What matters in the end

Michael Jensen observes the reality of mortality

sitting waiting
“Well, don’t worry: we are all in the queue”

I met up with David, who has terminal cancer, through a friend. He was pale, but not yet in an advanced state of illness.

As we sat drinking tea he said to me, "Well, don't worry: we are all in the line."

Dying seems to make people wise.

I was struck at that moment that, although I am dying no less than he is, he has more information about when it will be and what it will be like.

We have a more uneasy relationship with our mortality compared to other cultures and even our recent history.

Recently I have been reading a truly excellent book by Harvard professor and surgeon Atul Gawande called Being Mortal: Illness, Medicine, and What Matters in the End.

Our medical technology, Gawande notes, has given us a much greater life expectancy, and also an optimism that medical intervention will work— if not to cure disease outright, then at least to prolong life.

But the lack of an open discussion, according to Gawande, has meant there is little clarity on the purpose of intervening to keep someone alive.

At the end of life doctors wrestle with the tricky question of whether their remedies will cause more harm and pain than they will prevent.

In Gawande's account, more often than not, false hope is offered by doctors who (and who can blame them?) do not want to deliver the worst possible news to a patient.

He writes, "...again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power [to push against our genetic and cell limits] is finite, and always will be."

To remedy this grand mistake, Gawande offers the fascinating observation that we have a "remembering self" and an "experiencing self," which matter equally to us.

The human brain does not simply calculate an average of pain and pleasure over time, he argues. Instead, we tend to remember when pain was at its worst, and then the pain we last experienced.

It doesn't matter how long pain lasted for: it is the end experience that counts.

Gawande likens this to a game of sport in which your team leads until just before the final whistle, when it suddenly loses, and your overall experience turns negative instantly.

"For human beings, life is meaningful because it is a story," he explains "...and its [whole] arc is determined by the significant moments, the ones where something happens..."

When we approach death, he says, "We do not want to endure long pain and short pleasure. Yet certain pleasures can make enduring suffering worthwhile. The peaks are important, and so is the ending."

Patients often accept very risky medical procedures even though the surgery or chemotherapy administered takes away whatever moments of pleasure and happiness they have left to them.

Gawande argues very powerfully that as a culture we need to help each other to practice the art of dying well.

This may not mean "pain free", though pain alleviation will be part of it. But in particular, it means dying, as much as we can, meaningfully – and giving each other the opportunity to do so.

Gawande is right about our storied existence. But for the Christian, life is not framed by death.

Death is not the end of the story but a phase we are passing through. The end of the story matters, but death is not the end.

It is interesting how often the Bible treats suffering this way.

In Romans 8:18, Paul writes, "I consider that our present sufferings are not worth comparing with the glory that will be revealed in us."

Suffering, for the Christian, is actually a sign of hope, because it produces the endurance that will bear fruit beyond the moment of pain.

As Paul says in 2 Corinthians 4:17: "For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all."

This is telling Christians that even suffering that we perceive as meaningless and pointless is woven by God into His plan to work for the good those who love Him.

As for death itself: in 1 Thessalonians 4 Paul urges Christians who are suffering and have lost loved ones "not to grieve as those who have no hope."

For Christians, it is a different kind of grief - one that acknowledges the profound awfulness of dying and death, and which sheds many tears.

The Bible says that those who have died in the Lord have just "fallen asleep."

When Christ comes, with the sound of the trumpet, He will bring with Him all of those who have fallen asleep in Him. Death is not denied in the Bible. It is confronted, and defeated.

What does this mean for us all, since we are "all in the line"?

Without becoming morbid, I think we need to realize that most of us will die slowly and consider what life priorities we would endure suffering for. It is also likely that we will stand with someone we love as they go through this process.

I think we need to realize with Gawande that technological and scientific knowledge is not the same as wisdom to know what matters.

The Bible's wisdom instructs us to prepare for the end of life by seeking to make peace with God most of all, as well as with our families, friends, and those we have wronged.

God says that relationships matter more than anything else, so however much time we have on earth, it is for these most of all.?

Courtesy EternityNews.com.au.

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