DEATH, PERHAPS THE MAJOR FEAR IN OUR LIFE! 

WHAT HOLISTIC MEDICINE HAS TO DO WITH THE GRIM REAPER, and OUR SOCIETY’S FEAR OF DEATH?  -an opinion of a human being with experience with death.

“Pleasure is the sum of freedom from pain, coupled with freedom from dying”

                       Epicurus (341-270 BC), Greek philosopher

Epicurus, a Greek philosopher a generation younger than Plato (428-347 BC), and Aristotle (384-322 BC) taught a philosophy to achieve “pleasure and happiness”. Epicurus defined pleasure as freedom from pain, coupled with freedom from dying.

Can you picture yourself having a friendly conversation with the Grim Reaper? Does the thought of it give you chills? Do not worry, you are not alone, a multitude of my patients –and many other human beings, feel the same way. They have never imagined the “Big Bad Grim Reaper” dropping by just for dessert and coffee and a friendly conversation!

You may wonder why a medical doctor dares to talk about the Grim Reaper as a “friendly” individual, when by most this entity is regarded as a monster. But, why not? Is not the Grim Reaper a product of our imagination just like a mommy we watch at the movies? We have created such a negative image of death that we portray it as a “life taking”, rather as part of a life and death process. Holistic medicine is about seeing the human body as a something more valuable as a whole, than the sum of its parts. In Holistic medicine there is no separation between life and death, they both go together.

The word “Holistic” is believed to have been used for the first time in South Africa by Jan Christian Smuts (1870-1950), a prominent South African and Commonwealth statesman and military leader who believed that South Africa was more valuable as a whole, than the sum of its parts. As Prime Minister, he opposed a majority of Afrikaners that wished to continue and further the then present Apartheid politics of the inter-war years. After the Second World War, he established and supported the Fagan Commission, which advocated the complete abandonment of all segregation in South Africa. However, Smuts lost a general election before he could implement the suggestion, and died, just as legal Apartheid was being implemented.

Apartheid, or “separateness”, was a system of racial segregation that was in effect in South Africa from 1948 to early 1990’s and it is a topic beyond the scope of this essay. It is mentioned here because when we utilize the word “holistic”, we have to take into consideration the origin of the word and its meaning. It is worth clarifying that “holistic” did not come for what some people want to make us believe today as “healing” through deceiving concepts of so-called “natural supplements”, “natural herbs” or “natural vitamins”. It actually means something much bigger than that. It means that the human being as a whole is much more valuable than the sum of its parts.

Holistic, if you allow me, can be applied to the process that incorporated both, LIFE and DEATH, as a whole. Death is death, if death is not life; we have to find a word that incorporates both life and death a whole, not the sum of life parts plus death. Life plus death is the “sum of its parts”, a word that holds life and death as a whole will indicated a much more valuable phenomenon, a holistic approach, a holistic word.

It is amazing, but not surprising, how society portrays death as something “bad”. We are not trained to deal with death as a natural process. We talk about “natural” remedies, alternative “natural” methods of healing, “natural” vitamins, some markets even misleadingly claim to sale “only natural/organic products”, which use will lead to a healthy and longer life, etcetera. Nevertheless, we avoid dealing with death as a truly natural process.

Other confusing aspects of death are created by what we see in television and other media as we grow up. This society portrays the dead as the ones that will come from their tomb to come and “eat us” so they can become alive. We portrayed skeletons as something “bad”. I have a young son who loves to watch television cartoons. The other day, making a conscious effort to be in his world, I joined him. To my surprise, I watch for the first time in my life a funny cartoon involving a skeleton. This skeleton carried a Scythe, it was the Grim Reaper!!! (his name was “Grim”) who was friend with a boy (“Billy”) and a girl (“Mandy”). At the very beginning, I judged it was a bad idea to mix the Grim Reaper image with an innocent cartoon. Later on, I reflected on how society has program my brain to see death as something grim, rather as a natural process that should be welcomed as life is welcomed. We like to celebrate “life”, and avoid mentioning the word death. The words “A Celebration of Life” are mentioned in some funerals, rather than a “Celebration of Death”; but is not the norm. It is a taboo to acknowledge that death is something may be good and necessary. We cling to the very last moment of life while terrified of death. In many instances, we squander a considerable portion of our lives worried about our death and the death of our loved ones.

People die everyday, old people, young people, and very young people. Patient’s relatives ask their doctors to utilize every resource available to keep their loved ones alive. It does not matter how old or how sick they are. I am guilty of this behavior, too. In October of 1991, my two children were involved in a tragic car accident which left them in coma. My daughter, then ten years of age, woke up from coma in two weeks; However, my seven year old son remained in coma for two months requiring artificial ventilation, intravenous feeding, along with multiple extraordinary measures. The first night in intensive care at a children’s hospital, his blood pressure was very low, he was hemorrhaging and I thought he would not make it to the next day. I recall those days, as if it was yesterday, I did not care whether or not he stayed in coma, I just wanted him to stay alive. It did not matter to me, at that time, whether I would have to spend the rest of my life caring for a comatose child, I just wanted my son’s heart beating, and so I could enjoy his presence.

My son got to live for many years with multiple problems related to the accident; he was bound to a wheelchair and had severe injuries to his intestines that at the end he could not eat at all. I took him to the best doctors, the best hospitals, we tried to feed him intravenously for a while –after having multiple surgeries, etc. Well, it is a long story; the fact is that his body could not take it anymore and he finally passed away in October 28, 2007 at age 23. It was a tough time for me and my family; I resisted believing that we were being deprived of his physical presence forever. As time goes by, I come to the realization that my son was tired of living because he had no joy, I remember him telling me “Dad, why I just don’t die? I am so tired of this!” I tried to counsel him telling me him that God wanted him to live for a reason. The truth is that listening to his words used to break my heart. Today I am not “out of the woods” yet, but I am making progress. I miss him a lot –what can I say, he was (or is) my son! But I am accepting his death a little more than before. My brain has been intensively program to reject death and I am fighting it and trying to “convince” it that “it is OK to die”.

Every person’s severe sickness is different, and should be approached accordingly. I also had the experience of seeing my father dying of liver cancer. The liver was invaded with malignancy and there was no therapy that would prolong his life. He chose to die at home without further care. I was able to accept this option because being a liver specialist I knew there was no other reasonable one.

Having had such an experience with extremely sick, extremely young, and extremely closed loved ones, I am in a better position to understand the situation of the relatives of my very sick or dying patients. I can share my experience, and try to guide them to the best of my ability to make their own decision. As a doctor and human being I cannot judge who should live and who should die, this is a decision made by Nature, God, the Universe, or whatever you wish to call it. My job is to cope and lure others to cope with what is beyond our control.

© Copyright. 2012 Rafael E. Cuellar, MD