Disease   Death   &   Dying     
  I am not there - I do not sleep  
    Introduction

Welcome, Bienvenue, Willkommen, Namaste ...

Disease, death, ... and the dying that takes place in between: hardly the most uplifting of topics. But, sooner or later these are issues that everyone will have to face.

There are many websites that self-assuredly advocate solutions – cures for diseases, solace for the dying – solutions that guarantee all will be well if only you “do this” or, more frequently, “buy that”. This is not one of those websites. My aim, here, is a much less ambitious one: simply, to put forward some ideas and suggestions that you might not have considered, and which you might wish to investigate further. I hope that for some of you these suggestions will help, at least a little.

This site will focus on the concerns that come to mind when you, or someone close to you, is faced with a serious illness, an illness where the prospects of recovery are uncertain. The questions you’ll be asking in these circumstances rarely have satisfactory answers. But asking them and getting what answers may be available is, in and of itself, part of the process of moving forward:

    Finding a Cure

The first thought that comes to mind when serious illness strikes is how to go about finding a cure. We’ll have a look at some of the questions you may be asking, such as how to evaluate the treatments on offer from big-pharma and alternative medicine, how to determine if your doctor or health-care practitioner is competent, how to understand the jargon that peppers the medical research literature. These are the sorts of questions that you’ll need to answer if you are to navigate your way through the obstacle course of misinformation on medical treatments, an obstacle course that has been carefully constructed for you by those organizations with vested interests in your well-being – or, all too often, in its privation.

    Dealing with Pain

And then there are the twin afflictions of physical pain and mental pain – the Scylla and Charybdis of ill health.

You may belong to that significant percentage of the population for whom conventional painkillers do not work very well. We’ll have a look at the “analgesic ladder”, the hierarchy of conventional pain killers, and at some alternatives, both high-tech and low-tech.

And when physical pain is not pressing, there is usually mental pain to contend with. If you’re like most people, then life will not have turned out exactly as you might have wished: there will be the regrets that arise from hapless choices, from unheralded misfortunes, from dreams unfulfilled. We’ll have a look at some of the techniques you can employ to ease the pain: such as intense distraction to busy the mind with other matters; virtually living that idealised, long-wished-for life; and softening the blow for those who will remain behind (Mary Elizabeth Frye):

*Do not stand at my grave and weep,
I am not there - I do not sleep.
I am a thousand winds that blow,
I am the diamond glints on snow,
I am the sun on ripened grain,
I am the gentle autumn rain.
Do not stand at my grave and cry,
I am not there - I did not die.

    Finalizing Affairs

And then there’s the practical matter of finalizing affairs. For some people, “dotting the i’s and crossing the t’s” is important. For others, it’s a question of the legacies that they will leave behind.

    Withdrawal and Dissolution

And what if recovery from illness is not possible? There comes a time when the relatively steady state of unremitting illness ends and the process of dying begins, a form of involutional decay: the mind beings to withdraw from the outside world, while bizarre, and often disturbing, mental states may manifest themselves; the body’s organs begin to shrink, skin discoloration may occur as blood pools inside the body, and a loss of muscle tone may lead to incontinence. We’ll discuss what you, as a friend or family member, can do to help a dying person in these circumstances.

    The Art of Dying Well

And how does the process of withdrawal and dissolution seem from your perspective, when you’re the one who’s “doing the dying”? Can you exercise some control over the process of dying? In particular, what is the art of dying well?

We’ll have a look at the different mental states that you might experience during the process of dying.

We’ll help you assess whether you’re likely to have a good or a bad death – whether your experiences of dying are likely to tend towards the terrifying or the blissful. While these experiences will vary very much from one individual to another (and will be influenced by the nature of your terminal disease), what you are likely to experience will depend to some considerable extent on how you view death, and on what you believe happens after death. As Prince Hamlet would have us contemplate, “What dreams may come, when we have shuffled off this mortal coil?” Well, that is a question for you alone to answer, not that you will have much say in the matter – for we don’t choose our beliefs; our beliefs choose us:

*Perhaps you belong to that ever dwindling minority who see in death something that is, at worst, benign and, at best, propitious? If your beliefs surrounding death are heartening and have proved to be faithful friends over the years, then all you have to do is to hold onto them steadfastly (in the memorable words of Polonius, “Those friends thou hast, and their adoption tried, grapple them unto thy soul with hoops of steel.”).

*But if your perspective on death is bleak, if life’s harvest has proved barren, if the Grim Reaper is indeed seen to be “grim”, then you might have to work very hard to glean even a measure of equanimity.

However, irrespective of your viewpoint there are a number of practical steps that you can take to improve your experience of dying:

*We’ll have a look at how you can have a “sneak preview” at some of the states of mind that may manifest themselves when dying, a “dry run” as it were, so that you’ll have some idea of what to expect.

*More importantly, we’ll have a look at the skills you can develop and the techniques you can deploy to exercise a modest measure of control over the process of dying. Dying may well be a somewhat chaotic affair, but, like a flash flood, your mind when dying prefers to flow through well-worn channels, to take the paths of least resistance. We’ll look at how to fashion these channels so that you can choreograph, in part, the ballet of dream appearances and phantasms that may arise to mind.

The process of withdrawal and dissolution may well seem very disturbing – a far cry from the customary, though deceptive, portrayal on film, in which following a few sage and insightful words the dying person slips away serenely into that final sleep. You may have sat by the beds of those who have been dying, and what you have seen may well have filled you with dread. However, what others may see and what you may experience can be very different. In the process of dying there can be surprises (irrespective of your religious beliefs, or lack of them). Towards the end, even as the darkness continues to gather from without, a light may begin to grow from within; and your experience of dying in those final hours and days may depend on where you choose to rest your gaze:

*For the few, there is a rare and special joy born out of sorrow, a joy that shines with the light of a thousand suns.

    Dealing with Grief

And if you’re one of those who have been left behind, you will have the painful task of dealing with the grief that arises from the death of a friend or family member. We’ll have a look at the:

*Mental and physical manifestations of grief;

*Damage it causes to your health;

*Mechanisms that the mind employs to reduce the stress of grieving;

*Complications that can arise when grief is protracted;

*Psychological interventions you can use to ease the seemingly interminable torment of grief;

*Physiological remedies that can help to ameliorate its life-threatening health impacts;

*Types of grieving behaviour expected of you by society;

*Personality traits that affect your vulnerability to grief.