How can you make dying and death more bearable? BRIGITTE.de reader Elisabeth Freitag is a palliative care physician with heart and soul. She says: End-of-life care makes everyone richer.
“We are all on the same path”
Nina was 19 and I was 24 when our encounter sealed my professional life. She was a patient at the clinic where I was doing an internship on my way to becoming a doctor. There she was the young hummingbird among older patients and somehow out of place. She had cancer, which had begun to take hold of her life obsessively.
Nina and I attracted each other magically. I her because I gave her carefree girl moments through our curious getting to know each other. She me because she taught me to endure heaviness with her way of smiling gracefully at each new day. We cried together and didn’t tell anyone. Not her because she wanted to be a brave daughter, not me because I wanted to be a brave doctor. I will never forget her radiance when I thoughtlessly said to her: “Nina, you are such a beautiful woman!” Only later did I realize that I was touching something precious in her that had been buried by the illness.
We cried together and didn’t tell anyone
Nina died less than two weeks later on a sunny morning. Silent and brave in the presence of her family. Not being with her again that morning left me uncertain as to whether her death had been as light as a feather. She was so brave that it was easy to overlook her need.
As suddenly as Nina appeared in my life, she was snatched from me just as quickly. The doctor in me understood that Nina had to die. But the great rest howled snot and water, furiously cursing the injustice of the world. Later, I was shocked at myself by the feeling of “it’s okay” that felt healthy and treasonous at the same time trying to set in.
“Saving death” also means “saving life”
The first consolation came with the acknowledgment that Nina had given good hours in the bad time, with ease and also laughter. Just the improvement in my being and staying power gave me a glimpse of how much I could do if I had the medical knowledge to control symptoms. I realized that “saving a death” was also saving a life.
Nina has accompanied me ever since. I became a palliative medicine doctor. My heart belongs to this profession. To stay when healing is no longer possible, to follow the path as a confidante and try to make the unbearable become bearable. The moment when the worst fears come true or a fatal message from the blue – a moment that pulverizes the usual life, in fast motion and slow motion at the same time. Irreversible, devastating and merciless, life threatens to swallow itself the moment it holds up the mirror to finitude.
Palliative care is a parachute that, ideally, is strapped on as soon as an incurable illness is diagnosed, in order to get used to the feeling of security at a time when hardly anything seems certain anymore. Talking about possible symptoms of illness to be expected does not mean painting black and conjuring them up. On the contrary: It creates the possibility of being ready and then having a plan, which in turn means not being helpless, not having to idly surrender to the symptoms of the disease. That preserves autonomy, and that’s the goal.
Fear of death, fear of dying
In my work I see that you have to differentiate between whether someone is afraid of death or afraid of dying. For some people “being dead” is simply “being gone” and the idea is bearable because somehow you are no longer involved in it. Or because through faith there is a religious idea of ”afterwards” and this is comforting. For others, this is unimaginable – often out of fear of what will become of the people who stay and have to live with the loss. Still other people are less afraid of death than they are of dying. Fear of having to suffer, of being helpless and giving up self-determination. Facing these fears and thoughts together makes everyone involved richer, even if nobody knows the definitive answer.
The primary goal of palliative medicine is to maintain the best possible quality of life. This task has many dimensions. Hardship arises not only from suffering from physical symptoms, but also from unsolved life issues, spiritual hardship, financial worries and unfulfilled desires. The wish to die at home can also represent everything from self-understanding to a test of endurance. It is important to take the dying person and their relatives by the hand and to weigh up together which type of care can be provided with which location.
Add a blur to death
Palliative care cannot romanticize death, yet it usually manages to soften the impact of its arrival and soften the focus of its face. And to create a moment during the experience of dying for relatives that first disappears in the pain and then, when the grief unfolds, begins to bloom in the memory and is then able to comfort.
© Spirit Rainbow Verlag
The author: Elisabeth Freitag was born in 1984 in Erfurt. After working as a family doctor and with the “Specialized Outpatient Palliative Care” (SAPV), she has been working in a clinic for geriatrics and palliative medicine in the southern Palatinate since 2019. Her novel “The End of Finitude: The Life and Development of Emma Lillit” (Spirit Rainbow Verlag, 17 euros) wants to encourage people to deal with the fearful themes of life and death under the protection of a love story. She says: “We don’t risk anything when we think and talk about dying. Fear is a ghost that we can oppose together. You are not alone. We are all on the same path.”