In my experiences as a hospice volunteer and with my own family members and friends, I've encountered a diverse cross section of death scenarios. Yesterday at a meeting of health professionals and clinicians active in end-of-life care, someone used the expression "a good death". I was stunned.

I'm not sure how long ago it was when I first heard that term. But over the years, the media has latched onto this phrase with such gusto that it seems most Americans would argue that it is their inalienable right to be guaranteed a "good death".

But life is full of paradox and death is no exception. Do we unconsciously expect that the circumstances of our dying could somehow be determined by forces outside of us? That if we faithfully pay our taxes or see our physician once a year - that if we follow all the rules and eat all our vegetables, that somehow death will be kind to us? And better yet, maybe side step us altogether?

Yes, there will be conditions and details unique to each of us as death approaches, but I do not see them as occurring outside our field of influence, nor do I think we will be guaranteed anything, no matter how desperately we believe we've earned it or deserve it. Unlike a chess game, we simply will not be able to maneuver all the pieces that will characterize our last days, and coming to terms with this is not easy for such a self-determined, control oriented culture such as ours. Passing legislature to legalize physician assisted suicide points directly to this myth of a "good death". Giving terminally ill people the means to predetermine how and when they will die, does not eliminate all the ramifications the patient, friends and family members must deal with in contemplating suicide. Control can only go so far.

As I touched upon in my opening, there are many ways we can enter into this deep mystery we call dying. There seems to me a natural link between these final months, weeks, days or hours and the life that has led up to it. And this interdependency exists much deeper than the skin deep emphasis so played up in our death denying culture. Although the pragmatic and popular notions of how best to live a long and healthy life, while keeping dying in mind (i.e. nutrition, exercise, stress management, advance directives, POLST etc.) are still valid and valuable, old age, sickness and death will trump even the best player's hand. How we meet the circumstances of this last and paramount phase of our journey, will be solely up to us. So although the particulars of our dying experience may come as a surprise to us, presenting pleasant and unpleasant sensations, shifting moment to moment, we can learn how to welcome them all, embraced in a spirit of deep trust that the way things are, are exactly how they are meant to be. Now this takes practice and as viable frame of reference, may require some advanced attention and mindfulness, before all hell breaks loose.

Ask a roomful of end-of life care providers to tell their stories and you most certainly will hear jaw dropping details of high drama and crisis management in almost each and every one. We die as we live, with a confluence of contradictions and conflicts. And we do it the best we can, with the skills we have available to us at the time.

Do we really want our caregiver, hospice nurse or social worker critiquing our dying experience with his or her own subjective standards of "good" and "bad"? At such a vulnerable, wide open time in our lives, do we really want the people who are caring for us predetermining what kind of death they would like us to have, so that at the end of the day, they can pat themselves on the back because we met all their benchmarks for a "good" death?

Rather I think we need to adopt the attitude that Frank Ostaseski, an eminent teacher in end-of-life care, termed as the "Don't Know Mind." In other words, can we enter into someone's dying experience with a totally open heart, allowing whatever unfolds for them to simply be as it is, without overlaying it with our unexamined beliefs, fears and expectations? Can we bear witness to another's suffering with our full presence and compassion and accept it as perfect in that moment, without wanting to change the slightest detail? That doesn't mean we don't adjust their medications or in some other way respond to the situation skillfully. All this would take place in the moments following that deep connection with and acceptance of "what is". This place of "don't know mind" - of mutual vulnerability and transparency, where caregiver and patient meet on a level playing field - is the only soil fertile enough where seeds of true healing for both individuals can be sown.

Next time you hear someone utter the "good death" mantra, don't seize up like I did. Stop the conversation cold and ask questions. Penetrate this persona with a floodlight of playful curiosity. Let's all do our part to safeguard the consumer, taking yet another outdated label - "the good death" - off the shelf and out of the marketplace.

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