Conversations about death may be frightening, because death touches each of us at very unique personal and emotional layers of experience. Such conversations may also be deep and transformative.
Betsy MacGregor, MD, is especially sensitive to the complexities of how we think and talk about death. She worked in a busy city hospital for three decades, caring for seriously ill patients. In particular, she has focused on how her own profession relates to end-of-life issues.
“Until people in the healthcare professions really begin to look at their relationship to death and to dying, they don’t bring themselves to caring for people fully who are facing that life situation,” she told me.
MacGregor uses awe to help heal the healers who struggle to embrace their own emotional and spiritual needs. In turn, she hopes to improve the quality of care for dying patients. She urges her colleagues in organized medicine to open themselves to all of their human dimensions:
If we have closed off that part of our experience—maybe because we have had a difficult experience with a family member dying, or felt grief at the death of a patient, and have not really done the work of being with that experience, and allowing it to deepen in us and heal—then we have a closed door in us to caring for people who are approaching the end of their life.
MacGregor encourages healthcare practitioners, and all caregivers, to share their experiences and personal stories with others. When we share our stories, she says, we can cultivate a practice of deep listening that allows us to honor one another and those we care for and about.
I believe something happens when health practitioners tell these stories. Talking about feelings is not something that people in our profession do easily. In fact, in our training, we’re very often given the message that feelings don’t count. We have to get feelings out of the way. They interfere with professional objectivity and our ability to make decisions clearly . . . As a result, I think we keep a lot in ourselves that never integrates into our life experience, and it stays in a protected place.
Moving beyond such a protected place is not simple for any of us as we contemplate our own death or that of our loved ones. Nor is it easy to really ask ourselves questions about death and dying. The profound fear of death can limit our capacity to address these questions directly. For MacGregor, herself a breast cancer survivor, noetic insights can help us move beyond fear.
I really think it’s in our human nature to live with death. Death is not the opposite of life. It is part of life. If we’re not acknowledging its reality, its presence with us at any moment, we’re really selling ourselves short. We’re closing ourselves off to a whole aspect of life. If we decide to begin to explore into that reality, I think there’s something in us that will help us, because we have an inner knowing of who we are.
Thinking about death and dying helps us begin to ask the question, really, who am I as a human being? How did I come to be here? Why am I here? What is this life that I have for? How do I want to use it? These questions all come along with the question of what is death? What is dying? And I think those are such fruitful questions . . . [P]eople may experience fear in the beginning, but I think there’s something in us that wants to ask them and is impoverished if we’re not asking them.
While acknowledging the myriad challenges facing modern healthcare, MacGregor is optimistic. She sees a fundamental transformation in American culture regarding death and dying. She recalled the era twenty or thirty years ago when our relationship to birthing began to shift. At that time there was a move from labor and delivery being pathologized as a medical crisis to seeing them as a normal, joyful part of life. In the same way, death is becoming more normalized. MacGregor says:
We’re beginning to say in our culture more and more, “I want to die at home. I don’t want to die in a hospital. I don’t want my life prolonged further than I want it to be. I want the right to have a say in how I die.” The right to die in the way people choose is something that’s becoming acknowledged now in hospital settings, and it’s beginning to change the way patient rights are seen in healthcare practice.
Bringing death back into our homes, witnessing it, sharing it, learning how to grieve with family and community—these are steps McGregor feels will change the stigma around death:
The less we fear death, the less we will have other problems in our culture. I think that the materialistic greed in our culture is fed to a great degree [caused] by our fear of death, our denial of death, our effort to keep death from getting hold of us, and our . . . tendency to battle with each other. I think the more we see ourselves as having the same human experience of coming into life, living a life that has a purpose, and finishing our life . . . maybe that will chip away from that sense of separating ourselves from each other and identifying each other as enemies. I think it’s all related, really.