Senator Kennedy's Gift of Time: Dying on His Own Terms

When I heard that Senator Kennedy had died, one of my first thoughts was that he had been able to die on his terms. He announced in May 2008 that he had a malignant brain tumor. When he died on August 26th this year, he had lived over a year with his cancer diagnosis.

Ironically, Senator Kennedy outlived three brothers, four sisters and three nephews. His tribute to nephew John Kennedy Jr after his fatal plane crash was such a moving reflection on time and the years one is given to live.

His time, which was not doubled, but cut in half, will live forever in our memory...
But like his father, he had every gift but length of years.

A Gift of Time
He was given the time to say good by to family, friends and colleagues. He was given time to be honored for a lifetime of public service, receiving the Presidential Medal of Freedom, the nation's highest civilian honor. He was given the time to even plan and orchestrate his memorial and funeral services. President Obama also spoke of this gift of time in his eulogy for Senator Kennedy:

He was given the gift of time that his brothers were not, and he used that gift to touch as many lives and right as many wrongs as the years would allow.

The Final Year
In her interview with Maria Shriver spoke about her uncle's final year as a beautiful blessing. He lived to experience the love and the gratitude of his family and his colleagues, something that his brothers had not done.

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The Gift of Time given to Senator Kennedy allowed him to experience death on his own terms, to say good bye, to receive love from others and to have a say in how his final days would be spent.

This is the type of desired outcome that most practitioners of end-of-life care wish for their patients, the chance to experience the Gift of Time.

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Update September 11, 2009
CNN.com reported today that Senator Kennedy began planning his funeral in 2007, long before his brain tumor. According to the article, Senator Kennedy had informed fellow members of the Massachusetts congressional delegation in 2007 that he had been working on his memorial plans and reflecting on his legacy, most notably that of Health Care.

In addition, as I'd suspected, an unnamed source in the article told CNN that the senator had focused on specific arrangements of his funeral and memorial service in the months leading up to his death.

Source: CNN.com. September 11, 2009. Kennedy began planning funeral before brain tumor

Being with a Dying Person - A Sacred Event

For me when I was a medical student, a resident physician or a physician in practice and now as a bereavement professor, one of the most sacred experiences was that of being with a person during their final stages or life. Being able to walk with someone through the dying process is one of the most challenging and sacred of experiences.

This is the reason that I've selected the topic of Being with a Dying Person as the another topic for Sacred Life Sundays.

Sharing the End of Life
Sharing the wonder and the terror of being on the edge of being is bearing a witness to a person's final journey. Walking with a loved one or a patient on this sacred final path is a very extraordinary and intimate experience, as we learn the importance of just being.

Former New York Times book review editor and essayist, Anatole Broyard offered some wise first-hand insights about being with a person at the end of life in his essay "Doctor Talk to Me." In this article he encourages people, doctors in particular, to open their hearts to the dying patient with a reminder that...

Not every patient can be saved, but his illness may be eased by the way the doctor responds to him...
In learning to talk to his patients, the doctor may talk himself back into loving his work.
He has little to lose and much to gain by letting the sick man into his heart.
If he does, they can share, as few others can, the wonder, terror and exaltation of being on the edge of being.

Being a Healing Presence
Often the most difficult role of a physician or a family member is knowing when to "let go" with someone at the end of life and just "to be." We may feel as though we have little to offer the dying patient, yet these wise words from Anatole Broyard, a dying patient, can help us to realize that illness may be eased by the way the doctor (or the family) responds to the patient.

There is a healing power in human presence in simply being.

Just Be

Be yourself and relate person to person.
Be ready to listen again and again.
Be respectful.
Be aware of feelings and non-verbal cues.
Be present.
Be comfortable with silence.
Be human.
Be genuine.
Most of all--Be there.

© Kirsti A. Dyer, MD, MS

Sharing the Silence
Dr. Rachel Naomi Remen offers the following description of being and sharing true intimacy.

We experience intimacy not by sharing words,
but by sharing the silence.

In the end of life what matters, what makes the difference, is taking the time to slow down, to hold a hand, to give support, to just be and to share the silence.

Sacred Life Sunday
This post is one of the Celebrating Sacred Life Sundays Post, a weekly celebration of what is sacred and special in our life. See the first post on Sacred Life Sunday to read more.

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Sources:
Dyer, K. Healers and Healing. July 1998. At: http://dying.about.com/od/poetry/a/healers.htm
Ostaseski F. How to be with a Dying Person. On Our Own Terms. 2000, Educational Broadcasting Corporation/Public Affairs Television, Inc. At: http://www.pbs.org/wnet/onourownterms/articles/withperson-tools.html
Being a Supportive Friend to A Grieving Person, North Central Florida Hospice, Inc. 1996. http://www.journeyofhearts.org/jofh/kirstimd/friend.htm
Rabow MW, McPhee SJ. Beyond breaking bad news: how to help patient who suffer. WJM 1999:171:260-263. At: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1305864
Broyard A. Doctor Talk to Me. New York Times. August, 26 1990.

Image Source:
Julio Cid. Being Hands. Used with Permission