Rediscovering Death

One of the most striking situations I have faced as an oncologist pertains to a man who had just been diagnosed with terminal cancer. His disease had spread all over his body, and especially on the liver. The only way to treat him was with chemo, but we were unable to do so on account of liver failure. In short, this man didn’t have much time to live and there was nothing we could do about it.

After I explained to him the situation, he just glanced and me, his face overcome by sorrow, and he said:

“Oh, doc… I just got my retirement last month. I have been working hard all my life, sacrificing myself to get a comfortable retirement… I thought this was when I was gonna start living for real. And now this.”

In two weeks he was gone. He never got to enjoy the retirement he strived so much for.


This real story encapsulates an important life lesson. I must take solace in the thought that his tragic death was not in vain if we get a chance to learn something from it. For you see, this man embodies a very important mistake in our modern days: he lived as if he was not going to die.

In the last five centuries, Man has undergone an unprecedented evolution in the fields of science and technology. This evolution has, in fact, been exponential in growth, so that last century’s advancements dwarf the ones from the four centuries before… and the developments just from last year are too many to list appropriately.

We are now able to talk in real time with a person from the antipodes. We were able to put a man on the Moon. And the developments in the fields of medicine conquered many of the diseases that shortened Mankind’s lifespan.

But there is one thing we haven’t conquered still (and, because of the unforgivable laws of entropy, we may never conquer): Death.

Sooner or later, irrespective of all of our evolution, death will come to us all.

In this sense, death can only be viewed by Modern-day Man as a failure. The frontier he hasn’t conquered and knows not how to. Unconsciously, Modern-day Man “forgets” about death, and concentrates on his impressive achievements, making them permeate all aspects of his life. In short, he lives as if he were not going to die.

There are many symptoms of this. For example, we don’t bring our children to funerals, with the excuse of not “traumatizing” them. In fact, many adults feel “traumatized” with the simple thought as well, and will not enter a place where someone is almost dying. We also rush to buy new pets for our children whenever the previous one dies, so as to make them forget about the deceased one as soon as possible. We watch deaths every day in movies and television, just to see the protagonists “unexpectedly” being brought back to life after the final credits or in the next episode (and even if their deaths are permanent on screen, they are alive as real actors, so it’s all fun and games.)


But the most glaring examples come from the field of medicine (since it was medicine that was able to extend life expectancy so much.)

We “medicalized” death… most people don’t die at home anymore but in the hospital. Even when a person is moribund, their relatives just usher him to the doctor, as if he could be sustained a little while longer. The signs of death are not recognizable anymore since it is treated just like any other disease: “rush him to the hospital.”

This is not entirely people’s fault. They no longer have contact with death, so they don’t know how to recognize it. Much of the fault lies with the medical personnel too. Doctors have also been influenced by the modern mindset according to which death is a failure. A failure on their part. As doctors, they have tools at their disposal making them able to produce results which could only be regarded as miraculous by people in the distant past.

This leads to dysthanasia (not to be confused with euthanasia), also known as therapeutic obstination. Even though it seems to stand opposite to euthanasia, it is important to note that dysthanasia is considered by the vast majority of medical bioethical organizations and most religions (including Christians) as a grave bioethical error.

What is dysthanasia? Unduly extending life beyond its limits, instead of accepting the hard fact that that particular person’s time has come. This error usually comes at the expense of a significant break in the person’s quality of life. It is wrong, since it pushes off the boundaries of human activity into God territory: we can’t avert death indefinitely and it’s wrong to increase suffering by not accepting our finiteness on this issue.

Unfortunately, many pro-life activists, in their righteous fight against the evil of euthanasia, have unwillingly embraced this error. Clinging to mediatic cases, they advocate for invasive treatments and diagnostic measures to moribund patients with irreversible conditions, confusing a sober acceptance of one’s own death as letting someone die who might otherwise live (i.e. passive euthanasia.) I truly believe that a proper activism mandates that pro-life people are sufficiently familiar with bioethics to actually fight against the thing they claim to be fighting. Only by knowing one’s enemy will one be effective, instead of railing against windmills, squandering credibility in the process.

If pro-life activists do not learn to avoid the pitfall of dysthanasia, they will multiply the number of cases of inappropriate suffering, that will certainly be used as arguments by the pro-euthanasia folks.


However, I also believe that the most notorious symptom of this modern discomfort with death comes, paradoxically, from the pro-euthanasia field. How can this be, if they are asking for death to come more swiftly?

It is true that many people who request the right to end their own lives really want to avoid suffering, not death. However, as I noted in my previous article, this doesn’t seem to explain everything. My experience is that all my patients who consistently asked for euthanasia (and not just temporarily venting during an acute symptomatic peak that subsided after adequate medication) did not suffer major discomfort from their disease until the day they died. I remind you, this experience of mine is anecdotal, but I can’t simply eschew my observations as if I didn’t testify to them and shouldn’t learn from them…

If those patients were not suffering from pain or other symptoms, why were they so bent in asking for euthanasia? Well, they were suffering indeed, but not in a biological way. Rather in an existential way. These were usually well-educated people, who excelled in their field of work or in their hobbies. In short, extremely active folks. Suddenly, the rug had been swept beneath their feet. They were told they had weeks or months to live. All their plans immediately turned to dust.

