The end of life comes in many ways, some expected, some totally unexpected. I have witnessed both. I wonder which is best, and for who, and why, as if an answer exists.

Sudden Death

In my family, an early death is not uncommon, especially on my father’s side. Many of his 11 siblings passed before I came along: brother Victor at just 25; sister Helen at 27; brother Chester at 34, sister Gladys at 39. My dad died at 45. Others lived only into their 60’s. I’m told they contracted rheumatic fever during an outbreak in Boston in the 1930’s, which resulted in rheumatic heart disease, leaving them all vulnerable to valvular disease, heart failure, heart attacks, and cardiac arrest.

Most of these deaths were unexpected, in spite of our knowing the decedent had a heart condition. But they were not senseless. “They had heart trouble. What a shame.” Sad but not surprising: In their day, most people did not survive a heart attack. Cardiac care is much improved since then. People live a lot longer with “heart trouble.”

When my brother Vic died following an inexplicable motorcycle accident last summer, my brother Kenn asked, “Didn’t we already go through this with Daddy?” He went into cardiac arrest following a heart attack. Vic’s was a sudden death too, on the Fourth of July, a beautiful summer day, perfect. He had recently made some major life changes to fulfill a dream and was as happy as I’d ever seen him. We’d hosted a barbecue at my house that day with my husband’s family, the first time we’d gathered in many months due to the COVID-19 pandemic. We stayed outdoors the whole time, enjoying the holiday, oblivious as we celebrated that our lives had taken a tragic turn due to an accident on a winding Vermont highway almost 300 miles away.

The call came: Vic and Deanna were in a motorcycle accident. They passed away. “Are you kidding?” was my first reaction to the friend who relayed this news, a reflex response. Of course he wasn’t. Why would anyone kid about something so serious? But it was unbelievable. And senseless. Vic didn’t have a motorcycle at the time (he was riding a friend’s). A bike ride wasn’t part of that weekend’s plans. Why was he even on a motorcycle? His partner Deanna was on the back of the bike. I’m told it was her first motorcycle ride. Why didn’t she stay behind? These thoughts tormented me for days and still do. We have so many unanswered questions. And like my father’s death, it was sudden, and the suddenness made it so much worse. Vic was just 57.

Protracted Death

Conversely, in 2017 we lost another family member after he endured a vicious cancer that took him in less than two years. He had surgeries, chemo, radiation, everything, and yet succumbed. As the weeks ticked on and the outcome looked bleak we prepared ourselves for the phone call, but at the same time prayed and hoped for a miracle. Where life exists, so does hope. But we knew days before his death there would be no miracle, and I was at work when I got the call. I expected it, but still felt as though the floor dropped out from under me.

And I wonder: Is it better to know ahead of time, to prepare yourself for loss, or is it better to be blissfully unaware of impending doom and get the news like a gut punch, jolting you out of your world? And who benefits either way: you or the decedent?

I’ve heard people say it’s best to simply die in your sleep, in an instant, no warning. That might be better for the decedent but for those left to mourn it’s horrible. There’s no closure, too much unsaid and undone.

In my nursing career I witnessed hundreds of people suffer a slow, painful death, hanging on to the last possible moment, until nothing remained of them. Believe me: the will to live is the strongest force in life. People can endure tremendous physical challenges. But this leads to anticipatory grief, which can last months if not years, and places a tremendous strain on all involved. The upside is time to plan for the end, to sort things out, to make amends, to say goodbye, to say “I love you” one last time. Is this better?

Is anything “better” about any of this?

An Invitation

Please take this journey with me. We can communicate with one another in the comments, perhaps find healing together. Subscribe to this blog to receive email notifications of new posts. Thank you.