One response to “Do those confronting a terminal illness have insights that will help those who are not?”

1. Aaron Preston

   September 6, 2022 at 8:03 am

   Rather than looking to cancer memoirs (each of which is, I presume, essentially an "n=1" study), one might find more useful advice from end-of-life care specialists, who work with the dying in larger numbers. I've found Ira Byock's work (especially _Dying Well_ and _The Four Things That Matter Most_) to be useful in this regard. The lessons distilled from his work with countless Hospice patients — that we must learn to give and receive love, gratitude, and forgiveness, and to prioritize the maintenance and repair of important relationships — are as relevant to "ordinary life" as they are to life in the light of a terminal diagnosis. While they can be learned in other ways, Byock's stories suggest that many either haven't learned this, or aren't willing to act upon what they know, until confronted with their own impending death. It may be that some people have already learned these lessons and have nothing more to learn from death — Byock tells of one such patient — but, on Byock's account, that is not the norm.

   Byock's insights are consistent with the one thing Summers says he learned in the light of his cancer diagnosis: that his priority was "to help his son grow up," and that he can now "never forget that all those other priorities are, at best, second tier." But then Summers complains that this lesson is not transferable to ordinary life, where one cannot simply ignore less-important priorities to focus solely on the most important ones. That's a fair point, but Summers seems to be thinking an "all or nothing" terms here. One thing he might have learned is that, so long as he lives and is able (e.g., not prevented by ongoing cancer treatment), he can afford to increase the proportion of instances in which he sacrifices less important priorities to his most important one.

   He might also have realized that many of the things he *thought* were more important than playing catch with his son on a given afternoon really are not. Perhaps Summers had his priorities straight all along. But on Byock's account many who receive a terminal diagnosis don't — they can say that, should they survive, they would live differently in light of their confrontation with death. (And this "wisdom of the dying" is something that, in principle, the rest of us can benefit from.)

   Summers also says that his new insight into his highest priority would be applicable only in the form of long-term patterns of behavior: "Yet no one catch, or date night, or Thanksgiving, or coffee with a friend is anything special. Over time, the patterns are."

   I take this to be false. One-off events can indeed be deeply meaningful, even outside of terminal contexts. In terminal contexts, one-offs often have a kind of "denouement effect" that carries deep meaning for those involved. This is especially clear in cases of longstanding estrangement between family members who finally reconcile only when one is confronted with a terminal diagnosis.

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