By diminishing the taboo around discussing and studying death, the fields of hospice and palliative care have lessened the isolation of dying and in other ways helped people die better deaths. On the other hand, there is a tendency among those of us who regularly work the very sick to lose sight of just how terrifying death can be. For instance, death-and-dying pioneer Elizabeth Kubler-Ross wrote that ”I always say that death can be one of the greatest experiences ever.” Indeed, for some people the prospect of death prompts them to be fully present to life, to take in each moment of our precious and fleeting existence.
But I have also observed people be consumed by a sickening dread and despair when they face the reality of the mortality. Consider a poignant passage from Tolstoy’s Anna Karenina, in which Levin sees his brother sick with consumption. “Death, the inevitable end of all, for the first time presented itself to him with irresistible force. And death, which was here in this loved brother. . . was not so remote as it had hitherto seemed to him. It was in himself too, he felt that. If not today, tomorrow, if not tomorrow, in thirty years, wasn’t it all the same! And what was this inevitable death–he did not know, had never thought about it, and what was more, had not the power, had not the courage to think about it. I work, I want to do something, but I had forgotten it must all end; I had forgotten–death.” If we do not acknowledge death’s power, we will likely remain befuddled at why people go to such burdensome, costly, and sometimes futile lengths to have the chance at just a bit more life.