Must read: The sooner we start talking about death, the better.


Last Wednesday was “Education Day” for my Leadership Southern Indiana class. What we saw and learned on that day have since been the source of much introspection, and now to book-end the experience is this relatively short piece from yesterday’s NYT.

When I was in school, there was very little sex education and no death education. Ultimately we learned by doing, which arguably has more gratifying prospects for sex than death (there are seemingly limitless “do-overs” for the former), and yet this is small consolation when a loved one is approaching the final curtain, and the only tools in our arsenal for reacting to their needs as well as our own are fashioned from memories of heroic hack medical dramas on television.

For those inclined to religious belief, I’ll concede that it has a place in the conversation. I’d merely offer that knowing how things work is different from the way they’re used.

I’ve written too much already, so please read this essay and think about these matters. We already know the outcome, which makes the process is even more important.

First, Sex Ed. Then Death Ed. by Jessica Nutik Zitter (New York Times)

FIVE years ago, I taught sex education to my daughter Tessa’s class. Last week, I taught death education to my daughter Sasha’s class. In both cases, I didn’t really want to delegate the task. I wanted my daughters and the other children in the class to know about all of the tricky situations that might await them. I didn’t want anyone mincing words or using euphemisms. Also, there was no one else to do it. And in the case of death ed, no curriculum to do it with …

 … I am a doctor who practices both critical and palliative care medicine at a hospital in Oakland, Calif. I love to use my high-tech tools to save lives in the intensive-care unit. But I am also witness to the profound suffering those very same tools can inflict on patients who are approaching the end of life. Too many of our patients die in overmedicalized conditions, where treatments and technologies are used by default, even when they are unlikely to help. Many patients have I.C.U. stays in the days before death that often involve breathing machines, feeding tubes and liquid calories running through those tubes into the stomach. The use of arm restraints to prevent accidental dislodgment of the various tubes and catheters is common.