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Birth, Death, and Life in Between
“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. For more than half a century now, we have treated the trials of sickness, aging, and mortality as medical concerns.” —Atul Gawande
Everyone on this earth goes through the birth process, has a life to live, and then dies. It’s a span of years, sometimes short, sometimes much longer. Why are we here? Some say it is a surprising and singular event in the universe and when it’s over, that’s all there is. Others suggest that we came from divine origins and will return to heaven or some kind of life after death and we’re here to prepare for that eventuality.
The first two books celebrate birth and life, and the final one offers some perspective on dying, which is the most difficult to face and discuss.
In her memoir Baby Catcher, Peggy Vincent tells about her journey from being a student nurse in pediatrics to eventually becoming a midwife. With humor and a delight in the miracle of birth, she shares her experiences of assisting nearly 3,000 women through the birthing process.
Favorite Quotes
“Then Zelda winked at me, and as she flashed her smile full of crooked teeth, I knew we were in it together, conspirators at a birth. An hour passed this way, and I smiled and nodded my head in rhythm to her Gospel chanting. And she was right. She didn’t fall off the bed. I was the one who did the falling as I fell under her spell. It was as though I’d stumbled into a piney woods revival tent and been transported by the spirit of a new religion. She made the process look like so much fun, I almost wanted to dance with her.
“Fortunately, those same swinging doors ushered other women like Marianna and Zelda into the delivery room. They came in huffing and puffing, and I gravitated toward them like steel to a magnet—women who knew what they wanted and didn’t want anyone messing with them.
“I lived for these occasional women, the ones who were different, who thrived on the challenge and the passion. The women who wanted to sigh and moan and deep-breathe through their labors, to move around in the bed, to squeeze my hands and look into my eyes.”
In 1971, pregnant with our first child, I expected labor to be a cakewalk. I’d been teaching natural childbirth classes for two years. I’d seen hundreds of deliveries. Talk about a setup. An hour after my own labor started, I realized I didn’t know diddly.
“Given the freedom offered by the birth centers that popped up everywhere, nurses, midwives, and the pregnant women themselves, rediscovered a wisdom more valid than any method we tried to superimpose on the natural process. Women’s bodies have near-perfect knowledge of childbirth; it’s when their brains get involved that things can go wrong.
“I’ve got a station wagon,” said Teri. She pushed Susie toward the purple-haired woman and turned to wrap up loose ends. Teri’s eyes snapped with the composure of a quarterback, and her capable hands hung ready at her sides. With her short, dark hair sticking out at funny angles from her head, she looked like a five-year old who’d been playing beauty parlor with her little sister. But I didn’t care what she looked like. She had Attitude and a station wagon. She was my new best friend. The world needs more people like her, I thought.”
Gladys McGarey’s book, The Well-Lived Life, is full of wisdom and practices to experiment with, a 103-year old doctor shares her six secrets to health and happiness in every age of life.
Favorite Quotes
“First, take a moment to gently put your hand on your heart. Just rest it there, allowing your chest to feel the warmth of your hand, allowing your hand to feel the subtle movement of your heart beating. This is the deepest part of your being. This is where your soul lives. Whenever you fall out of alignment with life, move your hand back to your heart. This simple motion has immense power.
“Life itself is always in movement, so aligning with our life force means that we must always look for the flow within us. Though our bodies perform autonomic movement processes, it’s important for us to move consciously, as well.
“In addition, when we don’t release emotions and stuck energy, we compromise our lymphatic system, the organs and tissues that fight infection and rid the body of toxins. This is why bodywork is so important and why I myself prioritize receiving massage nearly every week in my stage of life.
