Opinion Today: What does it mean to be ‘ready’ to die?

This is how one physician thinks about her patients’ acceptance of death. [View in browser](~/AAAAAQA~/RgRmCqLRP4QoAWh0dHBzOi8vbWVzc2FnaW5nLWN1c3RvbS1uZXdzbGV0dGVycy5ueXRpbWVzLmNvbS90ZW1wbGF0ZS9vYWt2Mj9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDQwMSZpbnN0YW5jZV9pZD04OTAyNyZubD1vcGluaW9uLXRvZGF5JnByb2R1Y3RDb2RlPVRZJnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjkzMzQmdGU9MSZ1cmk9bnl0JTNBJTJGJTJGbmV3c2xldHRlciUyRjRlMGQzNWJmLWZkZjMtNTcxNC1iNWJkLTJjNTM4ZjEzYzI5ZSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmQh0R0oZNWuXc9SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~)|[nytimes.com](~/AAAAAQA~/RgRmCqLRP0SwaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwNDAxJmluc3RhbmNlX2lkPTg5MDI3Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTEyOTMzNCZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZCHRHShk1a5dz1IbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA)[Continue reading the main story](#a11y-skip-ad-marquee) [Marquee Ad](~/AAAAAQA~/RgRmCqLRP0SYaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9MTYyMTM5JmxpPVRZJm09YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDcmcD1UWV8yMDIzMDQwMSZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyMzA0MDFXA255dEIKZCHRHShk1a5dz1IbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA) [Read more from Opinion](~/AAAAAQA~/RgRmCqLRP0S_aHR0cHM6Ly93d3cubnl0aW1lcy5jb20vc2VjdGlvbi9vcGluaW9uP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwNDAxJmluc3RhbmNlX2lkPTg5MDI3Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTEyOTMzNCZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZCHRHShk1a5dz1IbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA) April 1, 2023 Death is never neat. A good death should be defined by how well and honestly we care for the dying, not by their performance on our behalf. Joshua Bright By Sunita Puri It’s been almost a decade since I finished my medical residency and became a “real doctor.” After training ended, I faced one final hurdle: passing a grueling eight-hour-long internal medicine board exam. Back then, it seemed as though there was nothing more important than knowing the right answers. What I didn’t know was that when practicing palliative care, it’s really about asking the right questions. As a resident, I would have never let myself consider only the most obvious diagnosis for a patient’s illness. But when it came to my patients’ personal lives, I too easily assumed the simplest narratives: Amid a health crisis, previously divided families would surely rally around their loved one. A person dying at the age of 90 must have lived a long and fulfilling life. Agreeing to hospice care meant that a patient had accepted that they were dying. Back then, I didn’t question what “accepting” death really meant, or whether it was something I could expect from my patients. I struggled to ask about their suffering unless they seemed ready to embrace their fate, fearful that I might inadvertently worsen it. But as I [write in my guest essay this week,](~/AAAAAQA~/RgRmCqLRP0TbaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMy8yOS9vcGluaW9uL2hvdy10by1hY2NlcHQtZGVhdGguaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDQwMSZpbnN0YW5jZV9pZD04OTAyNyZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjkzMzQmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmQh0R0oZNWuXc9SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~) I’ve learned that awaiting specific imaginings of acceptance only justified avoiding having necessary conversations with patients and loved ones about what they fear and need as death nears. Several days ago, I sat in the corner of a hospital room with the daughter of a patient suffering from incurable cancer. She was a nurse, and told me that she was worried that her mother hadn’t come to terms with the end of her life. I know the stages of grief, she said, and I think she is in denial, but maybe you could help her understand she needs to accept what is coming. Ten years ago, I would have nodded, confident that I might help her mother, earnest in my naïveté. I still feel the initial rush of my inclination toward rescue. I knew the answer she wanted, but instead I asked a question. “I’m happy to speak with your mother and understand how she is making sense of what she is going through. But is this conversation also a way to help you to find peace?” She considered my question. Then she met my gaze, her eyes brimming with emotion, whispering, only, “Yes.” READ SUNITA’S FULL ESSAY HERE [GUEST ESSAY As a Doctor, I Know Being Ready to Die Is an Illusion It is easier to search for readiness than to process what its absence means. By Sunita Puri](~/AAAAAQA~/RgRmCqLRP0TbaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMy8yOS9vcGluaW9uL2hvdy10by1hY2NlcHQtZGVhdGguaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDQwMSZpbnN0YW5jZV9pZD04OTAyNyZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjkzMzQmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmQh0R0oZNWuXc9SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~) [Article Image](~/AAAAAQA~/RgRmCqLRP0TbaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMy8yOS9vcGluaW9uL2hvdy10by1hY2NlcHQtZGVhdGguaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDQwMSZpbnN0YW5jZV9pZD04OTAyNyZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjkzMzQmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmQh0R0oZNWuXc9SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~) [Continue reading the main story](#a11y-skip-universal-0) ADVERTISEMENT [Ad](~/AAAAAQA~/RgRmCqLRP0SXaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjMwNDAxJnRlPTEmbmw9b3Bpbmlvbi10b2RheSZlbWM9ZWRpdF90eV8yMDIzMDQwMVcDbnl0QgpkIdEdKGTVrl3PUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~) THE WEEK IN BIG IDEAS [Article Image](~/AAAAAQA~/RgRmCqLRP0TzaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMy8yOC9vcGluaW9uL2FsZXhhbmRlci1za2Fyc2dhcmQtcGFydGhhLWRhc2d1cHRhLWVjb25vbXkuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDQwMSZpbnN0YW5jZV9pZD04OTAyNyZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjkzMzQmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmQh0R0oZNWuXc9SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~) [Alexander Skarsgard Explains the Answer to Everything. 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