and admit they were using secret Swiss bank accounts to avoid paying income taxes. Many
Americans spend a lot of money, employ tax lawyers and accountants, and think years ahead
in order to reduce their tax burden. These same Americans and most people in this country
spend almost no time, no money, and no effort preparing to die. While death is even more
inevitable than paying taxes; it is the most taboo subject in this nation. Even though every
human will die, we in America have engaged in a tradition of denial which would make
an ostrich proud. So let me say this as clearly as I can; everyone who ever reads this,
and even those who don't, will die. You will close your eyes one day and existence as you
know it will end. How prepared are you?
The answer to this question has huge personal and societal consequences. The
cover of Newsweek trumpets "The Case for Killing Granny...Curbing Excessive End of
Life Care is Good for America". As President Obama tries to reform healthcare, one of
the most explosive accusations from opponents is that he will create "death panels" to
council the elderly and get them out of the way to save money and pay for healthcare for
younger folks. According to Newsweek, $66.8 billion a year is spent on chronically ill
patients in the last two years of their lives. In many cases, 90% of healthcare dollars in
a person's lifetime are spent during the last 10% of a person's life. Why? Part of the reason
is that you are the sickest at that time. However, a significant part of the reason is fear.
The fear of dying drives people to seek or demand every procedure available no matter
what the cost. The procedure may only add a week to one's life, but we want that week
because the alternative scares us too much. If the patient isn't demanding heroic efforts,
many times the family often demands "everything" be done. We all know why...guilt.
Family members, many of whom have not been involved in a parent's or sibling's life
for years, feel guilty and demand everything possible be done. If not guilt, fear can drive
a family's decisions. The fear of losing a parent or loved one can be very powerful.
Why does death scare us so much? Why will we do anything to avoid talking
about death? Why will we do more research on buying a car than we do about death?
Have you ever talked with anyone about death? Have you ever thought about your own
death? What happens at that nano-second when you close your eyes and your body
ceases to function? What do you believe?
I have been scared of dying most of my life. I think that fear is one of the reasons
I took so many chances, broke so many rules, pushed so many boundaries, and remained
a psychological adolescent most of my adult life. As long as I felt and acted like a rebellious
teen, as long as I was irresponsible, as long as I didn't play by the rules; I was still too young,
too vibrant, too alive to have to admit that my body and this world are not permanent and
will end for me. For most of my adult life I have had doubts about my religious faith. I
wondered if I believed in God, Jesus, resurrection, and an after-life because death scared
me so much. Was religion a psychological crutch?
We are scared to death of death. We spend a fortune as a nation for healthcare
and most of that money is spent on putting off death. If our healthcare dollar was spent
to get better care, live healthier, even longer; we would spend more on primary care
doctors (the ones we see most of the time), we would eat well and exercise, we would
pursue interests which we are passionate about and would never stay in a dead-end or
spirit-wrecking job. If we really wanted a better quality of life, our society would be less
stressed, less lonely, and more nurturing. However, life in this country is far from
nurturing, very lonely (as the extended family disintegrates more and more) and stress
levels are through the roof. Facing all of these factors, a discussion about the end of life,
the impermanence of everything we know, ending connections with those we love, is not
a discussion we are eager to have.
I have a Buddhist friend who is fascinated by death. He says the whole purpose
of life is to prepare for that nano-second just as we close our eyes for the last time. He
says the Tibetan Book of Living and Dying is one of the most profound books he has ever
read. He reads and studies and meditates about death. He works on achieving detachment
from this world since everything is impermanent. Family and friends only have value at
that moment of death, to help you let go. Then it's just you. Everything else ceases to
exist. There is just you at that moment of transition. His notion of being totally alone
at the moment of death is so scary to us; we will spend or do anything to put it off for one
more day, even for a single hour. Our children are taught to fear death. A nation which is
uncomfortable talking about sex with its children will find it impossible to talk about the
far scarier topic of death. I told my friend Nana, talking about death is morbid. I don't
want to think about being separated from my wife and children and friends. He responded
by challenging me and refusing to agree that a discussion about death is morbid or sad.
What is really morbid is not talking about death until death approaches. Two questions
have to occur: What did you do? What did you leave behind? For him, death is so
important that a lack of preparation or discussion is really sad. Not preparing for death
makes those final days scary to him.
Fear of death leads to many costs that drive up medical care. It leads to a lack
of planning. Most people have no plan in place laying out their wishes about what they
do and do not want done medically. A program in Wisconsin, in which patients talked
to their doctors about how they want to deal with death, decreased medical costs by 35%
(according to the Archives of Internal Medicine). These are the so-called "death panels"
of Sarah Palin. Fear of death prevents discussions within families about what to do as
the end approaches.
The way we feel about death will have a direct effect on how we live. In St. John's
Gospel, Jesus says "...I came to bring you life and life to its fullest". For Christians, what
constitutes a full life? Love your neighbor as yourself. Turn the other cheek and forgive
an infinite number of times. We need to take care of the least of our brothers and sisters
and if we do we will develop a relationship with God so close we can refer to God as "Abba"
(daddy, pop, mom, momma or whatever is the most intimate term you used for a parent).
Christians are also promised that death is not the final answer. We go on! Living life fully
means death isn't scary. Death is the transition between one plane of existence and another.
My friend Nana says the purpose of life is preparing for that nano-second of
transition. Life is impermanent. At that moment we need to be at peace, comfortable
with ourselves and the life we have led. It takes a lifetime to be ready to die.
In some cases, the healthcare industry exploits or amplifies society's fear of
death. Medicine and technology do nothing for you at the final nano-second. They don't
ease the fear or the anxiety. As a result, we spend a fortune trying to push the moment
back even for only an hour or a day. As long as we continue to deny the inevitability of
death, we will demand everything be done to stop it's approach.
The President cannot start a national discussion about life and death. However,
churches, temples, and mosques can. Families can help each other and parents can give
their children a great gift if they begin a discussion about life and death. At that nano-second,
whatever you believe, be it theistic or a-theistic...a personal God or a personal process,
it should help you be at peace and able to let go.
The President wants to reform healthcare and bring down it's costs. Until we
admit, confront, and discuss our deaths, fear will keep costs high and we will hang on for
dear life. What do you think? I welcome your comments and rebuttals. Please send them