Living with a terminal diagnosis can be a very difficult process. It can deeply affect one’s relationship with the past, future and present and is perhaps the most disruptive news you can receive. The question of how to live in this context is a complicated one that needs to be handed delicately and will be different for each person.
Living with a terminal diagnosis
When Dr. Karen J. Warren received her terminal diagnosis, she can remember being flooded with questions. ‘Looking back, I see that my process for dealing with my MSA diagnosis involved answering seven questions. These questions may be helpful to anyone diagnosed with a terminal illness and their loved ones as they move forward from the diagnosis.’
These questions ranged from the immediate like ‘Whom should I tell about my illness?’ to the longer term ‘What do I need to prepare for life moving forward?’ to the existential ‘What really matters?’ For Dr Warren, all of these questions were an important part of her process, and she has written her answers to all seven of them to help others in a similar position here. She impresses that with a terminal diagnosis it is even more important to deal with the deeper questions, that in normal life we can overlook. She describes her first phone conversation with her case manager as so:
‘She encouraged me to make choices about what I want to do with the rest of my life and to figure out how to give life meaning as a dying person. That stumped me. As a retired Philosophy Professor, surely I was capable of knowing what gives my life meaning. But, in fact, I didn’t really know. So, I began by asking myself what I really cared about and wanted to do.’
How to live with dying
For Dianna Jones, living with her diagnosis of advanced bowel cancer with a prognosis of two years made her able to appreciate some things, and actually cultivated a gratefulness. ‘I’m not grateful that I’m going to die, soon, but I’m grateful I know. That’s what I’m grateful for, that I have the knowledge and therefore I’ve got time to prepare.’
For many who receive a terminal diagnosis, this new time pressure on their lives can bring about a real focus on what they want to achieve, a fresh realisation of just how precious time is. For Dianna this was also true and she soon knew what she wanted to invest her time in.
‘Since the diagnosis â€¦ my focus has been on what I’m going to do in that time, like replan my garden which I’ve started. And what I can do to help the others, when I’m gone. Which is get my affairs in order and that keeps me going, it gives me a positive focus and a goal. I feel much more organised now than I did when I was drifting along before.’
Living with dying
There is of course natural sadness and emotional distress in the process of living with dying too. For many this is to do with the relationships that they know they will have to leave behind, for Dianna this was her granddaughter. ‘I am sad that I won’t see my granddaughter grow, if I dwell on it and I only dwell on it when I’m with her. When I’m not with her, I try not to think about it.’
In ‘A Practical Guide to The Spiritual Care of the Dying Person’ a document written by many hospital chaplains, they acknowledged that having peace with our relationships is an important part of the process. ‘Dying is a complex process because it entails the whole of us, especially our relationships, not just our bodies.’
For Dr Warren, seeing to her broken relationships with friends was part of what she wanted to focus on after receiving her diagnosis. ‘I have time to prepare for dyingâ€”for example, by giving away things I don’t need, doing things I love but may have neglected, and renewing relationships with old friends. Healing unresolved conflicts in relationships and ensuring that I am comfortable with my relationships before I die.’
It is frequently remarked that no one’s deathbed regrets are not spending more time working, and that it is always the unsaid relational matters that come to the fore at the end of our lives. Fr Nelson Medina OP, compiled a list of the deathbed regrets he had heard and they were all to do with interpersonal matters. From ‘for the promises I didn’t fulfil’ to ‘for the times I took too long to forgive others and didn’t make a big enough effort to do it faster’ – it shows that we seem to have a lot left to repair when death draws near.
Ultimately, although an immensely difficult time, preparing for death can give focus to whatever time we have left, and can drive us to both rediscover what is meaningful to us and to make peace with those we know.
‘Into your hands I commend my soul:
I offer it to you with all the love of my heart,
for I love you, Lord, and so need to give myself,
to surrender myself into your hands without reserve,
and with boundless confidence,
for you are my Father.’
Blessed Charles de Foucauld