Those who lived their lives as if they would never die abruptly found themselves in a situation where death haunted the rest of their suddenly short lives. They who never prepared for death, for they never thought about it, saw death forcing its way through and permeating everything they did. Most importantly, they who always thought their lives were in their own hands, in the power of their own merits and knowledge and achievements, saw their lives suddenly under the rule of a new master: the Grim Reaper.

In a desperate way to regain control of their own lives, they ask for euthanasia. If death has to come, it must come out of my own choice. When I ask for it. On my own terms. This is a tragic illusion… they are not gaining control, for they still cannot avoid death, they cannot add one single minute to their own lives besides what death has stipulated. What they are doing is claiming an undue mastery over their own lives, opening a Pandora box in the process: the societal notion that it is acceptable (and even merciful) to end the lives of our sick people, as if they were not worth living. The illusion may be comforting, but its ramifications throughout the whole fabric of society are very real indeed.


People who lived before our day had a more healthy relationship with death. Being more in synch with nature, they saw death as an intrinsic stage of one’s own life, just like birth or marriage. They testified from tender age how the animals in the fields died, sometimes soon after birth.

Without cures available to most ailments, most of medicine was palliative in scope. It was as important to heal as it was to comfort. In fact, many early hospitals, created out of the charity of religious orders, focused precisely on that: comforting the sick and the moribund. In light of this, a person with a terminal illness who got to die comfortably, surrounded by his loved ones, at peace with his own story, was a success rather than a failure.

Most importantly, religions tempered Man’s hubris by constantly confronting him with his finiteness. Memento mori, quia pulvis est et in pulverem reverteris (“Remember that thou are dust and to dust thou shalt return”) was a part of the liturgy, namely on Ash Wednesday before Lent. Chapels were built in Italy, Portugal and the Czech Republic, using the bones of deceased people, so as to remind those who entered such sanctuaries of their own mortality. And many paintings featured the Danse Macabre, where any living person would become a skeleton and dance to Death’s song, irrespectively of sex, age, wealth or social status (death was the great equalizer, reducing both king, priest and peasant to the same condition.)

Ultimately, death was made present by the fact that Christian religion taught us that we ultimately live for a life beyond death. Every reality from this world is ephemeral and will soon come to pass. The wealth we earned will not follow us to the coffin, old age will eventually wrinkle all our efforts to perpetuate our beauty, fame and honor will soon give way to oblivion. All of this is vanity, so says Kohelet. But the most important things, on the other hand, are eternal, and can only be experienced in full after the soul has come through the ordeal of death.


Modern-day Man may counter by saying that such an emphasis on death is too morbid and not as healthy as I make it out to be. Besides, too great a focus on the afterlife may hinder the solving of actual problems in *this* life. There are some merits to these counter-arguments, but still, we can’t say that it is also healthy to live our lives in a complete alienation of one of our most inescapable and intrinsic realities: that we will die someday.

So maybe a balance between those two extremes may be found.

On my end, I think that humility would solve a lot of problems. Yes, Man has come a long way and found a lot of solutions to many problems. Man’s technology has evolved in impressive ways. Man has developed medicines to many ailments… and he continues to do so as we speak.

However, we should not see this with pride and boastfulness, but with gratitude and awe. We should be impressed by the strides made by a species such as ours, so ill-adapted to its natural surroundings (a man is probably less prone to survive in a jungle than a lion), inhabiting a small planet in an inconspicuous corner in the vastness of the universe. Still, those strides should not make us lose sight of our true dimension in the grand scheme of things.

In that grand scheme of things, Man will eventually die. It is a natural part of his life cycle. In the same way, as we should view our remarkable evolution, we should contemplate our lives with gratitude and awe. Every single day is a gift. And this is only highlighted by the fact that our lives are finite. We will not last forever. We can’t eternally forestall what needs to be done. There is a sense of urgency that makes living all the more important.

This day may be our last. So we need to live it to the fullest. Not squander it in vain, shallow and ephemeral activities, but actually use it wisely, like a good administrator of finite resources.

In this sense, death conveys meaning to life. If we forget about the existence of death, we may risk losing track of what’s truly important. We may risk existing instead of living every day.

Modern-day Man thinks he is omnipotent. And yet, death triumphs over Man every single day. It is something that Modern-day Man can never manipulate, something that goes forever beyond his reach, beyond his scope, beyond his power. In this sense, death also serves an important purpose: to temper Man’s pride, lest he forgets about his own limits.

Don’t get me wrong. Death is a harsh, cruel and horrible reality. I do not mean to sugarcoat it, by all means. But we need to live our lives through the lens of the inexorable reality of death. We can’t escape it. We can’t ward it off forever. This is the reality. It is not a failure, it is part of life. We need to accept it and better incorporate it into our life philosophy. Not by making it haunt us, but by making us re-center our priorities.

As my Palliative Care teacher always said: “We die the same way we live. So don’t wait for death to come to start to learn how to die. It is too late by then.”

Pedro Gabriel,
Blogger @

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