“I understand anger to largely be an issue of the adrenals. Forgiveness allows life to move again, while grudges keep it stuck. Sometimes this means letting life move through us and around us without trying to stop it. Other times, it means actually getting up and moving ourselves”
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“I don’t know what mistakes you’ve made in the past but I’d like to suggest that you, too, mostly did the best you could with what you had at the time. If you find yourself living with regret, try to catch it and see what’s moving. Did things mostly turn out all right? If so, be grateful! Is there anything funny about it? If so, laugh! Have you learned anything new since then? If so, enjoy what you now know and express it however you can! Do whatever you can do to let your regret go—forgive yourself and, if necessary, ask for forgiveness from others—so you can move on with your life.”
In his book, Being Mortal, Atul Gawande explains that medicine has transformed childbirth, injury, and disease from harrowing to manageable. Yet, how we help our loved ones and friends prepare for death is often an uncomfortable topic. In this book, the author explores the worst and best practices and what can make a difference.
Favorite Quotes
“In almost no [nursing home] does anyone sit down with you and try to figure out what living a life really means to you under the circumstances, let alone help you make a home where that life becomes possible
“I got better enough to realize how close I had come to losing my life, and I saw very differently that what mattered to me were other people in my life. As your horizons contract—when you see the future ahead of you as finite and uncertain—your focus shifts to the here and now, to everyday pleasures and the people closest to you.
“The soaring cost of health care has become the greatest threat to the long-term solvency of most advanced nations, and the incurable account for a lot of it.
“For a patient whose cancer proves fatal, though, the cost curve is U-shaped, rising toward the end—to an average of $94,000 during the last year of life with a metastatic breast cancer.
“Our medical system is excellent at trying to stave off death with $12,000-a-month chemotherapy, $4,000-a-day intensive care, $7,000-an-hour surgery.
“Almost all these patients had known, for some time, that they had a terminal condition. Yet they—along with their families and doctors—were unprepared for the final stage.
“In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions.
“In hospice, the initial visit is always tricky. A nurse has five seconds to make a patient like you and trust them. It’s in the whole way you present yourself. I do no come in saying, ‘I’m so sorry.’ Instead, it’s: ‘I’m the hospice nurse, and here’s what I have to offer you to make your life better. And I know we don’t have a lot of time to waste.’
“You’d think doctors would be well equipped to navigate the shoals here, but at least two things get in the way. First, our own views may be unrealistic. … Second, we often avoid voicing even these sentiments. But that doesn’t mean we are eager to make the choices ourselves. Instead, most often, we make no choice at all.
“Questions to ask: 1. Do you want to be resuscitated if your heart stops? 2. Do you want aggressive treatments such as intubation and mechanical ventilation? 3. Do you want antibiotics? 4. Do you want tube or intravenous feeding if you can’t eat on your own?
“We focus on laying out the facts and the options. But that’s a mistake, Block said. ‘A large part of the task is helping people negotiate the overwhelming anxiety—anxiety about death, anxiety about suffering, anxiety about loved ones, anxiety about finances.
“You’re trying to learn what’s most important to them under the circumstances. This process requires as much listening as talking. If you’re talking more than half the time, you’re talking too much. If time becomes short, you ask, ‘What is most important to you?’
“Bob Arnold, a palliative care physician explained that the mistake clinicians make in these situations it that they see their task as just supplying cognitive information—hard, cold facts and descriptions. They want to be Dr. Informative. But it’s the meaning behind the information that people are looking for more than the facts.
“Arnold had also recommended a strategy palliative care physicians use when they have to talk about bad news with people—they ‘ask, tell, ask.’ They ask what you want to hear, then they tell you, and then they ask what you understood.”
Conclusion
Most of us have a choice about how we will live, whether we will take this mortal experience for granted, or numb ourselves, or become the best version of ourselves. And at different ages, if we are observant, this question will arise again and again: “Why am I here?” And eventually, “How will I prepare for the end of life?”
Beginning Steps
financial situation is a disaster and how following four specific laws transformed his life.
two fathers, a rich one and a poor one. Robert writes, “One was highly educated and intelligent, had a Ph.D. and continue his advanced studies, all on full financial scholarships. The other father never finished the eighth grade.