?" It helped to remember some of my first encounters with death.

As a Medical Student

In my first week at London's Guy's Hospital, I interviewed a man still in his thirties with lung cancer and chronic obstructive airways disease. He had been heavily exposed during his working life to lung irritants. There was not enough oxygen in his blood, and his skin was an unhealthy, dusky blue. A onetime boxing champion, he was now scrawny and pitifully weak. Beside him were his wife and two young children. When I examined the man, his chest was marked by dark black lines, inscribed by medical staff, the target for radiotherapy. My naïve assumption was that this would work and he would get better.

As a Medical Student

He had travelled the world in the Navy, and had married only on coming ashore a few years earlier. I remember liking and respecting him for his dignity, his uncomplaining attitude and strong family values. He stuck particularly in my mind because, when I came to the ward the following morning, I discovered that he had died in the night. My thoughts went immediately to his wife and children. What would become of them? Death, and its consequences, was now very real for them. It had suddenly become real for me too.

Shock Tactics

Medical students then were not well trained for death. Our teachers used shock tactics. On the first day at medical school, long before we were to meet living patients, we had to attend the anatomy room, where fifty preserved human cadavers on tables awaited the dissection skills of two hundred students, most of us aged eighteen. There was no discussion about the identities of these people. We were kept ignorant of any human associations, and silently encouraged therefore simply to consider them as objects. The strongest message, then and throughout our training, was that we should suppress and ignore personal sentiments. This, we understood, was the ‘professional' approach. To do otherwise could only hinder our progress as doctors.

Shock Tactics

There was therefore no discussion of our thoughts and feelings on meeting the dead for the first time. I now think this was a mistake, and a valuable opportunity missed. About ten years later, I was in a small psychiatry training group when a psychologist asked us to remember that first day, and to be honest about the emotions we felt at the time.

We all recalled strong feelings, mainly of anxiety, and some also of self-doubt, coupled with guilt towards the dead person whose body we were about to desecrate, as it felt at the time. Three friends and I worked week by week throughout that year on the remains of an elderly woman; but I recall others dissecting a young female body. How could we not wonder who she had been and how she had died?

I remembered also feeling angry at being put in this highly uncomfortable position without any warning or preparation. It affected me deeply for a long time. From being ignorant of death, I had become both afraid of it, angry about it, and good at masking my feelings. Was this what my teachers intended? Meeting the sailor with cancer helped me start changing my attitude. Along with anxiety, fear, anger doubt and shame, I also began feeling sad about death.

In other words, death was no longer just something to be shunned and, whenever possible, fought against. It was not an enemy or some kind of failure. It might feel that way sometimes, especially for a doctor, but it was wiser to see it as ultimately inevitable, to accept it necessarily as a loss and feel sad.

My encounter with the dying man and his family led to the start of my emotional healing and rehabilitation on the subject. Unlike fear, anger, doubt, shame and the rest of the emotions stirred up when we resist loss, sorrow signals acceptance. Only when, at some level of consciousness, we honestly acknowledge the reality of loss, and our powerlessness to change the situation, can we be free to experience sadness, grieve, cry our tears and move on. When sorrow fades, we are left calmer and more cheerful, wiser and more resilient, bolder and more spontaneous. As we let go and our emotions heal, we grow. We cannot help it: we mature.

I did not weep immediately. It was several years later, actively bringing to mind several patients I had known who had died, before my grief truly hit me. It was a conscious practice, an exercise in bringing to the surface of my mind painful memories that I had been suppressing. It did not then take long to release that entire, dammed-back flood of tears. I was ready. It felt good and it did me good. For this, I remain grateful to that former boxer, seaman, husband and father, and all the rest, even though their names are forgotten. They helped form the doctor I became and the person I am today. They also helped me get ready to understand the import of my grandfather's final message, and I will say more about that another time.

Copyright Larry Culliford

Larry's books include ‘The Psychology of Spirituality', ‘Love, Healing & Happiness' and (as Patrick Whiteside) ‘The Little Book of Happiness' and ‘Happiness: The 30 Day Guide' (personally endorsed by HH The Dalai Lama).