Book provides guide to terminal illness

Review by WAYNE HOLST
Special to the WCR

A monk was being chased by a panther when he found himself on the edge of an embankment. His eyes rapidly scanned the bank. He saw a rope which he believed would serve as his escape route. He quickly began his descent, but looking down he saw a second panther waiting below. He looked up again, this time to see a mouse gnawing on the rope. He stopped. In front of him and within arm's reach he saw a ripe strawberry. He picked and carefully placed it in his mouth. "What a most delicious piece of fruit," he said.

- Zen Buddhist lesson

Kuhl, a Soros Faculty Scholar for the Project on Death, specializes in helping people better understand the experience of dying and bereavement. He is committed to influencing change in the way our culture treats death.

The author, a Vancouver-based physician, believes that - dreaded as it is - the realization of impending demise can actually transform the experience of dying into a special time.

What Dying People Want offers a guide for people who have a terminal illness, who know someone who has a terminal illness, or who wish to enhance their understanding of the dying process. It is based on the stories of people who knew they were dying. It recognizes that these are not just stories, but someone's life in the truest sense. The stories of dying people can become healing medicine to strengthen and enhance our lives.

Chapters range from the significance of the present, human vulnerability, being a wounded healer, healing touch, and reviewing life; to speaking the truth, longing to belong, self-realization, and embracing life and its transcendent meaning.

Dying is a process that fully engages one's whole being and integrates body, mind and spirit.

"If you've got something you would like to say to someone, it is important enough to say right now." - Dr. David Kuhl

The author views his patients as co-researchers. He considers them authorities since only those with a terminal illness know what it is like to live with such awareness. They hold the knowledge of the lived experience.

Talking about death is difficult.

As a young practitioner, Kuhl realized that he was good at asking questions of the patient, but not so adept at getting the real message the speaker was trying to have him understand. He had to set aside professional bias and avoid trying to explain, predict or control. He undertook a program in communication studies that changed his understanding of what an effective doctor/patient relationship might be.

He began to "be with" that other person and to hear what was really being said. "I had to stop being a detective," he writes. He now seeks to engage in an "I-Thou" relationship and to enter the experience of his patient.

"I had to respect that . . . whatever those people were saying was their truth, their reality, their experience of living . . . (because) they were indeed living with dying. . . . I wanted to understand the complexities of the physical, psychological, and spiritual components of knowing what it is to live with a terminal illness."

As the doctor took the time and really listened to his patients he began to learn some very important lessons. For example:

• Time is now. You discover how many things you have taken for granted."
• Communication is of the essence. The way a doctor reveals bad news to an anxious patient can render ineffective all the good that medicine seeks to accomplish and can even increase the suffering.
• Speaking the truth. Truth, no matter how difficult, but spoken by those we love can change one's life. It can break down long-standing barriers between family members.

His most important learning:

Procrastination in talking about the end of life is not in anyone's best interest. "It is never too early to connect with the people we care about. . . . If you've got something you would like to say to someone, it is important enough to say right now."

Dying is a time of transition, of moving from one place to another.

It is at this juncture, suspended between ordinary time and eternity, that this book is such a wonderful contribution to human knowledge and understanding.

(Wayne Holst is a writer who has taught religion and culture at the University of Calgary.)

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