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Breaking the taboo around death and dying

Kate Granger is a registrar in elderly medicine at Pinderfields Hospital and terminally ill.

Rather than wallow in self-pity, like many of us would, she continues to work and has recently finished the second of her medical text books detailing her experiences of treatment.

Kate is suffering from desmoplastic small-round-cell-tumour, and decided at the start of the year to stop having chemotherapy.

She hopes her books, called The Other Side and The Bright Side, will help colleagues better understand their patients. All proceeds are going to the Yorkshire Cancer Centre in Leeds. She’s currently raised over £20,000 and sold over 3,000 copies.

Here’s an excerpt from The Bright Side, which is available to buy here:

Why as a cancer patient are you seen as ‘heroic’ and a ‘fighter’ if you accept all the burdensome, in the most part futile treatment for incurable cancer? Does this mean that if you refuse these interventions that you are somehow foolish or weak? I have been thinking about this a great deal recently.

There is a tendency for media surrounding cancer to use highly emotive language. For example the Cancer Research charity slogan is ‘together we will beat cancer’. No we won’t and I very much doubt DtM is ever going to be out of work. It is a result of being a living organism that cell division and repair will sometimes go awry and the result of this will be cancer. We may become increasingly capable of counteracting the pathology, but I cannot imagine there will ever be a human society without cancer.

I do not mean to say that people who choose to go through lots of treatment are doing anything wrong if this is truly what they want to do, but I think all too often patients feel under external pressures to battle on when deep down inside they just want to enjoy their remaining time without so many medical interventions.

Death and dying are such taboo subjects in our society and I have never fully understood why, after all it is the one thing that we all have in common, we are all going to die one day. There are campaigns and organisations out there such as ‘Dying Matters’ and the National Council for Palliative Care tackling these issues but it is going to take such a monumental effort to change societal attitudes. Acceptance is a hugely difficult thing.

I think we could all do to open up discussion with our loved ones about death. I see it all too often when I sit down with families when their relatives are gravely ill that no-one has ever discussed topics such as resuscitation when they were well. I am extremely, perhaps abnormally open about these issues and am completely comfortable talking about them.

I realise many people would not be as at ease discussing such things but if just a little of my attitude was adopted I am sure that many of the communication nightmares towards the end-of-life would be dissipated. Being in the situation I am in, I am astonished that more patients with life limiting illnesses do not make their wishes known. Perhaps it is to do with denial. Choosing to talk about resuscitation with a patient on their death bed when they have been battling cancer for months or years is far from the right time in my eyes and these conversations need to happen much earlier in illness.

Decisions can always be reviewed, but we all need to be more open and more realistic. I am not saying everyone needs to get down to the solicitors and start making Advance Directives but if we all just asked ourselves ‘what would I want if I was dying?’ and talked about our answers to that question with our loved ones then I am sure more people would have better deaths.

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2 Responses to “Breaking the taboo around death and dying”

  1. Tom Goodfellow says:

    “Death and dying are such taboo subjects in our society and I have never fully understood why, after all it is the one thing that we all have in common, we are all going to die one day.”

    I know that it is unfashionable to quote the bible these days but in fact the Psalmist hit the nail on the head.

    If you are not religious then just edit out the God bits of the following and meditate on the poetry and the wisdom.

    “You turn people back to dust,
        saying, “Return to dust, you mortals.” 
    A thousand years in your sight
        are like a day that has just gone by,
        or like a watch in the night. 
    Yet you sweep people away in the sleep of death—
        they are like the new grass of the morning:
    In the morning it springs up new,
        but by evening it is dry and withered.

    Our days may come to seventy years, 
        or eighty, if our strength endures;
    yet the best of them are but trouble and sorrow, 
        for they quickly pass, and we fly away. 

    Teach us to number our days, 
        that we may gain a heart of wisdom.”

    Psalm 90, NIV

    Kate is saying the same as the Psalmist. We all need to gain a little more wisdom on this crucial issue.

  2. Noreen Boland says:

    How fantastically refreshing to hear someone intelligently discuss the taboo subject of “heroism” and Warriors” when on a cancer journey. For myself and my family after losing our 26 year old daughter in the space of 4 weeks to Sarcoma. We find it extremely upsetting this idea that warriors beat cancer as opposed to…
    Unfortunately Gemma our daughter ,ourselves and the hospitals involved had no idea of the serious nature of Gem’s illness.
    Good luck on your journey.
    Noreen Boland

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